Microsurgical Denervation of the Spermatic Cord

A Surgical Alternative in the Treatment of Chronic Orchialgia

Levine, Laurence A.*
Matkov, Thomas G.
Lubenow, Timothy R.

From the Departments of Urology and Anesthesia (Rush Pain Center), Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Accepted for publication July 14, 1995.
*Requests for reprints: Department of Urology, Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Pky., Chicago, Illinois 60612.

Journal of Urology 155(3):p 1005-1007, March 1996.

Purpose

We demonstrated effective treatment of chronic orchialgia by microsurgical denervation of the spermatic cord.

Materials and Methods

Seven men with a history of chronic orchialgia (mean duration 16.6 months) underwent this surgical procedure after conservative treatment failed. A bupivacaine spermatic cord block resulted in temporary pain relief.

Results

There was an excellent correlation between the response to preoperative temporary cord nerve block and the surgical result. Six men had complete and permanent pain relief after surgery. One patient with bilateral orchialgia had complete unilateral relief and partial relief on the contralateral side. There was no complaint of postoperative regional hypoesthesia.

Conclusions

Microsurgical denervation of the spermatic cord is an effective testicular sparing surgical alternative for the treatment of chronic orchialgia.