title: Inhibition of adhesion and fibrosis improves the outcome of epididymectomy as a treatment for chronic epididymitis: a multicenter, randomized controlled, single-blind study.
abstract: OBJECTIVE
  We measured the effectiveness of inhibition of adhesion and fibrosis on patient outcomes after epididymectomy as a treatment for chronic epididymitis.
  
  
  METHODS
  An initial cohort of 152 patients was treated conservatively for chronic epididymitis. Of these patients 43 did not respond to conservative treatment and following informed consent they were enrolled in the clinical trial. The patients were randomized into 2 groups so that 22 underwent epididymectomy with concurrent administration of the inhibitors of adhesion and fibrosis hyaluronic acid and carboxymethylcellulose (group 1), and 21 underwent epididymectomy only (group 2). Visual analog pain scores and patient satisfaction scores were obtained at postoperative weeks 4, 12 and 24.
  
  
  RESULTS
  There were no postoperative complications such as wound infection or hematoma in either group. One patient was lost to followup from group 1 and 2 were lost from group 2. At postoperative week 24, 12 patients (57.1%) from group 1 and 3 (15.8%) from group 2 were pain-free, 6 (28.6%) from group 1 and 6 (31.6%) from group 2 exhibited limited pain relief, 2 (9.5%) from group 1 and 7 (36.8%) from group 2 exhibited no pain relief, and 1 (4.8%) from group 1 and 3 (15.8%) from group 2 exhibited recurrence of pain after initial resolution at earlier followup intervals (p = 0.028).
  
  
  CONCLUSIONS
  Inhibition of adhesion and fibrosis after epididymectomy as a treatment for chronic epididymitis improves pain relief and patient satisfaction.
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
authors.forename: Hong Sang
authors.initials: HS
authors.lastname: Moon
authors.forename: Hong Yong
authors.initials: HY
authors.lastname: Choi
authors.forename: Tae Yoong
authors.initials: TY
authors.lastname: Jeong
authors.forename: U-Syn
authors.initials: US
authors.lastname: Ha
authors.forename: Jun Hyun
authors.initials: JH
authors.lastname: Han
authors.forename: Jeong Man
authors.initials: JM
authors.lastname: Cho
authors.forename: Tae Hyo
authors.initials: TH
authors.lastname: Kim
authors.forename: Seung Wook
authors.initials: SW
authors.lastname: Lee
mesh_terms: D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004822:Epididymis / Q000601:surgery*; D004823:Epididymitis / Q000601:surgery*; D005355:Fibrosis / Q000517:prevention & control; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D000267:Tissue Adhesions / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium