Treating Chronic Testicular Pain - Microsurgical Denervation of the Spermatic Cord

Treating Chronic Testicular Pain

A new microsurgical technique performed by Dr. David Fenig is now available for chronic testicular pain in men who have not had success with conservative treatments. The procedure is called microsurgical denervation of the spermatic cord, or cord stripping.

This surgery, which has a high success rate and preserves the physiological function of the testes, is often life-changing for men whose chronic testicular pain has no known cause. As one of the only urologic surgeons in the Baltimore area to offer the procedure, Dr. Fenig has provided relief to many grateful men who previously suffered from this serious and severe condition.

Dr. Fenig is experienced in treating testicular pain caused by infection of the testicle (orchitis) or epididymis (epididymitis), post surgical pain, trauma, tumors, hernia, torsion (twisting of the testicle), varicoceles, hydroceles or spermatoceles. Fortunately, most of these are easily diagnosed and treated, but sometimes the pain becomes chronic despite treatment, and in almost one-fourth of patients the cause cannot be determined.

Diagnosing for Chronic Testicular Pain

Diagnostic tests like scrotal ultrasound are first used to try and discover any overt cause for the pain, and initial treatment usually consists of taking antibiotics or anti-inflammatory drugs.

If this does not resolve the problem, a nerve block is administered to assess whether microsurgical removal of the nerve tissue may be beneficial. This technique for non-responsive testicular pain is called microsurgical denervation of the spermatic cord or “cord stripping.”


Microsurgical Denervation of the Spermatic Cord – The Procedure

Dr. Fenig performs the procedure on an outpatient basis in Chesapeake Urology’s state-of-the-art microsurgery facility. The procedure takes approximately one hour under general anesthesia utilizing a high-powered microsurgical microscope.

To perform microsurgical denervation, Dr. Fenig makes a small, 2-centimeter incision in the groin to access the spermatic cord. Using an operating microscope, he separates and removes the tissue carrying small nerves in the spermatic cord, thus eliminating or reducing the nerves carrying pain signals. The arteries to the testicle and lymphatics (drainage vessels) are left untouched.

Fenig site

Because Dr. Fenig is experienced in the microsurgical procedure that is less invasive and more precise, your recovery will be faster and you’ll experience less pain and post-surgical complications. You will recover at home and can return to normal activities and work in approximately two to five days.

Post-vasectomy pain management

Chronic pain after a vasectomy, called post-vasectomy pain syndrome, is a form of chronic testicular pain that has been attributed to congestive epididymitis, thought to be related to congestion from the backup of sperm in the epididymis. This pain affects the quality of life in 2.2 percent of men with this problem. Microsurgical denervation of the spermatic cord is one surgical treatment  Dr. Fenig performs to treat this pain. Other patients may be better served with a vasectomy reversal, conversion to an open-ended vasectomy, excision of a sperm granuloma, or epididymectomy.