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Microsurgical Denervation of Spermatic Cord

Targeted denervation for chronic orchialgia.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Microsurgical Denervation of Spermatic Cord?

Microsurgical denervation of the spermatic cord (MDSC) is a targeted procedure under operating microscope, in which all autonomic nerves traveling along the cremasteric muscle, perivasal sheath and cord lipomatous tissue are selectively transected while preserving the testicular artery, vas deferens and lymphatics.

It is offered to patients with chronic orchialgia (≥3 months) refractory to conservative therapy whose pain transiently resolves with cord block. Reported success rates are 70-90% at 1 year for unilateral chronic testicular pain.

Symptoms

Chronic dull or sharp testicular/scrotal pain
Pain radiating to inguinal, perineal or thigh region
Discomfort during prolonged sitting or sexual activity
Functional impairment of work and exercise
Anxiety and reduced quality of life

Risk Factors

Prior inguinal hernia repair (genitofemoral nerve injury)
Vasectomy (post-vasectomy pain syndrome)
Varicocele or hydrocele surgery
Recurrent epididymitis
Testicular trauma history
Idiopathic chronic orchialgia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent testicular pain longer than 3 months
  • Failure of analgesics, antibiotics and pelvic floor therapy
  • Positive diagnostic spermatic cord block (>50% pain relief)
  • Pain affecting daily activities and sexual function
  • Normal scrotal ultrasound and laboratory workup

Treatment Methods

01
Diagnostic cord block confirmation before surgery
02
Microsurgical exposure of the spermatic cord at sub-inguinal level
03
Identification and preservation of testicular artery (Doppler-guided)
04
Stripping of perivasal sheath and lipomatous tissue with all nerve fibers
05
Preservation of vas deferens and lymphatics for fertility and lymph drainage
06
Postoperative scrotal support and gradual activity
07
Multidisciplinary pain management for residual symptoms

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.