Strip or ligate the vas deferens during microscopic spermatic cord denervation for chronic scrotal content pain? a multicenter study

You have accessJournal of UrologyCME1 Apr 2023MP62-19 STRIP OR LIGATE THE VAS DEFERENS DURING MICROSCOPIC SPERMATIC CORD DENERVATION FOR CHRONIC SCROTAL CONTENT PAIN? A MULTICENTER STUDY Adnan El-Achkar, Muhammed Hammad, David Barham, Charles Loeb, Jake Miller, Lawrence Jenkins, Tung Chin Hsieh, Darshan Patel, Siriam Eleswarapu, Jesse Mills, and Faysal Yafi Adnan El-AchkarAdnan El-Achkar More articles by this author , Muhammed HammadMuhammed Hammad More articles by this author , David BarhamDavid Barham More articles by this author , Charles LoebCharles Loeb More articles by this author , Jake MillerJake Miller More articles by this author , Lawrence JenkinsLawrence Jenkins More articles by this author , Tung Chin HsiehTung Chin Hsieh More articles by this author , Darshan PatelDarshan Patel More articles by this author , Siriam EleswarapuSiriam Eleswarapu More articles by this author , Jesse MillsJesse Mills More articles by this author , and Faysal YafiFaysal Yafi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Microscopic denervation of the spermatic cord (MSCD) is an effective treatment for men with intractable scrotal content pain (SCP). For patients not interested in preserving fertility, some advocate ligation of the vas deferens during MSCD while others prefer stripping. This multicenter study sought to compare these two techniques in the aim of determining which intervention provides better pain relief. METHODS: A retrospective chart review of 59 patients who underwent MSCD for SCP (> 3 months duration, no structural abnormalities and no history of vasectomy or other scrotal surgery) from 2020-2022 was performed. Patients’ demographics including history of prior surgical procedures was recorded. Response to surgery was evaluated as either complete resolution of pain, partial resolution of pain or no improvement in pain. RESULTS: 59 patients underwent MSCD with a median age of 35 (IQR 25-37) years and median duration of pain of 18 months (IQR 12-32). 37 patients (62%) underwent stripping of the vas while 22 (38%) underwent ligation. Five patients (13%) had prior inguinal surgery in the stripping group compared to 11 (50%) in the ligation group. There was no significant difference between the groups regarding suspected etiology. There was no significant difference in response to MSCD between the 2 groups (stripping: 68% complete and 27% partial response; ligation: 82% complete, 18% partial response, p =0.36). There were no serious post-operative complications in either group (Table 1). CONCLUSIONS: In men with intractable chronic SCP with no interest in preserving fertility, ligation or stripping of the vas deferens seems to yield comparable outcomes with regards to pain resolution. Both techniques are safe with no reports of serious post-operative complications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e869 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adnan El-Achkar More articles by this author Muhammed Hammad More articles by this author David Barham More articles by this author Charles Loeb More articles by this author Jake Miller More articles by this author Lawrence Jenkins More articles by this author Tung Chin Hsieh More articles by this author Darshan Patel More articles by this author Siriam Eleswarapu More articles by this author Jesse Mills More articles by this author Faysal Yafi More articles by this author Expand All Advertisement PDF downloadLoading ...