La. Levine et Tg. Matkov, Microsurgical denervation of the spermatic cord as primary surgical treatment of chronic orchialgia, J UROL, 165(6), 2001, pp. 1927-1929
Purpose: We evaluate the effectiveness of microsurgical denervation of the
spermatic cord for treatment of chronic orchialgia.
Materials and Methods: Patients referred to our clinic diagnosed with chron
ic orchialgia are evaluated with a thorough medical and psychiatric history
, physical examination and scrotal ultrasound when indicated. A total of 27
patients with chronic orchialgia refractory to nonsurgical management who
had temporary pain relief after undergoing outpatient cord block were candi
dates for denervation. There were 6 patients who had bilateral pain, theref
ore, 33 testicular units were denervated. Followup ranged from 1 to 74 mont
hs (mean 20).
Results: Complete pain relief was noted in 25 (76%) testicular units, parti
al relief in 3 (9.1%) and no relief in the remaining 5 (15%), with a mean f
ollowup of 19, 24 and 10 months, respectively. There was no significant dif
ference in outcome when evaluated by the etiology of orchialgia.
Conclusions: When conservative treatment fails, microsurgical denervation o
f the spermatic cord should be considered first rate surgical therapy for p
atients with chronic orchialgia.