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La prise en charge de la douleur testiculaire chronique due a un syndrome de charniere thoraco-lombaire : étude pilote
(Management of chronic testicular pain due to thoracolumbar junction syndrome: A pilot study)

Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie Date: 2020/03, 30(2):Pages: 114-118. doi: Subito , type of study: clinical trial

Full text    (https://www.sciencedirect.com/science/article/pii/S1166708719306499?via%3Dihub)

Keywords:

osteopathic manipulativ treatment [9]
chronic scrotal pain [1]
thocacolumbar dysfunction [1]
TLD [1]
chronic testicular pain [1]
male [479]

Abstract:

INTRODUCTION: Thoracolumbar dysfunction (TLD) had been evoked as a possible etiology of chronic testicular pain. Our study investigated the efficacy of osteopathic diagnosis and treatment of TLD in men with chronic testicular pain. METHODS: Patients suffering from testicular pain were examined for thoracolumbar dysfunction and enrolled in a prospective trial if they have both conditions. Following standardized examination, all patients were prescribed 1 to 3 osteopathic treatment sessions, usually at weekly interval. Treatment success was evaluated using the Visual Analog scale and durability was assessed by regular follow-up. Patient satisfaction was also assessed. Comparison of pain improvement was done using Wilcoxon matched-pairs signed-ranks test. Logistic regression was used to assess for risk factors of success. A P<0.001 was used for significance. RESULT: Out of 62 patients enrolled, 41 patients (median age 32 years, IQR 24-37) were suffering from chronic testicular pain and TLD. 37 of the 41 participants completed the treatment and follow-up according to the plan. Patients underwent a median of 2 osteopathic treatment sessions (range 1-3). Overall, pain disappeared completely in 25 patients (67.5%) and improvement was noted in 7 patients (18.9%). After initial improvement, two patients experienced relapse at their last visit (5.4%). Five patients (13.5%) had no improvement of their symptoms after osteopathic treatment. Statistically, improvement was significant with a P<0.001 and on logistic regression, site of pain and duration of pain were the sole predictors of failure. CONCLUSION: TLD is a pathology that should be considered in the differential diagnosis in patients with chronic testicular pain and osteopathic manipulation of the spine appears to be an effective treatment option.


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