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Published in: Current Sexual Health Reports 4/2018

01-12-2018 | Male and Female Surgical Interventions (A Burnett and C Carson, Section Editors)

Spermatic Cord Denervation for Chronic Orchialgia

Authors: Sarah C. Vij, Daniel A. Shoskes

Published in: Current Sexual Health Reports | Issue 4/2018

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Abstract

Purpose of Review

To review the surgical management of chronic scrotal content pain with microsurgical spermatic cord denervation (MSCD).

Recent Findings

The data continues to support the use of MSCD for patients with chronic idiopathic scrotal content pain. The use of the robotic approach to this operation is novel but may still be cost-prohibitive and more studies are needed to prove equivalence to the standard microsurgical approach.

Summary

MSCD has evolved into a very effective treatment for a difficult patient population with few options. It should be considered surgical standard of care for men with persistent chronic scrotal content pain whose symptoms are temporarily resolved with a spermatic cord block.
Literature
1.
go back to reference Gray C, Powell C, Amling C. Outcomes for surgical management of orchialgia in patients with identifiable intrascrotal lesions. Eur Urol. 2001;39(4):455–9.CrossRef Gray C, Powell C, Amling C. Outcomes for surgical management of orchialgia in patients with identifiable intrascrotal lesions. Eur Urol. 2001;39(4):455–9.CrossRef
2.
go back to reference Padmore D, Norman R, Millard O. Analyses of indications for and outcomes of epididymectomy. J Urol. 1996;156(1):95–6.CrossRef Padmore D, Norman R, Millard O. Analyses of indications for and outcomes of epididymectomy. J Urol. 1996;156(1):95–6.CrossRef
3.
go back to reference • Parekattil S, Gudeloglu A, Brahmbhatt J, Priola K, Vieweg J, Allan R. Trifecta nerve complex: potential anatomical basis for microsurgical denervation of the spermatic cord for chronic orchialgia. J Urol. 2013;190(1):265–70 This is an important study explaining the anatomic basis for MSCD. CrossRef • Parekattil S, Gudeloglu A, Brahmbhatt J, Priola K, Vieweg J, Allan R. Trifecta nerve complex: potential anatomical basis for microsurgical denervation of the spermatic cord for chronic orchialgia. J Urol. 2013;190(1):265–70 This is an important study explaining the anatomic basis for MSCD. CrossRef
6.
go back to reference •• Devine C, Schellhammer P. The use of microsurgical denervation of the spermatic cord for orchialgia. Trans Am Assoc Genitourin Surg. 1978;70:149–51 This study is the original description of MCSD. PubMed •• Devine C, Schellhammer P. The use of microsurgical denervation of the spermatic cord for orchialgia. Trans Am Assoc Genitourin Surg. 1978;70:149–51 This study is the original description of MCSD. PubMed
8.
go back to reference Choa RG, Swami KS. Testicular denervation. A new surgical procedure for intractable testicular pain. Br Journaloj Urol Br J Urol. 1992;70:417–9.CrossRef Choa RG, Swami KS. Testicular denervation. A new surgical procedure for intractable testicular pain. Br Journaloj Urol Br J Urol. 1992;70:417–9.CrossRef
10.
go back to reference Oomen R, Witjens A, van Wijck A, Grobbee D, Lock T. Prospective double-blind preoperative pain clinic screening before microsurgical denervation of the spermatic cord in patients with testicular pain syndrome. Pain. 2014;155(9):1720–6.CrossRef Oomen R, Witjens A, van Wijck A, Grobbee D, Lock T. Prospective double-blind preoperative pain clinic screening before microsurgical denervation of the spermatic cord in patients with testicular pain syndrome. Pain. 2014;155(9):1720–6.CrossRef
11.
go back to reference Strom K, Levine L. Microsurgical denervation of the spermatic cord for chronic orchialgia: long-term results from a single center. J Urol. 2008;180(3):949–53.CrossRef Strom K, Levine L. Microsurgical denervation of the spermatic cord for chronic orchialgia: long-term results from a single center. J Urol. 2008;180(3):949–53.CrossRef
12.
go back to reference Tan WP, Levine LA. What can we do for chronic scrotal content pain? World J Mens Health. 2017;35(3):146–155.CrossRef Tan WP, Levine LA. What can we do for chronic scrotal content pain? World J Mens Health. 2017;35(3):146–155.CrossRef
13.
go back to reference •• Jarvi K, Wu C, Nickel JC, Domes T, Grantmyre J, Zini A. Canadian Urological Association best practice report on chronic scrotal pain. Can Urol Assoc J. 2018;1212(6):161–72. https://doi.org/10.5489/cuaj.5238 These are the only society supported guidelines available for clinicians on chronic orchialgia. CrossRef •• Jarvi K, Wu C, Nickel JC, Domes T, Grantmyre J, Zini A. Canadian Urological Association best practice report on chronic scrotal pain. Can Urol Assoc J. 2018;1212(6):161–72. https://​doi.​org/​10.​5489/​cuaj.​5238 These are the only society supported guidelines available for clinicians on chronic orchialgia. CrossRef
14.
go back to reference Parekattil S, Cohen M. Robotic surgery in male infertility and chronic orchialgia. Curr Opin Urol. 2010;20(1):75–90.CrossRef Parekattil S, Cohen M. Robotic surgery in male infertility and chronic orchialgia. Curr Opin Urol. 2010;20(1):75–90.CrossRef
15.
go back to reference Parekattil S, Gudeloglu A. Robotic assisted andrological surgery. Asian J Androl. 2013;15(1):67–74.CrossRef Parekattil S, Gudeloglu A. Robotic assisted andrological surgery. Asian J Androl. 2013;15(1):67–74.CrossRef
16.
go back to reference • Polackwich A, Arora H, Li J, Sijo P, Shoskes D. Development of a clinically relevant symptom index to assess patients with chronic orchialgia. J Urol. 2016;195(4):e455. https://doi.org/10.21037/tau.2018.04.10 A validation of a symptom index for chronic orchialgia which can be used in future studies to standardize pain assessment. CrossRef • Polackwich A, Arora H, Li J, Sijo P, Shoskes D. Development of a clinically relevant symptom index to assess patients with chronic orchialgia. J Urol. 2016;195(4):e455. https://​doi.​org/​10.​21037/​tau.​2018.​04.​10 A validation of a symptom index for chronic orchialgia which can be used in future studies to standardize pain assessment. CrossRef
Metadata
Title
Spermatic Cord Denervation for Chronic Orchialgia
Authors
Sarah C. Vij
Daniel A. Shoskes
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Sexual Health Reports / Issue 4/2018
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI
https://doi.org/10.1007/s11930-018-0178-x

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