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Targeted Microsurgical Denervation of the Spermatic Cord for Chronic Orchialgia: the Current Standard of Care

  • Surgery (M Desai, Section Editor)
  • Published:
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Abstract

Purpose of Review

This paper reviews the pathophysiology, current literature, techniques for full microsurgical denervation (MDSC) and targeted microsurgical denervation (TMDSC) of the spermatic cord, and outcomes for these treatment options for patients with chronic scrotal content pain (CSCP) or orchialgia.

Recent Findings

Significant reduction in pain (77–100%) is reported across various studies for CSCP patients with minimal patient morbidity. The testicular atrophy/loss risk is less than 1%. Testosterone levels do not appear to be affected by TMDSC/MDSC. The outcomes between TMDSC and MDSC are comparable (not statistically significantly different). However, TMDSC is significantly more efficient and a lot less tedious to perform. TMSCD had a shorter microsurgical operative time (21 min vs 53 min, P = 0.0001) than MDSC.

Summary

Targeted or full microsurgical denervation of the spermatic cord is a safe and effective treatment option that is well published across several studies. The targeted MDSC approach is a more efficient and potentially less risky approach with similar outcomes to full MDSC.

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Authors and Affiliations

  1. Avant Concierge Urology & University of Central Florida, 15548 W. Colonial Drive, Winter Garden, FL, 34787, USA

    Sijo Joseph Parekattil

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  1. Sijo Joseph Parekattil
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Correspondence to Sijo Joseph Parekattil.

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Parekattil, S.J. Targeted Microsurgical Denervation of the Spermatic Cord for Chronic Orchialgia: the Current Standard of Care. Curr Urol Rep 21, 47 (2020). https://doi.org/10.1007/s11934-020-00999-8

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  • DOI: https://doi.org/10.1007/s11934-020-00999-8

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