Reply To: surgeons who practice preventive neurectomy
A few patients have a bulky cremasteric muscle that can make the repair of the inguinal floor difficult, in those patient I sometimes remove the cremastic muscle. If the cremasteric muscle is excise the testicle does not retract in response to cold and during intercourse.
If there is a lipoma of the spermatic cord or an indirect hernia, the cremasteric muscle can be split to get access to those structures. The cremasteric does not have to be excised.
I do not routinely cut the nerves. Once cut there is no way to be sure that it will grow back.
Bill Brown MD