Abstract

Introduction: Post-varicocelectomy pain is a considerable pain with probability of promotion toward chronicity. Some reasons, including surgical technique or nerve injury and inappropriate attention to treatment of acute pain play role in the emergence of acute pain. The pain could lead to limitation in movement and working, patient dissatisfaction and waste of medical resources. Transcutaneous electrical nerve stimulation (TENS) therapy as the patient control analgesia (PCA) is associated with reduction of pain intensity and analgesic consumptions. This study aimed to evaluate the effect of TENS therapy on reducing the acute and chronic pain following varicocelectomy. Methods and Materials: The study was conducted after obtaining the approval of the local Institute Ethics Committee and written informed consent from all of the patients. Eighty patients scheduled for undergoing varicocelectomy, were randomly classified according to a randomization list prepared using online software at a 1:1 ratio to Groups A (intervention group) and B (placebo group). In postoperative and recovery period, Group A received TENS therapy for 30 minutes in parallel to surgical scar with high frequency by sensory level. Group B was treated with off-device. The treatment course was replicated for the two groups at 2, 6, 12 and 24 hours after operation. Then, postoperative pain was measured by VAS (visual analogue scale) at the same time and after 1 week and 1, 2 and 3 months. The amount of used analgesics was recorded. Results: The results showed that based on the VAS, pain significantly decreased after intervention in 2 hours (25% with VAS = 5 versus 32.5% with VAS = 8 in control group). The differences among, amount of used analgesics at 2, 6 and 12 hours were significant with p-value = 0.001, Conclusion: TENS therapy could efficiently decrease pain degree for hours, weeks and months after varicocelectomy; this was associated with decreased post-operation analgesic requirements.

Highlights

  • Post-varicocelectomy pain is a considerable pain with probability of promotion toward chronicity

  • The study was conducted after obtaining the approval of the local Institute Ethics Committee and written informed consent from all of the patients

  • Postoperative pain was measured by Visual Analogue Scale (VAS) at the same time and after 1 week and 1, 2 and 3 months

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Summary

Introduction

Post-varicocelectomy pain is a considerable pain with probability of promotion toward chronicity. Some reasons, including surgical technique or nerve injury and inappropriate attention to treatment of acute pain play role in the emergence of acute pain. The pain could lead to limitation in movement and working, patient dissatisfaction and waste of medical resources. This study aimed to evaluate the effect of TENS therapy on reducing the acute and chronic pain following varicocelectomy. Pain related to varicocelectomy can become chronic due to surgery technique damaging neuronal fibers. It has some reasons such as outpatient surgery and inadequate pain treatment. It can entail limited movement, problems in working, patient dissatisfaction and unnecessary consumption of treatment resources and long stay in the hospital. The prevalence of varicocele in normal population is 15% to 20% and in infertile men is 68% to 81% with 2% to

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