慢性睾丸疼痛与心理健康诊断之间的关系。
Relationship between chronic testicular pain and mental health diagnoses.
作者信息
Mwamukonda Kuwong B, Kelley Jeremy C, Cho Doug S, Smitherman Anna
机构信息
Urology Clinic, Brooke Army Medical Center, San Antonio, TX, USA.
出版信息
Transl Androl Urol. 2019 Mar;8(Suppl 1):S38-S44. doi: 10.21037/tau.2019.02.05.
BACKGROUND
Chronic testicular pain (orchialgia) has been defined as intermittent or constant unilateral or bilateral testicular pain that lasts 3 months or longer, significantly interfering with daily activities, and prompting the patient to seek medical attention. In many instances, the etiology of the pain is not identified. The contribution of psychological factors is unclear. The purpose of this study was to identify the categories of mental health (MH) diagnoses that are most frequently associated with orchialgia and determine if a correlation exists between MH diagnoses and orchialgia.
METHODS
A retrospective review was performed to identify all adult patients within the San Antonio Military Health System with a new diagnosis of orchialgia from January 2005 to April 2015. Patients with acute pathology or recent inguinal/scrotal surgery were excluded. A comparative cohort of all men presenting with hydroceles within the same timeframe was obtained. The presence of coexisting MH diagnoses in both cohorts was then determined.
RESULTS
Four hundred and forty-four men met the inclusion criteria for orchialgia, with 133 men presenting with hydroceles. The incidence of orchialgia increased significantly over the study period (P=0.001). MH diagnoses in the study population did trend upward over the years, but not significantly (P=0.063). MH diagnoses were not significantly higher in the cases compared to the controls (21.6% 18.8%, P=0.479). The prevalence of anxiety was twice as high in the cases (9% 4.5%), though not significantly (P=0.075). The prevalence of all MH diagnoses was significantly higher than in the general US population based on National Institute of Mental Health statistics.
CONCLUSIONS
The incidence of orchialgia rose significantly over time, but it was not significantly associated with MH diagnoses. These results may also be skewed by the overall higher percentage of MH diagnoses in the study population than in the general population.
背景
慢性睾丸疼痛（睾丸痛）被定义为间歇性或持续性的单侧或双侧睾丸疼痛，持续3个月或更长时间，严重干扰日常活动，并促使患者寻求医疗关注。在许多情况下，疼痛的病因尚不明确。心理因素的作用尚不清楚。本研究的目的是确定与睾丸痛最常相关的心理健康（MH）诊断类别，并确定MH诊断与睾丸痛之间是否存在相关性。
方法
进行回顾性研究，以确定2005年1月至2015年4月在圣安东尼奥军事医疗系统中所有新诊断为睾丸痛的成年患者。排除患有急性病变或近期腹股沟/阴囊手术的患者。获得了同一时间段内所有患有鞘膜积液的男性的对照队列。然后确定两个队列中并存的MH诊断情况。
结果
444名男性符合睾丸痛的纳入标准，133名男性患有鞘膜积液。在研究期间，睾丸痛的发病率显著增加（P = 0.001）。多年来研究人群中的MH诊断确实呈上升趋势，但不显著（P = 0.063）。与对照组相比，病例组中的MH诊断并无显著更高（21.6%对18.8%，P = 0.479）。病例组中焦虑症的患病率是对照组的两倍（9%对4.5%），但差异不显著（P = 0.075）。根据美国国立精神卫生研究所的统计数据，所有MH诊断的患病率均显著高于美国普通人群。
结论
随着时间的推移，睾丸痛的发病率显著上升，但与MH诊断并无显著关联。这些结果也可能因研究人群中MH诊断的总体百分比高于普通人群而产生偏差。
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