Management of chronic testalgia by microsurgical denervation

[jon]

I'm contacting these guy to see if they could help me. I wish they were in the US. They claim 96% cure rate for men.

Eur Urol. 2002 Apr;41(4):392-7.
Management of chronic testalgia by microsurgical testicular denervation.
Heidenreich A1, Olbert P, Engelmann UH.
Author information
Abstract
OBJECTIVES:

Chronic testicular pain (CTP) is defined as uni- or bilateral, intermittent or continuous testicular discomfort of at least 3 months duration that interferes with the patient's daily activities and prompts him to seek medical advice is a rather common urological manifestation of chronic pain syndrome. Diagnosis and treatment of CTP has been a difficult and often unrewarding clinical situation. Success rates of conservative and surgical measures including epididymectomy and orchiectomy rarely exceed 55-73% and 10-40%, respectively. We report our experience on microsurgical testicular denervation as therapeutic option in CTP.
PATIENTS AND METHODS:

Following an extensive preoperative work-up (urine/semen cultures, transrectal ultrasound, testicular sonography, pain and orthopedic consultation) not revealing any pathologic abnormalities and a positive response to spermatic cord block, 35 patients underwent microsurgical testicular denervation. In brief, spermatic cord was dissected, vas deferens, cremasteric muscle and testicular vessels were separated. After identification of the testicular artery by application of vasodilatating agents using magnifying loops or the operating microscope, all structures besides the testicular artery, vas deferens and 1-2 lymphatic vessels were coagulated and transsected using bipolar diathermy.
RESULTS:

After a mean follow-up of 31.5 months 34/35 (96%) patients are completely pain-free; no intra- or postoperative complications were encountered. No case of testicular atrophy or hydrocele formation was observed during postoperative follow-up.
CONCLUSIONS:

Microsurgical testicular denervation results in reliable and reproducible excellent therapeutic success rates of 96% and should be integrated in the management of CTP at an early stage. High success rates require adequate and meticulous diagnostic work-up of the patients by spermatic cord block using saline as placebo and different local anaesthetics as an initial therapeutic armentarium predicting postoperative outcome.

[Violet M]

I think one of the keys is the meticulous diagnostic work-up that they mentioned. Also, before undergoing such a procedure, it seems like it would be important to ask what prevents you from having phantom pain afterward. Cutting a nerve doesn't mean their are no more pain signals to the brain. A second opinion might be a good idea.

Violet