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The Journal of Urology Feb 1990
Review
Topics: Humans; Infant, Newborn; Male; Orchiectomy; Scrotum; Spermatic Cord; Spermatic Cord Torsion
PubMed: 2405183
DOI: 10.1016/s0022-5347(17)39919-6 -
Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis.Pediatric Radiology Jul 2002Although the primary abnormality in testicular torsion is at the spermatic cord, imaging studies up to now have mostly been oriented to evaluation of the testicle... (Clinical Trial)
Clinical Trial
BACKGROUND
Although the primary abnormality in testicular torsion is at the spermatic cord, imaging studies up to now have mostly been oriented to evaluation of the testicle itself, with emphasis on color Doppler ultrasonography (US). However, findings can be inaccurate when there is incomplete interruption of testicular flow. Indirect findings, such as morphological changes in the testis alone, are not reliable for the diagnosis since they become evident late in the disease.
OBJECTIVE
To call to attention to the fact that sonographic visualization of the spermatic cord can be the key for diagnosis in those patients with acute scrotal pain as a result of testicular torsion, particularly when color Doppler US shows that intratesticular flow is present within the affected testis.
PATIENTS AND METHODS
Six patients who presented clinically with acute scrotal pain and had spermatic cord torsion, proven at surgery. All patients were initially studied with color Doppler US, and intratesticular flow was detected in all of them. Patients who showed structural abnormalities on gray-scale US and/or absence of intratesticular vascular flow in the affected testis were not included. In addition to a conventional study, the spermatic cord was examined.
RESULTS
The spermatic cord was shown to be rotated on the symptomatic side in all patients. Local morphological and vascular flow changes, distal and at the site of the torsion, were found and registered.
CONCLUSIONS
The finding of a rotated spermatic cord could be a highly reliable and direct sign for the diagnosis of a testicular torsion, and this is especially important when vascular flow is present within the affected testis on color Doppler US examination. Examination of the spermatic cord should be added to evaluation of the testis in patients with suspected testicular torsion to enhance sensitivity of the examination.
Topics: Acute Disease; Adolescent; Adult; Child; Humans; Male; Pelvic Pain; Rotation; Spermatic Cord; Spermatic Cord Torsion; Torsion Abnormality; Ultrasonography, Doppler, Color
PubMed: 12107581
DOI: 10.1007/s00247-002-0701-z -
Acta Haematologica 1994Primary lymphomas of the spermatic cord (LSC) are rare and have only been described in 10 cases in the literature. The present study is a review of the... (Review)
Review
Primary lymphomas of the spermatic cord (LSC) are rare and have only been described in 10 cases in the literature. The present study is a review of the clinicopathological features of LSC described in the cases reported in the literature and presents a new case. LSC is a tumour affecting middle-aged men and is frequently misdiagnosed as an inguino-scrotal hernia. It is often of high malignancy grade. Stage I LSC has a poor prognosis when treated only locally.
Topics: Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Diagnosis, Differential; Fatal Outcome; Genital Neoplasms, Male; Hernia, Inguinal; Humans; Lymphatic Metastasis; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neoplasm Staging; Radiotherapy Dosage; Spermatic Cord
PubMed: 8023646
DOI: 10.1159/000204256 -
The Journal of Sexual Medicine Mar 2013Microdenervation of the spermatic cord (MDSC) has been demonstrated to be an effective treatment for men with intractable scrotal content pain.
INTRODUCTION
Microdenervation of the spermatic cord (MDSC) has been demonstrated to be an effective treatment for men with intractable scrotal content pain.
AIM
This study evaluates the correlation between a positive response to a spermatic cord block with local anesthetic and the subsequent surgical outcome following MDSC.
MAIN OUTCOME MEASURES
Pre- and post-cord block pain and pre- and post-MDSC pain.
METHODS
A retrospective review of 74 patients (77 testicular units) who underwent MDSC from 2006 to 2010 was performed. Pre- and post-spermatic cord block pain scores based on a 0-10 visual analog scale (VAS) were compared with pre- and post-MDSC pain scores. A positive response to the block was defined as greater than or equal to 50% temporary reduction of pain based on VAS.
RESULTS
The average patient age was 42 years with a mean follow-up of 10 months. The mean duration of symptoms before surgery was 69 months. Mean pre-cord block pain score was 8 with an 89% average decrease in pain following the block. Mean post-MDSC pain score was 2 with an average decrease of 73%. The level of temporary improvement from the cord block appeared to be a useful predictor of sustained improvement with MDSC (P = 0.05). Positive response to spermatic cord block was an independent predictor of MDSC response (P = 0.03).
CONCLUSIONS
Men with chronic orchialgia who have a positive response to a spermatic cord block are likely to have durable and complete resolution of symptoms after undergoing MDSC. The amount of pain relief obtained after the cord block correlates with pain relief after undergoing a MDSC. Men with chronic orchialgia who desire surgical correction should undergo a preoperative spermatic cord block as part of their complete evaluation. The result of the cord block can help guide the practitioner and the patient toward definitive surgical management via MDSC.
