Podium Session

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PD05-04: Early Experience with Microsurgical Spermatic Cord Denervation in a Canadian Centre

Friday, May 12
10:00 AM - 10:10 AM
Location: BCEC: Room 159

Presentation Authors: Darby Cassidy*, Prince George, Canada

Introduction: Microsurgical spermatic cord denervation (MSCD) is an effective surgical technique to manage chronic medically refractory orchalgia, but has not been widely accepted by Canadian Urologists. This paper reviews the early experience of a single Urologist in Canada

Methods: 18 consecutive testicular units underwent MSCD over a 48 months by a single surgeon in a Canadian centre. All patient's had reversible causes of pain ruled out and had a successful diagnostic spermatic cord block.


Results: A total of 18 patients underwent microsurgical spermatic cord denervation by a single surgeon over 4 years. The average patient age was 45 years. The average pre-procedural pain score was 8.5/10. The average post procedural pain score in respond was 0.4/10. The overall success rates was 83% (15/18), with a complete response seen in 61% (11/18) and a partial but acceptable response in 22% (4/18). The failure rate was 17% (3/18) with these patients demonstrating no significant change in their postoperative pain scores. The complication rate was 11% (2/18) with 1 postoperative testicular loss and 1 postoperative hydrocele. The recurrence rates was also 11% (2/18) with these patients having a recurrence in their pain after 6 months of follow-up.

Conclusions: Chronic orchialaia is a challenging entity to treat with poor reported success rates in the literature for both medical and surgical treatments.

Our results are consistent with the medical literature.

Microsurgical spermatic cord denervation does offer a favourable success rate and acceptable complication rate and should be considered part of the armamentarium for the treatment of chronic medically refractory orchialgia.

Source Of Funding: None.

Darby James Cassidy, MD

University Hospital of Northern British Columbia

Darby James Cassidy, MD, FRCSC. Male Reproductive and Sexual Medicine. University Hospital of Northern British Columbia.
Staff Urologist, University Hospital of Northern British Columbia, Prince George, BC, Canada.
Clinical Instructor, Department of Urologic Sciences, University of British Columbia.
Andrology Fellowship, University of Toronto, Toronto, ON, Canada

Surgeon, artist, gentleman adventurer, dilettante.

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