Leslie Thomas A, Illing Rowland O, Cranston David W, Guillebaud John
The Elliot-Smith Clinic, The Churchill Hospital, Oxford, UK.
BJU Int. 2007 Dec;100(6):1330-3. doi: 10.1111/j.1464-410X.2007.07128.x. Epub 2007 Sep 10.
To assess the extent of scrotal pain in men before and after vasectomy, to produce accurate data for the benefit of men considering this procedure, and hence improved informed consent about the outcomes, as chronic scrotal pain after vasectomy is a poorly quantified clinical problem.
Between November 2004 and January 2006 nine surgeons carried out vasectomies in 625 men (mean age 39.9 years, sd 5.6) under local anaesthesia. A questionnaire was devised to establish the presence of any scrotal or testicular pain, and to characterize this discomfort; 6 months after the procedure a modified version of the same questionnaire was administered.
In all, 593 (94.7%) men returned the preoperative questionnaires and were entered into the study; 488 (82.2%) of these completed the follow-up questionnaire, giving a mean (sd) follow-up of 6.8 (1.6) months. In all, 65 men reported new-onset scrotal pain at 7 months (14.7%). The mean visual analogue score for this pain was 3.4/10. Four men (0.9%) in the responding group described pain after vasectomy as 'quite severe and noticeably affecting their quality of life'.
At 7 months after vasectomy about 15% of previously asymptomatic men have some degree of scrotal discomfort. These early data indicate that chronic scrotal pain after vasectomy is a genuine entity, but a longer-term follow-up in this group will be important to allow further evaluation of how this pain develops with time.
评估男性输精管结扎术前和术后阴囊疼痛的程度,为考虑接受该手术的男性提供准确数据,从而改善对手术结果的知情同意情况,因为输精管结扎术后慢性阴囊疼痛是一个量化不足的临床问题。
2004年11月至2006年1月期间,9名外科医生为625名男性(平均年龄39.9岁,标准差5.6)实施了局部麻醉下的输精管结扎术。设计了一份问卷,以确定是否存在任何阴囊或睾丸疼痛,并对这种不适进行描述;术后6个月,使用同一问卷的修改版进行调查。
共有593名(94.7%)男性返回了术前问卷并纳入研究;其中488名(82.2%)完成了随访问卷,平均(标准差)随访时间为6.8(1.6)个月。共有65名男性在7个月时报告出现了新的阴囊疼痛(14.7%)。这种疼痛的平均视觉模拟评分为3.4/10。在回复组中,有4名男性(0.9%)将输精管结扎术后的疼痛描述为“相当严重,明显影响了他们的生活质量”。
输精管结扎术后7个月,约15%之前无症状的男性出现了一定程度的阴囊不适。这些早期数据表明,输精管结扎术后慢性阴囊疼痛是一个真实存在的问题,但对该组患者进行长期随访对于进一步评估这种疼痛如何随时间发展非常重要。