Topics: Adolescent; Adult; Aged; Anesthetics, Local; Denervation; Follow-Up Studies; Humans; Linear Models; Male; Middle Aged; Nerve Block; Pain Measurement; Pain, Intractable; Retrospective Studies; Spermatic Cord; Testicular Diseases; Young Adult
PubMed: 23016953
DOI: 10.1111/j.1743-6109.2012.02937.x -
Journal of the College of Physicians... Apr 2022Paratesticular liposarcoma (PLS) is a rare type of genitourinary malignancy in the spermatic cord presenting as scrotal swelling. In this case study, we report an...
Paratesticular liposarcoma (PLS) is a rare type of genitourinary malignancy in the spermatic cord presenting as scrotal swelling. In this case study, we report an 82-year male who presented with prolonged left scrotal swelling and pain that did not respond to analgesic treatment for one week. His ultrasound confirmed increased fluid content in the left scrotal compartment in the form of septated hydrocele, and hydrocelectomy was planned. During the operation, infected fluid was drained. The testicle and surrounding tissues were infected; hence, left orchiectomy was performed. The pathological examination revealed a dedifferentiated liposarcoma. To our knowledge, this is the first report of liposarcoma of the spermatic cord with hydrocele in the literature. Key Words: Liposarcoma, Spermatic cord, Scrotal swelling, Hydrocele.
Topics: Genital Neoplasms, Male; Humans; Liposarcoma; Male; Orchiectomy; Scrotum; Spermatic Cord
PubMed: 35632994
DOI: 10.29271/jcpsp.2022.Supp1.S1 -
The Journal of Urology Feb 2013Microdenervation of the spermatic cord is an effective treatment for men with intractable scrotal content pain. We evaluated a single center experience, analyzing...
PURPOSE
Microdenervation of the spermatic cord is an effective treatment for men with intractable scrotal content pain. We evaluated a single center experience, analyzing patients in whom prior surgical attempts had failed to correct pain who subsequently underwent microdenervation of the spermatic cord.
MATERIALS AND METHODS
A retrospective chart review of 68 patients who underwent microdenervation of the spermatic cord from 2006 to 2010 was performed. Prior ipsilateral surgical procedures with the intent to correct scrotal content pain were selected, identifying 31 testicular units.
RESULTS
Chart review was performed on 68 men with mean age of 42 years at presentation and a mean followup of 10 months. Patients in whom prior surgical correction had failed and who subsequently had microdenervation of the spermatic cord had a mean postoperative pain score of 3 (range 0 to 10) with an average decrease in pain of 67%. Those who had not undergone a prior attempt at surgical correction had a mean post-microdenervation of the spermatic cord pain score of 2 (range 0 to 10) and an average pain decrease of 79% which did not differ statistically from those in whom prior surgery failed. In addition, 50% of men who had undergone surgery before microdenervation of the spermatic cord had complete relief of pain after microdenervation of the spermatic cord vs 64% of those who had not undergone previous surgery.
CONCLUSIONS
Men with chronic scrotal content pain in whom prior attempts to correct pain have failed have similar, albeit lower, success rates as those without prior surgical intervention. Therefore, men with chronic scrotal content pain in whom prior surgical management has failed and who have a positive spermatic cord block should be considered candidates for microdenervation of the spermatic cord.
Topics: Adolescent; Adult; Aged; Algorithms; Chronic Pain; Denervation; Genital Diseases, Male; Humans; Male; Microsurgery; Middle Aged; Remission Induction; Retrospective Studies; Scrotum; Spermatic Cord; Testicular Diseases; Urologic Surgical Procedures, Male; Young Adult
PubMed: 23260554
DOI: 10.1016/j.juro.2012.09.026 -
Urology Aug 2019To assesses the efficacy of ultrasound-guided targeted cryoablation (UTC) of the perispermatic cord as a salvage treatment for patients who failed microsurgical...
Salvage Ultrasound-guided Targeted Cryoablation of The Perispermatic Cord For Persistent Chronic Scrotal Content Pain After Microsurgical Denervation Of The Spermatic Cord.
OBJECTIVE
To assesses the efficacy of ultrasound-guided targeted cryoablation (UTC) of the perispermatic cord as a salvage treatment for patients who failed microsurgical denervation of the spermatic cord.
METHODS
Retrospective review of 279 cases (221 patients: 58 bilateral) undergoing UTC between November 2012 and July 2016, performed by 2 fellowship trained microsurgeons. UTC was performed using a 16-gauge cryo needle (Endocare, HealthTronics, Austin, TX). Branches of the genitofemoral, ilioinguinal, and inferior hypogastric nerves were cryoablated medial and lateral to the spermatic cord at the level of the external inguinal ring. Level of pain was measured preoperatively and postoperatively using the visual analog scale and Pain Index Questionnaire-6 (QualityMetric Inc., Lincoln, RI).
