Tan Wei Phin, Levine Laurence A
Department of Urology, Rush University Medical Center, Chicago, Illinois, USA.
Asian J Androl. 2016 May-Jun;18(3):332-7. doi: 10.4103/1008-682X.175090.
Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options.
输精管切除术后疼痛综合征仍然是较具挑战性的泌尿外科管理问题之一。对于患者和临床医生而言，这可能是一个令人沮丧的过程，因为目前尚无公认的诊断方案或可靠有效的治疗方法。许多此类患者最终会辗转于多个学科就诊，这让他们更加沮丧。输精管切除术后疼痛综合征的病因尚不清楚。推测包括免疫系统的炎症作用对阴囊和精索神经结构的损伤、输精管和附睾梗阻产生的背压效应、血管淤滞、神经受压或神经周围纤维化。输精管切除术后疼痛综合征定义为阴囊内容物慢性或间歇性疼痛至少持续3个月。本文综述了目前对输精管切除术后疼痛综合征的认识、其病理生理学背后的理论、评估途径和治疗选择。
