Etiología del dolor testicular 2019: Clasificación en diez subgrupos lógicos

Palabras clave: Dolor, Dolor agudo, Dolor crónico, Dolor visceral, Dolor ecrotal, Dolor testicular, Orquialgia

Resumen

Introducción: El dolor testicular es un vasto campo de diagnóstico médico, donde convergen múltiples órganos y sistemas. El dolor testicular agudo es una emergencia médica que necesita una evaluación adecuada y una resolución inmediata; pero cuando aparece como un problema crónico, se convierte en un enigma que requiere un buen conocimiento de los mecanismos del dolor testicular y el diagnóstico diferencial.

Objetivo: Revisar la etiología del dolor testicular y proponer una nueva clasificación en diez subgrupos etiológicos.

Método: Se realizó una búsqueda bibliográfica en Google y las bases de datos National Library of Medicine’s PubMed para identificar artículos originales y de revisión, publicados o publicados electrónicamente, sobre el dolor testicular, hasta marzo de 2020. Los términos de la búsqueda incluyeron: Términos MESH: Enfermedad testicular (Classificacion, complicationes, etiologia, trauma, microbiologia, patologia, fisiopatologia, secondaria, cirugía, tratamiento) y vasectomia. Términos No MESH: orquialgia aguda y crónica, escrotalgia, orquidinia, inguinalgia, epididimalgia, testalgia, dolor testicular crónico, síndrome de dolor escrotal crónico, síndrome de dolor testicular, síndrome de dolor epididimario y síndrome de dolor post vasectomía. La búsqueda inicial produjo 625 artículos y 145 se incluyeron en la presente revisión.

Resultados: De 100 diagnósticos posibles, para comprender mejor la etiología del dolor testicular, se pueden subdividir en diez subgrupos: infecciosos, neoplásicos, traumáticos, torsionales, vasculares, inmunológicos, neurológicos, farmacológicos, post obstrucción y causas diversas.  Asimismo, el tratamiento se puede dividir en dos grupos mayores según las opciones terapéuticas: tratamiento farmacológico y no farmacológico, este último con una subdivisión: opciones no invasivas e invasivas (quirúrgicas) que se están expandiendo.

Conclusiones: El dolor testicular debe entenderse como un síndrome doloroso complejo con un origen enigmático. El éxito del tratamiento depende de la correcta identificación de la fuente del dolor; con un centenar de causas posibles, el uso de una agrupación lógica podría facilitar esta identificación.

Citas

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Publicado
2020-08-17
Sección
Artículos originales