Targeted Robotic Assisted Microsurgical Denervation of the Spermatic Cord for the Treatment of Chronic Orchialgia or Groin Pain: A Single Center, Large Series Review
2017; Lippincott Williams & Wilkins; Volume: 199; Issue: 4 Linguagem: Inglês
10.1016/j.juro.2017.10.030
ISSN1527-3792
AutoresNahomy Calixte, Bayo Tojuola, İbrahim Güven Kartal, Ahmet Güdeloğlu, Matthew Hirsch, Mohamed Etafy, Richard Mendelson, Borivoje Djokić, Sarah Sherba, Kunal Shah, Jamin Brahmbhatt, Sijo Parekattil,
Tópico(s)Reproductive Health and Technologies
ResumoNo AccessJournal of UrologyAdult Urology1 Apr 2018Targeted Robotic Assisted Microsurgical Denervation of the Spermatic Cord for the Treatment of Chronic Orchialgia or Groin Pain: A Single Center, Large Series Review Nahomy Calixte, Bayo Tojuola, Ibrahim Kartal, Ahmet Gudeloglu, Matthew Hirsch, Mohamed Etafy, Richard Mendelson, Borivoje Djokic, Sarah Sherba, Kunal Shah, Jamin Brahmbhatt, and Sijo Parekattil Nahomy CalixteNahomy Calixte More articles by this author , Bayo TojuolaBayo Tojuola More articles by this author , Ibrahim KartalIbrahim Kartal More articles by this author , Ahmet GudelogluAhmet Gudeloglu More articles by this author , Matthew HirschMatthew Hirsch More articles by this author , Mohamed EtafyMohamed Etafy More articles by this author , Richard MendelsonRichard Mendelson More articles by this author , Borivoje DjokicBorivoje Djokic More articles by this author , Sarah SherbaSarah Sherba More articles by this author , Kunal ShahKunal Shah More articles by this author , Jamin BrahmbhattJamin Brahmbhatt More articles by this author , and Sijo ParekattilSijo Parekattil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.10.030AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Microsurgical denervation of the spermatic cord is a treatment option for chronic orchialgia refractory to conservative treatment. A recent study showed specific nerve fibers as the possible cause of chronic orchialgia. Our goal was to present the outcomes of ligation of these nerves using a technique of targeted robotic assisted microsurgical denervation of the spermatic cord. Materials and Methods: We retrospectively reviewed the records of 772 patients who underwent targeted robotic assisted microsurgical denervation of the spermatic cord from October 2007 to July 2016. Selection criteria were chronic testicular pain more than 3 months in duration, failed conservative treatments, negative neurological and urological workup, and temporary resolution of pain with a local anesthetic spermatic cord block. Targeted robotic assisted microsurgical denervation of the spermatic cord was performed. Pain was assessed preoperatively and postoperatively using a subjective visual analog scale and objectively with the standardized and validated PIQ-6 (Pain Impact Questionnaire-6) score. Results: Followup data were available on 860 cases. During a median followup of 24 months (range 1 to 70) 718 cases (83%) showed a significant reduction in pain and 142 (17%) had no change in pain by subjective visual analog scale scoring. Of cases with a significant reduction in pain 426 (49%) had complete resolution and 292 (34%) had a 50% or greater reduction. Objective PIQ-6 analysis showed a significant reduction in pain in 67% of patients 6 months postoperatively, in 68% at 1 year, in 77% at 2 years, in 86% at 3 years and in 83% at 4 years. Conclusions: Targeted robotic assisted microsurgical denervation of the spermatic cord is an effective, minimally invasive approach with potential long-term durability in patients with refractory chronic orchialgia. References 1 : Chronic orchialgia: evaluation and discussion of treatment options. Ther Adv Urol2010; 2: 209. Google Scholar 2 : Analysis and management of chronic testicular pain. J Urol1990; 143: 936. 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Google Scholar © 2018 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySmith J (2018) This Month in Adult UrologyJournal of Urology, VOL. 199, NO. 4, (863-864), Online publication date: 1-Apr-2018. Volume 199Issue 4April 2018Page: 1015-1022Supplementary Materials Advertisement Copyright & Permissions© 2018 by American Urological Association Education and Research, Inc.KeywordstestispaindenervationroboticsmicrosurgeryMetricsAuthor Information Nahomy Calixte More articles by this author Bayo Tojuola More articles by this author Ibrahim Kartal More articles by this author Ahmet Gudeloglu More articles by this author Matthew Hirsch More articles by this author Mohamed Etafy More articles by this author Richard Mendelson More articles by this author Borivoje Djokic More articles by this author Sarah Sherba More articles by this author Kunal Shah More articles by this author Jamin Brahmbhatt More articles by this author Sijo Parekattil More articles by this author Expand All Advertisement PDF downloadLoading ...
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