Microdenervation of the spermatic cord for chronic scrotal content pain: single institution review analyzing success rate after prior attempts at surgical correction

J Urol. 2013 Feb;189(2):554-8. doi: 10.1016/j.juro.2012.09.026. Epub 2012 Dec 20.

Abstract

Purpose: Microdenervation of the spermatic cord is an effective treatment for men with intractable scrotal content pain. We evaluated a single center experience, analyzing patients in whom prior surgical attempts had failed to correct pain who subsequently underwent microdenervation of the spermatic cord.

Materials and methods: A retrospective chart review of 68 patients who underwent microdenervation of the spermatic cord from 2006 to 2010 was performed. Prior ipsilateral surgical procedures with the intent to correct scrotal content pain were selected, identifying 31 testicular units.

Results: Chart review was performed on 68 men with mean age of 42 years at presentation and a mean followup of 10 months. Patients in whom prior surgical correction had failed and who subsequently had microdenervation of the spermatic cord had a mean postoperative pain score of 3 (range 0 to 10) with an average decrease in pain of 67%. Those who had not undergone a prior attempt at surgical correction had a mean post-microdenervation of the spermatic cord pain score of 2 (range 0 to 10) and an average pain decrease of 79% which did not differ statistically from those in whom prior surgery failed. In addition, 50% of men who had undergone surgery before microdenervation of the spermatic cord had complete relief of pain after microdenervation of the spermatic cord vs 64% of those who had not undergone previous surgery.

Conclusions: Men with chronic scrotal content pain in whom prior attempts to correct pain have failed have similar, albeit lower, success rates as those without prior surgical intervention. Therefore, men with chronic scrotal content pain in whom prior surgical management has failed and who have a positive spermatic cord block should be considered candidates for microdenervation of the spermatic cord.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Algorithms
  • Chronic Pain / surgery*
  • Denervation / methods*
  • Genital Diseases, Male / surgery*
  • Humans
  • Male
  • Microsurgery
  • Middle Aged
  • Remission Induction
  • Retrospective Studies
  • Scrotum*
  • Spermatic Cord / innervation*
  • Spermatic Cord / surgery*
  • Testicular Diseases / surgery*
  • Urologic Surgical Procedures, Male / methods
  • Young Adult