World J Mens Health.  2019 Jan;37(1):78-84. 10.5534/wjmh.180035.

Microsurgical Denervation of Spermatic Cord for Chronic Idiopathic Orchialgia: Long-Term Results from an Institutional Experience

• Chaudhari
• Sharma S
• Khant S
• Raval K

• KMID: 2429724
• DOI: http://doi.org/10.5534/wjmh.180035

Abstract

PURPOSE
Chronic testicular pain remains an important challenge for urologists. At present there are many treatment modalities available for chronic orchialgia. Some patients remain in pain despite a conservative treatment. Microsurgical denervation of spermatic cord appears to be successful in relieving pain in patients who fail conservative management. We assessed the long-term efficacy, complications and patient perceptions of microsurgical denervation of the spermatic cord in the treatment of chronic orchialgia.
MATERIALS AND METHODS
A prospective study was conducted from January 2007 to January 2016 which included men with testicular pain of >3 months duration, failure of conservative management, persistent of pain for >3 months after treating the underlying cause. Total 48 patients with 62 testicular units (14 bilateral) showed the response to spermatic cord block and underwent Microsurgical Denervation of Spermatic Cord.
RESULTS
Out of 62 testicular units (14 bilateral) which were operated, complete 2 years follow-up data were available for 38 testicular units. Out of these 38 units, 31 units (81.57%) had complete pain relief, 4 units (10.52%) had partial pain, and 3 units (7.89%) were non-responders. Complications were superficial wound infection in 3 units (4.83%), hydrocele in 2 units (3.22%), subcutaneous seroma in 2 units (3.22%), and an incisional hematoma in 1unit (1.61%) out of 62 operated testicular units.
CONCLUSIONS
Idiopathic chronic orchialgia remains a difficult condition to manage. If surgery is considered, microsurgical denervation of spermatic cord should be considered as a first surgical approach to get rid of pain and sparing the testicle.

Keyword

Chronic pain; Denervation; Pain management; Scrotum; Spermatic cord; Testis

MeSH Terms

Chronic Pain
Denervation*
Follow-Up Studies
Hematoma
Humans
Male
Pain Management
Prospective Studies
Scrotum
Seroma
Spermatic Cord*
Testis
Wound Infection

Figure

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  Fig. 1 Flow chart showing study protocol.

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