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KMID : 1037120190370010078
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The World Journal of Men′s Health
2019 Volume.37 No. 1 p.78 ~ p.84
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Microsurgical Denervation of Spermatic Cord for Chronic Idiopathic Orchialgia: Long-Term Results from an Institutional Experience
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Chaudhari Rajeev
Sharma Satyadeo
Khant Shahil
Raval Krutik
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Abstract
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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.
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KEYWORD
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Chronic pain, Denervation, Pain management, Scrotum, Spermatic cord, Testis
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