Microsurgical denervation of the spermatic cord: a surgical alternative in the treatment of chronic orchialgia.

Abstract

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