Efficacy of Epididymectomy in Treatment of Chronic Epididymal Pain: A Comparison of Patients With and Without a History of Vasectomy

Abstract

OBJECTIVES To evaluate the surgical outcome in, and satisfaction with treatment of, patients undergoing epididymectomy for postvasectomy pain syndrome. METHODS A total of 49 patients were included. All participants had undergone epididymectomy for chronic epididymal pain from January 2000 to June 2009. Of the 49 patients, 4 had undergone bilateral epididymectomy, and the total number of procedures was 53: 18 in patients with postvasectomy pain syndrome (group 1, n = 16), 21 in patients with chronic epididymitis and no history of vasectomy (group 2, n = 19), and 14 in patients with an epididymal cyst and no history of vasectomy (group 3, n = 14). The preoperative and postoperative pain scale scores and surgical outcome were analyzed. RESULTS For the total patient sample, the mean age was 52.91 +/- 13.51 years, and the mean body mass index was 24.10 +/- 3.22 kg/m(2). The mean duration of pain was 1.3 years (range 0.25-20), and the mean duration of postoperative follow-up was 4.2 years (range 0.05-10.25). The mean preoperative pain score was 6.91 +/- 0.97. The mean postoperative pain scale score was 1.92 +/- 1.54 (P < .01). Statistically significant differences in the preoperative and postoperative pain scores were found for each group: group 1, 5.38 +/- 1.47 (range 3-8); group 2, 4.10 +/- 1.41 (range 2-6), and group 3, 5.21 +/- 1.88 (range 2-8; P = .004). In group 1, excellent surgical outcomes and high patient satisfaction were reported for 94.5% (17 of 18) of the procedures performed. CONCLUSIONS The results of our study have shown that epididymectomy is more effective in patients with a history of vasectomy than in those without. UROLOGY 77: 177-182, 2011. (C) 2011 Elsevier Inc.