[Microsurgical testicular spermatic cord denervation as therapy of chronic testicular pain].
Diagnosis and treatment of chronic testicular pain (CTP) has been a difficult and often unrewarding clinical situation. Success rates of conservative and surgical measures rarely exceed 55% to 73% and 10% to 40%, respectively. We report on our experience with microsurgical testicular denervation as therapeutic option in CTP. Following an extensive preoperative work-up and a positive response to spermatic cord block, 25 patients underwent microsurgical testicular denervation. After a mean follow-up of 31.5 months 24/25 patients are painfree; no intra- or postoperative complications were encountered. In none of the cases testicular atrophy or testicular hydrocele was observed during postoperative follow-up. Microsurgical testicular denervation produces reliable and reproducible excellent therapeutic success rates and should be integrated in the management of CTP at an early stage. High success rates, however, require adequate and meticulous diagnostic workup of the patients with the spermatic cord block using saline and different local anaesthetics being an initial diagnostic armentarium predicting postoperative outcome.
Klinik für Urologie und Kinderurologie, Philipps-Universität Marburg, Baldingerstrasse, 35043 Marburg.
A
A
Heidenreich
P
P
Olbert
U H
UH
Engelmann
D000328:Adult; D002908:Chronic Disease; D003714:Denervation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery*; D013085:Spermatic Cord / Q000294:innervation*; D013733:Testicular Diseases / Q000209:etiology / Q000601:surgery*