Testicular Pain Following Laparoscopic Renal Surgery

Main Category: Urology / Nephrology
Article Date: 14 Jan 2009 - 4:00 PDT

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UroToday.com - Male patients undergoing laparoscopic renal surgery in which the gonadal vein is transected are at high risk for developing ipsilateral testicular pain post-operatively.

In this important prospective assessment, all patients undergoing laparoscopic renal surgery at Indiana University, including donor nephrectomy and radical nephrectomy, were evaluated with pre- and post- operative pain analog questionnaires. Twenty-one percent of 64 patients developed post-operative ipsilateral testicular pain. This ranged from 55% of the laparoscopic donor nephrectomy patients to 20% of the radical nephrectomy patients. In 29 patients in whom the gonadal vein was preserved, only one patient (3.4%) developed post-operative testicular pain. Of the 39 patients in this study who underwent gonadol vein ligation during their procedure, 33% experienced post-operative ipsilateral testicular pain - ranging from 1 to 8, with a mean pain intensity of 4 out of 10.

It was found that the testicular pain resolved without any intervention at a median of 34 days after surgery. It would seem prudent to attempt to preserve the gonadal vein whenever possible during laparoscopic renal surgery. However, all patients should be advised of this potential post-operative complication, and when it occurs reassured that it will usually resolve spontaneously.

Why this post-operative complication can occur remains unclear.

Gjertson CK, Sundaram CP
J Urol. 2008 Nov;180(5):2037-41.
doi:10.1016/j.juro.2008.07.045

Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE

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