PURPOSE: We evaluated the effectiveness of microsurgical ligation for painful varicocele and predictive factors of pain resolution. MATERIALS AND METHODS: Between January 2006 and March 2009, a total of 114 patients (mean age, 30.2+/-8.9 years), who underwent microsurgical inguinal varicocelectomy for painful varicocele, were included and followed up for 1 year after the surgery. The quantity of preoperative and postoperative pain was assessed by means of 11-point numeric rating scale (NRS). We retrospectively analyzed the outcome of surgical ligation and predictive factors of pain resolution using patient age, height, weight, body mass index, grade and location of varicocele, duration, quantity and quality (dull, dragging, aching) of pain, and postoperative pain resolution. RESULTS: In 104 patients (91.2%), complete or marked resolution of pain was reported at follow-up 1 year after surgery. Only 10 patients (8.8%) had recurrent or persistent pain (> or =3 points in NRS scores). On multivariate analysis, low quantity (< or =6 points in NRS scores) and dull or dragging natured preoperative pain were independent factors associated with surgical success rates (p=0.004; odds ratio=1.62, p=0.012; odds ratio=1.76, respectively). CONCLUSION: Microsurgical ligation is an effective treatment of painful varicocele. The quantity and quality of preoperative pain are independent predictive factors of pain resolution after surgery.
Adult ; Follow-Up Studies ; Humans ; Ligation/methods ; Male ; Microsurgery/*methods ; Pain Measurement ; Pain, Postoperative/diagnosis/*prevention & control ; Pelvic Pain/diagnosis/*surgery ; Predictive Value of Tests ; Retrospective Studies ; Varicocele/*surgery ; Young Adult

No abstract available.
Colectomy/methods ; Colonic Neoplasms/*diagnosis ; Colonoscopy ; Endometriosis/complications/*diagnosis/pathology/surgery/ultrasonography ; *Endosonography ; Female ; Humans ; Laparoscopy ; Middle Aged ; Muscle Neoplasms/*diagnosis ; Pelvic Pain/etiology ; Predictive Value of Tests ; Sigmoid Diseases/complications/*diagnosis/pathology/surgery/ultrasonography

Cervical stenosis is a challenging condition that often recurs despite intervention. Multiple therapeutic options have been described, but a clearly effective and reliable treatment method has yet to be identified. Patients with recurrent stenosis are at risk of developing severe complications such as chronic pelvic pain and infertility. We describe a case of congenital cervical stenosis with secondary haematometra in which repeated cervical dilatation, hysteroscopic canalisation and administration of medications to retard endometrial development were unsuccessful in relieving the obstruction and preventing re-accumulation of menstrual blood. Total hysterectomy was eventually mandated by spontaneous rupture of the haematometra.
Adult ; Constriction, Pathologic ; complications ; diagnosis ; Endometrium ; pathology ; Female ; Hematometra ; complications ; diagnostic imaging ; surgery ; Humans ; Infertility ; Pelvic Pain ; Recurrence ; Risk ; Rupture, Spontaneous ; complications ; Tomography, X-Ray Computed ; Uterine Cervical Diseases ; complications ; diagnosis ; Uterine Diseases ; complications ; diagnosis ; Uterine Hemorrhage ; complications ; diagnosis ; Uterine Rupture ; diagnostic imaging ; etiology ; surgery

OBJECTIVETo investigate the influence of hip and pelvic fracture, especially acetabular fracture complicated by sciatic nerve injury on clinical features and prognosis of sciatic nerve injury.

METHODSFrom January 1987 to January 2000, 17 patients (14 male and 3 female) who had hip and pelvic fractures complicated by sciatic nerve injury were treated with operative reduction and internal fixation and followed up from 10 months to 5 years. The average age was 38 years (ranging 23-56 years). The left extremities were involved in 11 patients and the right in 6. Twelve patients underwent primary exploration and neurolysis and 5 patients underwent secondary operation.

RESULTSPreoperatively, 8 patients were treated with large doses of oral narcotics to control their severe sciatic pain. Three of the 8 patients underwent patient-controlled analgesia and epidural analgesia. After operation, excellent and good rates of reduction and functional recovery of sciatic nerve were 94.1% and 88% respectively. Four patients still had sciatic pain and 2 patients failed to recover. Sciatic nerve function improved within 3-6 months after surgery in 11 patients.

CONCLUSIONSHip and pelvic fractures can result in sciatic nerve injury, especially common peroneal nerve injury and prognosis is poor. Open reduction and internal fixation combined with nerve exploration and neurolysis should be used as early as possible for severe sciatic pain.

Adult ; Analgesics ; therapeutic use ; Cohort Studies ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; rehabilitation ; Hip Fractures ; complications ; diagnostic imaging ; surgery ; Humans ; Intraoperative Complications ; Joint Dislocations ; complications ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Multiple Trauma ; diagnostic imaging ; rehabilitation ; surgery ; Pain Measurement ; Pelvic Bones ; injuries ; surgery ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; complications ; diagnosis ; drug therapy ; Treatment Outcome