ABSTRACT
OBJECTIVE: To assess the extent of scrotal pain in men before and after vasectomy, to produce accurate data for the benefit of men considering this procedure, and hence improved informed consent about the outcomes, as chronic scrotal pain after vasectomy is a poorly quantified clinical problem. PATIENTS AND METHODS: Between November 2004 and January 2006 nine surgeons carried out vasectomies in 625 men (mean age 39.9 years, sd 5.6) under local anaesthesia. A questionnaire was devised to establish the presence of any scrotal or testicular pain, and to characterize this discomfort; 6 months after the procedure a modified version of the same questionnaire was administered. RESULTS: In all, 593 (94.7%) men returned the preoperative questionnaires and were entered into the study; 488 (82.2%) of these completed the follow-up questionnaire, giving a mean (sd) follow-up of 6.8 (1.6) months. In all, 65 men reported new-onset scrotal pain at 7 months (14.7%). The mean visual analogue score for this pain was 3.4/10. Four men (0.9%) in the responding group described pain after vasectomy as 'quite severe and noticeably affecting their quality of life'. CONCLUSION: At 7 months after vasectomy about 15% of previously asymptomatic men have some degree of scrotal discomfort. These early data indicate that chronic scrotal pain after vasectomy is a genuine entity, but a longer-term follow-up in this group will be important to allow further evaluation of how this pain develops with time.
Subject(s)
Pain, Postoperative/etiology , Scrotum , Vasectomy/adverse effects , Adult , Chronic Disease , Epidemiologic Methods , Humans , Male , Medical Audit , Pain Measurement , Pain, Postoperative/epidemiology , Quality of Life , Severity of Illness Index , Surveys and Questionnaires , United Kingdom/epidemiologyABSTRACT
High-intensity focused ultrasound (HIFU) continues to be a very attractive option for minimally invasive procedures. Using well-established principles, this ablative therapy can be used to treat a number of benign and malignant diseases with few side effects. During the last 15 years, there has been an enormous amount of work, both laboratory based and in the form of clinical trials, aimed at developing devices that can deliver treatments with safe and effective outcomes. In this article, we aim to outline the principles of HIFU, describe the current commercially available machines and their applications, and discuss the role of HIFU in the future.
