non-invasive management of varicocele-related scrotal pain using transcutaneous neuromuscular electrical stimulation

<meta charset="utf8"></head><body>电刺激疗法：精索静脉曲张诱发疼痛的非手术疗法

Varicocele is a prevalent vascular abnormality affecting the male reproductive system, characterized by the enlargement, elongation, and tortuosity of the spermatic cord&#39;s venous plexus. It often leads to scrotal pain, discomfort, and progressive testicular hypogonadism, and is a major contributing factor to male infertility. Epidemiological studies have shown that varicocele affects approximately 10% to 15% of adult males. Among infertile men, the prevalence of varicocele can reach 40%, and scrotal pain occurs in 2% to 10% of cases1.
Varicose veins commonly occur on the left side of the spermatic cord, which can be attributed to two primary factors. Firstly, the left spermatic vein is anatomically longer than the right spermatic vein. Secondly, the right spermatic vein connects to the inferior vena cava, experiencing lower pressure, whereas the left spermatic vein joins the left renal vein at a right angle, resulting in higher pressure2. Increased venous pressure in the left renal vein, situated between the abdominal aorta and the superior mesenteric artery, leads to elevated pressure within the corresponding spermatic vein3.
The exact mechanism underlying scrotal pain in varicocele remains unclear. Potential contributing factors include elevated testicular temperature, oxidative stress, testicular hypoxic injury, endocrine dysregulation, and the influence of renal/adrenal metabolic toxins. These factors stimulate receptors, triggering the generation of action potentials that propagate through neural pathways within the spinal cord, ultimately transmitting electrical signals to the brain via the thalamic tracts located on the medial and posterior aspects of the spinal cord, resulting in pain perception4.
Clinical treatments for scrotal pain associated with varicocele encompass general measures, medication, and surgical interventions. General treatment involves lifestyle and dietary adjustments, which can provide some degree of symptom reduction. Pharmacological approaches often include the administration of hepatic saponins, such as Aescuven Forte, which exhibit anti-inflammatory and anti-exudative properties and help maintain the structural integrity of venous walls, particularly collagen fibers5. Treatment with hepatic saponins, such as Aescuven Forte, gradually restores the elasticity and contractile function of venous walls, thereby increasing venous blood reflux rate, reducing venous pressure, and alleviating symptoms like scrotal discomfort. Flavonoids and non-steroidal anti-inflammatory drugs are other commonly employed therapeutic agents that offer some efficacy in improving scrotal pain symptoms. Although physical cooling and scrotal rest have been utilized for varicocele-associated scrotal pain, their usage is limited due to decreased patient acceptance6.
Surgical interventions, such as open surgery, laparoscopic surgery, microscopic surgery, and interventional surgery, are commonly selected for patients with varicocele who experience more pronounced scrotal pain symptoms or infertility. Surgical treatment is currently regarded as the most effective approach, achieving up to an 80% success rate in relieving pain symptoms. However, it is important to acknowledge potential postoperative complications, including bleeding, wound infection, testicular sheath effusion, and testicular atrophy. Regardless of the surgical method chosen, the recurrence rate of varicocele ranges from 1.9% to 17.2%7.
Transcutaneous electrical nerve stimulation (TENS) is an extensively employed non-invasive physical therapy that applies electrical stimulation to the skin&#39;s surface, leading to pain relief and enhanced nerve function. By transmitting electrical currents through electrodes into nerve tissue, TENS influences nerve activity and finds widespread applications, including: (1) Pain relief: TENS effectively alleviates various types of pain, including muscle pain, neuralgia, and joint pain. The stimulation of nerve endings through TENS promotes the secretion of natural pain-relieving substances, such as endorphins, thereby reducing pain; (2) Rehabilitation training: TENS serves as a valuable tool in rehabilitation training, aiding in the restoration of impaired muscle and nerve function. For instance, after a sports injury, TENS can be used to alleviate pain and facilitate the recovery process; (3) Neuromodulation: TENS is also utilized for neuromodulation purposes, such as managing symptoms associated with urinary incontinence and constipation8.
The diverse therapeutic potential of transcutaneous electrical nerve stimulation (TENS) in pain management, rehabilitation, and neuromodulation highlights its efficacy and applicability. Through the stimulation of nerve endings, TENS promotes desirable neuromuscular responses, effectively ameliorating associated symptoms. Notably, TENS has demonstrated favorable efficacy in addressing male conditions such as erectile dysfunction and premature ejaculation. Patients readily embrace TENS due to its advantageous features of safety, reliability, and affordability. Furthermore, TENS treatment for venous vascular diseases yields beneficial outcomes, including pain relief, enhanced blood flow, and expedited wound healing9.
This study utilizes electrophysiological therapy-related technology to examine the effectiveness of transcutaneous neuromuscular electrical stimulation in alleviating scrotal pain associated with varicocele. The findings of this investigation have the potential to offer a valuable alternative treatment approach for individuals experiencing varicocele-related scrotal pain.

<meta charset="utf8"></head><body>作者聚焦：通过神经肌肉电刺激推进精索静脉曲张治疗

经皮神经肌肉电刺激治疗精索静脉曲张诱发的阴囊疼痛

使用经皮神经肌肉电刺激无创治疗精索静脉曲张相关阴囊疼痛

non-invasive-management-varicocele-related-scrotal-pain-using

Research

JoVE Journal

Medicine

Non-Invasive Management of Varicocele-Related Scrotal Pain Using Transcutaneous Neuromuscular Electrical Stimulation

237 次观看. 首先，指导患者在手术床上静坐或平躺 15 分钟。患者进入检查室后，要求患者按照系统语音指示进行动作。点击 冻结 保存图像。然后，将鼠标移动到患者动作画面中的睾丸上，观察体温异常区域。从受影响睾丸的温度中减去健康睾丸的温度，得到双侧阴囊温差。将电极垫涂抹在患者的腹部和双侧腹股沟区域。将电极垫上的电流强度和脉?...

视频: 使用经皮神经肌肉电刺激无创治疗精索静脉曲张相关阴囊疼痛

Transcutaneous Neuromuscular Electrical Stimulation for Treating Varicocele-Induced Scrotal Pain

Varicocele is a prevalent vascular disorder affecting the male reproductive system, leading to scrotal pain and testicular dysfunction. Epidemiological studies have shown that varicocele occurs in approximately 10% to 15% of adult males, while scrotal pain affects 2% to 10% of the population. Currently, clinical treatment options for varicocele-induced scrotal pain include general therapy, medication, and surgery. Among these, surgical intervention is considered the most effective method, boasting a success rate of 80%. However, it carries risks such as postoperative bleeding, infection, and recurrence, making it less desirable for some patients. In recent years, transcutaneous neuromuscular electrical stimulation has gained wide acceptance for treating various andrological conditions, including erectile dysfunction and premature ejaculation, yielding positive outcomes. This non-invasive technique offers a promising alternative for managing varicocele-induced scrotal pain, potentially reducing the need for surgical intervention and its associated risks. Its growing popularity underscores the need for further research and clinical trials to validate its efficacy and safety in treating this condition.

This protocol outlines the use of transcutaneous neuromuscular electrical stimulation for treating varicocele-induced scrotal pain. It compares visual analog scale (VAS) scores and imaging changes before and after treatment to assess effectiveness. Results indicate that patients experienced improved scrotal pain symptoms following the treatment.

Varicocele is a prevalent vascular disorder affecting the male reproductive system, leading to scrotal pain and testicular dysfunction. Epidemiological ...