Standard vs Targeted Microsurgical Denervation of Spermatic Cord for Chronic Orchialgia: A Prospective Comparative Study.

OBJECTIVE

To prospectively compare the safety and efficacy of standard vs targeted MDSC in patients with chronic orchialgia.

METHODS

A prospective non-randomized comparative study including patients with unilateral idiopathic testicular pain persisting for more than 3 months and unresponsive to conservative treatment. Sixty patients were allocated into equal two groups; group 1 (No = 30) underwent standard MDSC, and group 2 (No = 30) underwent targeted MDSC. Pain was assessed using the visual analog scale (VAS) preoperatively and at 1 week, 1 month, 6 months, and 12 months postoperatively. Primary outcomes included pain relief (complete, partial, or failure) and perioperative complications.

RESULTS

Fifty patients completed the follow-up (27 in group 1 and 23 in group 2). Both groups showed significant improvement in VAS scores at all postoperative intervals compared to baseline (P < .001). Complete pain relief was achieved in 74.1% of patients in group 1% and 60.9% in group 2, while partial pain relief was reported in 18.5% and 26.1%, respectively. Minor postoperative complications occurred in four patients, without significant intergroup differences.

CONCLUSION

Targeted MDSC offers similar efficacy for the management of patients with idiopathic chronic orchialgia with potentially reduced risk to spermatic cord microstructures.