Podium Session

Poster, Podium & Video Sessions

PD05-06: PHYSICAL THERAPY FOR ORCHALGIA

Friday, May 12
10:20 AM - 10:30 AM
Location: BCEC: Room 159

Presentation Authors: Matthew Nielsen*, Norfolk, VA, Charles Gresham, Norfolk , VA, Erin Glace, Virginia Beach, VA, Courtney Anderson, Hadiza Galadima, Jessica Delong, Jeremy Tonkin, Ramon Virasoro, Kurt McCammon, Norfolk, VA

Introduction: Chronic pelvic pain and orchalgia are challenging conditions to treat in urologic practice. Recent research and treatment have begun to focus on musculoskeletal dysfunction as a major contributor to pelvic pain and orchalgia. The objective of this study is to assess the clinically reported outcomes of patients in our center that presented with orchalgia who underwent physical therapy.


Methods: A retrospective chart review was conducted on men who initially presented to our practice with orchalgia from January 2009 to June 2016 and referred for pelvic floor physical therapy. Each patient had a urologic assessment prior to physical therapy referral. Patients were evaluated and treated by our physical therapy team according to any presenting musculoskeletal impairments/complaints. Treatments included pelvic alignment exercises, therapeutic stretching/strengthening, manual therapy, dry needling and biofeedback. Following treatment, a subjective global response measure was assessed based on patients&[prime] self-reports of improvement. Additionally, if available, NIH Chronic Prostatitis Symptom Index (NIH-CPSI) data was collected. Statistical analysis was performed in SAS 9.4 (SAS Institute, Cary, NC) where all P-values less than 0.05 were considered statistically significant.

Results: A total of 392 patient charts met inclusion criteria for this retrospective study. Average age was 42.8 years with mean longevity of symptoms of 32.8 months. 49.1% had co-existing urinary complaints. Pre-treatment average day pain was 4.5 (analog scale 1-10); worst day pain was 7.6. 83.2% of patients indicated their testicular pain was better, 16.1% reported no change and 0.7% reported worsening of their pain at average follow up of 6.4 months. 150 patients (38%) completed a NIH-CPSI questionnaire both pre and post treatment. Of these patients, those who reported improvement in their pain (n=138) had decrease in pain scores from average of 16.7 to 11.3, decrease in urinary score from 2.6 to 2.0, and improvement in quality of life score from 8.1 to 4.2; each was statistically significant (p<0.01). Patients who did not improve or had worsening of symptoms with physical therapy (n=12) did not have statistically significant improvement in pain, urinary or quality of life scores (p=0.36, p=0.78, p=0.17; respectively).

Conclusions: Physical therapy serves as a valid and effective treatment option for patients with orchalgia, following a comprehensive urologic examination. The significant subjective and objective improvement reported by this group of patients with no adverse side effects points towards early referral to a pelvic physical therapy practice.

Source Of Funding: none

Matthew Nielsen, MD

Eastern Virginia Medical School

Matthew A. Nielsen MD, Eastern Virginia Medical School, Norfolk, Virginia.

Education

Residency 07/01/14—current
Eastern Virginia Medical School, Norfolk, Virginia
Department of Urology
Urology Resident

Internship 07/01/13—06/30/14
Eastern Virginia Medical School, Norfolk, Virginia
Department of Surgery
Intern

Doctor of Medicine 08/05/09—06/30/13
University of Texas Health Science Center San Antonio (UTHSCSA), San Antonio, Texas
Summa Cum Laude

Bachelors of Business Administration 08/01/05—06/01/09
Baylor University, Waco, Texas
Summa Cum Laude


Professional Memberships

American Urological Association, Member, 2014-current
Society International Urology, Member, 2016-current
Alpha Omega Alpha, Member, 2012-current.

Honors

Eastern Virginia Medical School, Department of Surgery, Intern of the Year 2014
Alpha Omega Alpha, Medical Honor Society, Elected as Junior Medical Student 2012

Research

Physical Therapy for Orchialgia
Matthew Nielsen MD, Kurt McCammon MD, Erin Glace MSPT
Poster presentation at SUFU Meeting, March 2017.

Myofascial Trigger Point Dry Needling for Pelvic Pain and Urinary Symptoms: An Initial Single Center Experience
Matthew Nielsen MD, Kurt McCammon MD, Erin Glace MSPT
Podium presentation at SUFU Meeting, February 2016.

Overholser S, Nielsen M, Torkko K, Cwilka D, Weaver B, Shi X, Leach RJ, Hernandez J, Huang T, Thompson IM, Thompson IM. Active Surveillance is an Appropriate Management Strategy for a Proportion of Men Diagnosed with Prostate Cancer by Prostate Specific Antigen Testing. J Urol 2015; 194 (3): 680-4.

Clinical Effectiveness of Percutaneous Tibial Nerve Stimulation: A Single Center Experience
Matthew Nielsen MD, Kurt McCammon MD, Erin Glace MSPT
Poster Presentation at MA/NE AUA Joint Section Meeting, October 2015.

Gender Differences in Urinary Bother Due to Stress Urinary Incontinence
Matthew Nielsen MD, Jack Zuckerman MD, Ramon Virasoro MD, Jeremy Tonkin MD, Jessica Delong MD, Kurt McCammon MD
Poster Presentation at SUFU Meeting, February 2015.

Presentation(s):

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PD05-06: PHYSICAL THERAPY FOR ORCHALGIA



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