Jalali M, Rahmani S, Joyce A D, Cartledge J J, Lewis M H, Ahmad N
Leeds Teaching Hospitals NHS Trust, UK.
Ann R Coll Surg Engl. 2012 Sep;94(6):407-10. doi: 10.1308/003588412X13171221592177.
Laparoscopic donor nephrectomy (LDN) is now a well established method for kidney procurement from living donors. In our centre, LDN is currently offered only to donors suitable for left nephrectomy. The aim of this study was to investigate the incidence of testicular pain and swelling following LDN.
A total of 25 left-sided LDN male patients were assessed in a prospective structured interview together with a control cohort of 25 male patients who had undergone left-sided open donor nephrectomy (ODN).
Data were collected on testicular pain, swelling, numbness, urinary symptoms and sexual dysfunction from all 50 patients (100% response rate). Of the 25 LDN patients, 11 (44%) experienced ipsilateral testicular pain and/or swelling. In most instances, pain was of immediate onset, mild to moderate in severity, lasted for a few days to several weeks and was associated with testicular swelling (10 of 11 cases). However, testicular pain and/or swelling were not apparent in ODN patients, with only 2 of 25 (8%) experiencing mild testicular pain, 1 of whom also had swelling.
Testicular pain and swelling following LDN is a common problem. It is underreported in the literature and LDN should be included in the differential diagnoses of testicular pain and swelling. Further investigation is required to confirm our findings.
腹腔镜供体肾切除术（LDN）目前是一种成熟的从活体供体获取肾脏的方法。在我们中心，目前仅对适合左肾切除术的供体进行LDN。本研究的目的是调查LDN后睾丸疼痛和肿胀的发生率。
对25例接受左侧LDN的男性患者进行了前瞻性结构化访谈，并与25例接受左侧开放性供体肾切除术（ODN）的男性患者组成的对照队列进行了评估。
收集了所有50例患者（回复率100%）的睾丸疼痛、肿胀、麻木、泌尿系统症状和性功能障碍的数据。在25例LDN患者中，11例（44%）出现同侧睾丸疼痛和/或肿胀。在大多数情况下，疼痛为急性发作，程度为轻至中度，持续数天至数周，并伴有睾丸肿胀（11例中有10例）。然而，ODN患者未出现睾丸疼痛和/或肿胀，25例中只有2例（8%）出现轻度睾丸疼痛，其中1例也有肿胀。
LDN后睾丸疼痛和肿胀是一个常见问题。文献中对此报道不足，LDN应纳入睾丸疼痛和肿胀的鉴别诊断。需要进一步研究来证实我们的发现。
