Microsurgical Spermatic Cord Denervation as a Treatment for Chronic Scrotal Content Pain: A Multicenter Open Label Trial
2015; Lippincott Williams & Wilkins; Volume: 194; Issue: 5 Linguagem: Inglês
10.1016/j.juro.2015.05.081
ISSN1527-3792
AutoresMarcelo Marconi, Cristián Palma, Pablo Troncoso, Arturo Dell Oro, Thorsten Diemer, W. Weidner,
Tópico(s)Reproductive Health and Technologies
ResumoNo AccessJournal of UrologyAdult Urology1 Nov 2015Microsurgical Spermatic Cord Denervation as a Treatment for Chronic Scrotal Content Pain: A Multicenter Open Label Trial Marcelo Marconi, Cristian Palma, Pablo Troncoso, Arturo Dell Oro, Thorsten Diemer, and Wolfgang Weidner Marcelo MarconiMarcelo Marconi Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile More articles by this author , Cristian PalmaCristian Palma Department of Urology, Hospital Clínico Universidad de Chile, Santiago, Chile Department of Urology, Clinica Las Condes, Santiago, Chile More articles by this author , Pablo TroncosoPablo Troncoso Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile More articles by this author , Arturo Dell OroArturo Dell Oro Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile More articles by this author , Thorsten DiemerThorsten Diemer Department of Urology, Pediatric Urology and Andrology, University Clinic of Giessen, Giessen, Germany More articles by this author , and Wolfgang WeidnerWolfgang Weidner Department of Urology, Pediatric Urology and Andrology, University Clinic of Giessen, Giessen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.05.081AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We prospectively evaluated the results of microsurgical spermatic cord denervation in a series of patients with chronic scrotal content pain in a multicenter study, including 1 center in Germany and 3 centers in Chile. Materials and Methods: A total of 50 patients with chronic scrotal content pain more than 3 months in duration were prospectively selected for standardized operative microsurgical spermatic cord denervation as pain treatment. In all patients preoperative management included a positive response to a spermatic cord block test with local anesthesia. Pain severity was assessed using an analog visual pain scale (range 0 to 10) for 30 consecutive days. A total of 52 testicular units were operated on using a subinguinal approach. In all cases a surgical microscope was used to identify the arteria testicularis. Results: No intraoperative complications were observed and no testicular units were lost. Two reoperations were performed, including 1 for hematocele and 1 for hydrocele. Six months after surgery 40 patients (80%) were completely pain-free. In 6 patients (12%) intermittent testicular discomfort persisted, which could be managed by acetaminophen on demand. Four patients (8%) had no change in pain severity after surgery. Conclusions: After proper selection of patients microsurgical spermatic cord denervation seems to be a safe and efficient procedure to treat chronic scrotal content pain. Considering the limitations of the study, a randomized, controlled trial with longer followup is highly warranted. References 1 : Analysis and management of chronic testicular pain. J Urol1990; 143: 936. Link, Google Scholar 2 : Chronic testicular pain: an overview. Eur Urol2004; 45: 430. Google Scholar 3 : Clinical management of chronic testicular pain. Urol Int2010; 84: 125. Google Scholar 4 : The patient with chronic epididymitis: characterization of an enigmatic syndrome. J Urol2012; 167: 1701. Google Scholar 5 : Inhibition of adhesion and fibrosis improves the outcome of epididymectomy as a treatment for chronic epididymitis: a multicenter, randomized controlled, single-blind study. J Urol2013; 189: 1730. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCalixte N, Tojuola B, Kartal I, Gudeloglu A, Hirsch M, Etafy M, Mendelson R, Djokic B, Sherba S, Shah K, Brahmbhatt J and Parekattil S (2018) Targeted Robotic Assisted Microsurgical Denervation of the Spermatic Cord for the Treatment of Chronic Orchialgia or Groin Pain: A Single Center, Large Series ReviewJournal of Urology, VOL. 199, NO. 4, (1015-1022), Online publication date: 1-Apr-2018.Furr J and Bowen A (2018) Editorial CommentaryUrology Practice, VOL. 5, NO. 4, (277-277), Online publication date: 1-Jul-2018.Bach P and Goldstein M (2018) Editorial CommentJournal of Urology, VOL. 195, NO. 6, (1847-1847), Online publication date: 1-Jun-2016.Smith J (2018) This Month in Adult UrologyJournal of Urology, VOL. 194, NO. 5, (1181-1182), Online publication date: 1-Nov-2015. Volume 194Issue 5November 2015Page: 1323-1327 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsdenervationscrotumspermatic cordtestischronic painMetricsAuthor Information Marcelo Marconi Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile More articles by this author Cristian Palma Department of Urology, Hospital Clínico Universidad de Chile, Santiago, Chile Department of Urology, Clinica Las Condes, Santiago, Chile More articles by this author Pablo Troncoso Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile More articles by this author Arturo Dell Oro Department of Urology, Pontificia Universidad Católica de Chile, Santiago, Chile More articles by this author Thorsten Diemer Department of Urology, Pediatric Urology and Andrology, University Clinic of Giessen, Giessen, Germany More articles by this author Wolfgang Weidner Department of Urology, Pediatric Urology and Andrology, University Clinic of Giessen, Giessen, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...
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