1 in 8 males undergo scrotal surgery 20 years after kidney donation

Embargoed for release until 5:00 p.m. ET on Monday 10 November 2025   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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1. 1 in 8 males undergo scrotal surgery 20 years after kidney donation

Study suggests action is needed to inform past and future male donors of risk and potential symptoms

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02257 

URL goes live when the embargo lifts             

A population-based cohort study evaluated the long-term scrotal surgery rates after laparoscopic nephrectomy in male living kidney donors compared with nondonors. The findings revealed that the cumulative incidence for scrotal surgery among donors was 1 in 8 after 20 years, compared with 1 in 143 for nondonors. Even with this risk, most males who donate a kidney won’t develop this complication, so it shouldn’t discourage donation. Encouraging kidney donation remains vital. The study is published in Annals of Internal Medicine.  

Some males who donate a kidney through a laparoscopic technique end up with fluid building up around the testicle on the same side as the kidney that was removed. This is called a scrotal hydrocele. Over the years, this fluid accumulation can enlarge and cause discomfit requiring surgical drainage. Until now, we haven’t had good information about how often this happens.

A team from the London Health Sciences Centre Research Institute (LHSRI) and colleagues used linked administrative health care databases in Ontario, Canada to study almost 900 male patients who underwent a laparoscopic donor nephrectomy between 1 April 2002 and 31 March 2023. These donors were matched in a 1:10 ratio with almost 9000 male nondonors with similar baseline characteristics. The researchers found that the rate of hospitalization for surgery to address a unilateral scrotal fluid collection was 8.3 per 1000 person-years in donors compared to 0.2 per 1000 person-years in nondonors. Over a 20-year period, 1 in 8 donors underwent scrotal surgery compared to 1 in 143 nondonors. Most surgeries were under general anesthesia and did not require a hospital stay.  The hydrocelectomies occurred years after donation when the transplant surgeon was no longer involved in the donor’s care. After this type of scrotal surgery, it typically takes a few weeks to fully heal and return to normal activities. Overall, laparoscopic nephrectomy is associated with a higher long-term risk for scrotal surgery in male living kidney donors, underscoring the need for past and future male kidney donors to be informed about the risk and advised on symptoms to monitor after donation. Research is needed to understand if changing the donation surgery technique can lower the risk of it occurring.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Amit X. Garg, MD, PhD, please contact Celine Zadorsky, Senior Media Relations Consultant, London Health Sciences Centre, at (226) 927-2309 or media@lhsc.on.ca. 

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2. 1 in 10 primary care patients report unmet social needs, regardless of setting or patient population type

Review identified strengths and growth areas for primary care-based social needs screening and intervention programs

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00308

Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-25-03979

URL goes live when the embargo lifts             

A systematic review examined program-level processes that may influence the implementation of primary care-based social needs screening and intervention programs. The review found that programs focusing on a smaller, targeted population were more likely to screen and provide interventions to patients. The findings suggest that health care systems could benefit from knowledge sharing and systematic evaluations to achieve better success in social needs screening and intervention programs. The review is published in Annals of Internal Medicine.  

Researchers from Advocate Aurora Research Institute at Advocate Health in Milwaukee, Wisconsin reviewed 23 studies published between January 2015 to April 2025 that evaluated U.S.-based programs using structured tools to screen adult patients for at least one of three social needs measures (food insecurity, transportation, and housing insecurity) followed by an intervention to address the identified needs in a primary care setting. Studies were categorized by the patient populations eligible for screening: targeted or general. Targeted studies defined their eligible population by clinical condition, health care use, or insurance, whereas general studies included all patients. The review found that screening rates ranged widely, from 2% to 91%. Among targeted populations, screening rates ranged from 38.3% to 90.9%. Among studies screening the general population, the percentage of patients screened ranged from 32% to 57%. In the four studies with the highest percentage of screened patients, all 4 received additional staff to assist the clinic with the screening process. The percentage of patients reporting at least one social need ranged between 10% and 100% across 13 studies. Programs reported wide variability in their ability to address unmet social needs, with 28% to 89% of patients receiving needed resources and effectively closing the social care loop. Intervention rates were generally higher among programs focusing on targeted populations compared to general populations. Few studies reported clinical and health care use outcomes, and the findings were mixed. The findings of this review emphasize that considerable gaps remain in our understanding of the factors required to successfully screen for social needs, address those needs, and improve health outcomes.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Eva Chang, PhD, MPH please email Myra Wright at Myra.Wright@Advocatehealth.org. 

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3. Report suggests Oropouche virus strain was milder in Perú

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02192

URL goes live when the embargo lifts             

A retrospective cross-sectional study characterized the epidemiology, clinical presentation, and outcomes of laboratory-confirmed Oropouche virus disease (OVD) cases in Iquitos, Perú after the 2023 OVD outbreak in Latin America. The findings highlight the disease’s predominance in the Loreto region of Peru and a hospitalization rate of 2%, suggesting a milder disease course potentially related to regional viral strains or host factors. The findings are published in Annals of Internal Medicine.

Researchers from The Working Group for Emerging Tropical Diseases in Iquitos, Perú analyzed data obtained from Peru’s National Epidemiological Surveillance System for Arboviruses detailing 496 patients with OVD confirmed by qualitative reverse transcription–polymerase chain reaction (qRT-PCR) from 31 December 2023 to 30 September 2024. The mean age of the cohort was 27.7 years, and 37.7% of patients were children. Over 60% of cases occurred in early 2024, and the predominant clinical manifestations were headache, fever, myalgia, and arthralgias. There was one dengue co-infection and 1 malaria co-infection. 2% of patients required hospitalization compared to hospitalization rates of 10% to 15% reported in Brazil. Pediatric patients had a lower frequency of prior dengue infection, comorbidities, and back pain. The authors say enhanced surveillance is warranted to monitor co-circulating arboviruses, potential sexual transmission, neurologic complications, and adverse birth outcomes.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding authors Edgar A. Ramírez García, MD please email Edgar.Ramirez@unapiquitos.edu.pe.

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Also new this issue:

A Reminder in Every Story: The Cost of Vaccine Hesitancy

Roban Shabbir, BA and Zubair Shabbir, BS

Ideas and Opinions

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02508

Management of Sepsis in Hospitalized Patients

Jessica A. Palakshappa, MD, MS and Stephanie P. Taylor, MD, MS

In the Clinic

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-02685