Preoperative Predictors of Failure of Microsurgical Spermatic Cord Denervation for Men With Chronic Orchialgia.
Urology
; 149: 30-33, 2021 03.
Article
in En
| MEDLINE
| ID: mdl-33253741
OBJECTIVE: To evaluate predictors of failure of microsurgical spermatic cord denervation (MSCD) for men with chronic orchialgia. METHODS: Retrospective chart review of men who underwent MSCD. Outcomes were recorded with potential preoperative predictors of failure. RESULTS: One hundred and five men underwent MSCD, and of those, 38 were bilateral for a total of 143 testicular units. Overall, 97 of 143 (67.8%) had complete resolution of pain, 27 of 143 (18.9%) had improvement of pain, and 19 of 143 (13.3%) were considered failures with either no improvement or less than 50% improvement in pain after MSCD with a 1-year follow-up period. Overall, 59 of 143 (41%) presented with intermittent orchialgia while 84 of 143 (59%) presented with constant pain. The mean preoperative visual analog scale was 6.8 ± 2 and the mean duration of pain prior to MSCD was 62.5 ± 100 months. Potential etiologies of pain per testicular unit included previous scrotal/inguinal surgery 17 of 143 (11.9%), postvasectomy pain syndrome (PVPS) 30 of 143 (21%), infectious epididymitis 9 of 143 (6.3%), trauma 15/143 (10.5%), and idiopathic 72/143 (50.3%). The only pre-operative predictor having an association with predicting failure was the etiology of orchialgia. Relative to men who had idiopathic orchialgia or prior scrotal/inguinal surgery inciting orchialgia, men with PVPS had increased odds of failure with MSCD. CONCLUSION: PVPS is an etiology associated with a higher risk of failure to respond to MSCD than idiopathic chronic orchialgia or chronic orchialgia subsequent to scrotal/inguinal surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pain
/
Spermatic Cord
/
Testicular Diseases
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Denervation
/
Microsurgery
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Urology
Year:
2021
Document type:
Article