Incidence and correlates of testicular pain after kidney donation
Nisarg Gandhi1, Dina N Murad1, Sean A Hebert1, Monica Morgan2, Duc T Nguyen3, Edward A Graviss3,4, Hassan N Ibrahim1.
1Department of Medicine, Houston Methodist, Houston, TX, United States; 2Department of Urology, Houston Methodist, Houston, TX, United States; 3Department of Pathology and Genomic Medicine, Institute for Academic Medicine, Houston Methodist, Houston, TX, United States; 4Department of Surgery, Houston Methodist, Houston, TX, United States
Introduction: Testicular pain after kidney donation is often understudied with previous literature reporting on less than 100 total cases. Herein, we describe the incidence of testicular pain after kidney donation in 2551 kidney donors and explore factors associated with its development.
Methods: We evaluated the presence of testicular pain in a retrospective cohort study of kidney donors who donated between 1963 to 2007 at three US transplant centers as part of The Renal and Lung Living Donor Evaluation Study. Univariate, bivariate and multivariate generalized linear model (GLM) were used to determine factors associated with having testicular pain.
Results: Of the 2551 male donors, 54 (2.12%) developed testicular pain 19 days (IQR 7, 40) after donation: 34 had testicular pain only, 6 had epididymitis, and 14 had both. Donors developing pain were 4 years older and pain occurred more often in those undergoing laparoscopic nephrectomy; 3.6% vs. 1.1% for open nephrectomy. Post-donation testicular pain was more likely to be experienced by non-Hispanic White donors; RR 5.56 (95% CI 1.35, 22.84), p=0.02 and those undergoing laparoscopic nephrectomy; RR 3.11 (95% CI 1.71, 5.65), p<0.001. Neither laterality of the kidney removed nor the number of renal arteries in the donated kidney were associated with an increased risk of pain; RR 1.35 (95% CI 0.67, 2.72), p=0.40 and RR 1.73 (95% CI 0.94, 3.18), p=0.08, respectively (Figure 1, Figure 2).
Conclusions: The incidence of testicular pain was 2.12%; similar to previous retrospective studies. Factors associated with its development include non-Hispanic White ethnicity and undergoing a laparoscopic nephrectomy. Contrary to previous reports, the laterality of the donated kidney was not associated with an increased risk of testicular pain. We believe that donors should be routinely asked about this potentially bothersome complication.
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