Outcomes for surgical management of orchalgia in patients with identifiable intrascrotal lesions

Objective: The outcome of surgery for relief of orchalgia in patients with identifiable intrascrotal pathology is not well defined. We evaluated the s uccess of commonly performed surgical procedure indicated for pain relief i n patients with specific intrascrotal lesions. Methods: Surgical cases performed for relief of painful scrotal pathology w ere reviewed, including ligation of internal spermatic vein, hydrocelectomy , spermatocelectomy, and orchiopexy for suspected intermittent torsion. Rel ief of pain as reported to the physician and time for return to full activi ty were determined, Pain relief was compared to a 50% placebo rate using Fi sher's exact test. Results: Eigthy-five of 151 patients (56%) undergoing surgery for pain reli ef had complete data and adequate follow-up for analysis. Of 40 patients wh o had ligation of the internal spermatic vein, 30 (75%) were relieved of pa in (p = 0.037), All 19 patients with painful hydroceles and 16 of 17 (94%) with spermatoceles were relieved of pain (p<0.001). Of 9 patients undergoin g scrotal orchiopexy for suspected intermittent torsion, 8 (89%) were pain- free (p<0.001). Conclusion: Surgical management of specific intrascrotal lesions is highly effective. Copyright (C) 2001 S. Karger AG, Basel.