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Dr. Towfigh – Neurectomy
Good morning Doctor, and thank you for the reply.
The procedure that was done was a spermatic cord denervation, although my urologist did not use a microscope to perform the procedure.. He claimed it was not necessary to use a microscope.
I underwent the procedure to deal with some testicular pain I had been experiencing. A little over 10 years ago when I was in my late teens, I had epididymitis due to infection. I treated the infection with antibiotics, however I always experienced some residual testicular pain with activities. My urologist told me that the cord stripping procedure would alleviate this pain, so I agreed to it. I have never had a vasectomy or any other type of groin surgery.
The incision was made low in the groin, just above the pubic tubercle. There was no incision made in the scrotum. Here is operation report, if this helps:
“”The patient was given a general anesthetic and placed in the supine position where he was prepped with Betadine and draped in sterile fashion. A transverse right inguinal incision was made just above the pubic tubercle and the right spermatic cord was identified just below the external inguinal ring. A Penrose was placed under the spermatic cord. Electrocautery was used to divide internal spermatic fascia and cremasteric muscle fibers in a circumferential fashion. Smaller spermatic veins were ligated with silk and divided. Care was taken to avoid damage to the vas deferens and vasal artery and to a moderate-sized internal spermatic vein. Scarpa’s fascia was closed with interrupted 3-0 Vicryl suture. Skin edges were reapproximated with running subcuticular 3-0 Monocryl. A total of 8 mL of 0.25% plain Marcaine was used for local anethesia. Dermabond was placed in the incision. The patient tolerated the procedure well. He was awakened from anethesia and transported to the recovery room in stable condition.”
The pain, from my perspective, seems to be in the distribution of the genital branch of the genitofemoral nerve. I do have skin hypersensitivity and burning pain on the lateral edge of the scrotal skin. I believe I have this on the upper inner thigh as well. Physical activity does increase the pain and discomfort. When I first wake up in the morning, there is not too much discomfort. But as soon as I start moving around, the pain starts and persists throughout the day. Sitting is also very uncomfortable.
I had the surgery back on April 20. When I initially began experiencing the symptoms (about two weeks after surgery), I did go back to my urologist to let him know what was going on. He said that the symptoms were just typical recovery symptoms and that I had nothing to worry about. The symptoms continued intensifying though, so I went to a different doctor (pain management physician) who diagnosed the condition as genitofemoral neuralgia. In doing my own research, my symptoms seem to correlate with this condition.
I no longer have the testicular pain that I had before the surgery. The symptoms I have now are all new and were not experienced prior to the operation.
Please let me know if I can provide additional info, Doctor, and thank you so much for taking the time to answer my questions.