RESULTS
Median age was 43 years, operative duration 20 minutes, and postoperative follow-up 36 months (24-60). Subjective visual analog scale outcomes: 75% significant reduction in ain (11% complete resolution and 64% ≥50% reduction in pain). Objective Pain Index Questionnaire-6 outcomes: 53% significant reduction at 1 month (279 cases), 55% at 3 month (279 cases), 60% at 6 month (279 cases), 63% at 1 year (279 cases), 65% at 2 years (275 cases), 64% at 3 years (232 cases), 59% at 4 years (128 cases) and 64% at 5 years (53 cases) post-op.
COMPLICATIONS
2 wound infections, 4 penile pain cases (resolved in a few months).
CONCLUSION
UTC of the perispermatic cord is a safe potential treatment option for the salvage management of persistent chronic scrotal pain in patients who have failed microsurgical denervation of the spermatic cord.
Topics: Adult; Chronic Pain; Cryosurgery; Denervation; Genital Diseases, Male; Humans; Male; Microsurgery; Pelvic Pain; Postoperative Complications; Retrospective Studies; Salvage Therapy; Scrotum; Spermatic Cord; Surgery, Computer-Assisted; Treatment Outcome; Ultrasonography, Interventional
PubMed: 31063763
DOI: 10.1016/j.urology.2019.04.027 -
The Journal of Urology Jan 1984We review 3 cases of spermatic cord liposarcoma that have been followed for 12 months to 5 years after diagnosis. Inguinal orchiectomy rendered adequate treatment....
We review 3 cases of spermatic cord liposarcoma that have been followed for 12 months to 5 years after diagnosis. Inguinal orchiectomy rendered adequate treatment. Preoperative diagnosis of liposarcoma of the spermatic cord is unusual although gray scale sonography may be of some assistance. A review of the literature reveals that adjunctive medical or surgical treatment appears to be superfluous.
Topics: Adult; Aged; Castration; Genital Neoplasms, Male; Humans; Liposarcoma; Male; Middle Aged; Spermatic Cord
PubMed: 6690750
DOI: 10.1016/s0022-5347(17)50205-0 -
BJU International May 2014To describe a microsurgical technique for denervation of the spermatic cord and use of multiphoton microscopy (MPM) laser to identify and ablate residual nerves after...
OBJECTIVE
To describe a microsurgical technique for denervation of the spermatic cord and use of multiphoton microscopy (MPM) laser to identify and ablate residual nerves after microsurgical denervation. To evaluate structural and functional changes in the rat testis and vas deferens after denervation.
MATERIALS AND METHODS
Nine Sprague-Dawley rats were divided into three experimental groups: sham, microsurgical denervation of the spermatic cord (MDSC), and MDSC immediately followed by laser ablation with MPM. At 2 months after surgery, we assessed testicular volume, functional circulation of the testicular artery with Doppler, patency of the vas deferens, and histology of the testis and vas deferens.
RESULTS
There was a significant decrease in the median number of nerves remaining around the vas deferens with MDSC alone (3.5 nerves) or MDSC with MPM (1.5 nerves) compared with sham rats (15.5 nerves) (P = 0.003). Although, MDSC with MPM resulted in the fewest remaining nerves, this result was similar to MDSC alone (P = 0.29). No deleterious effects on spermatogenesis or vas patency were seen in the experimental groups when compared with the sham rats.
CONCLUSION
A microsurgical approach can be used to effectively and safely denervate the rat spermatic cord with minimal changes to structure and function of the testis and vas deferens. MPM can be used as an adjunct to identify and ablate residual nerves after MDSC.
Topics: Animals; Denervation; Disease Models, Animal; Laser-Doppler Flowmetry; Male; Microscopy, Confocal; Microsurgery; Pain; Pain Measurement; Rats; Rats, Sprague-Dawley; Regional Blood Flow; Spermatic Cord; Testicular Diseases; Treatment Outcome
PubMed: 24053156
DOI: 10.1111/bju.12421 -
Nigerian Journal of Clinical Practice Sep 2017Torsion of the spermatic cord may lead to loss of the testis when presentation is delayed. In our environment, a high premium is placed on the male child and his ability...
Torsion of the spermatic cord may lead to loss of the testis when presentation is delayed. In our environment, a high premium is placed on the male child and his ability to procreate. Hence, torsion of the spermatic cord is a true surgical emergency. Here, we report a case of torsion of the spermatic cord in a 19-year-old student that exemplifies early presentation and short presentation-detorsion time. Immediately after the operation, the clinical information in the patient's case file was summarized. A literature search was conducted on the subject matter, and the findings were compared with those of the present patient. The determinants of outcome include presentation time and the time between presentation and operation. Unfortunately, in many series, late presentation is still the norm. In the index patient, the presentation time was very short. In our environment, patients with torsion of the spermatic cord can present early and be operated promptly if we can provide public health education, mobile phones, commercial taxis, and good road networks.
Topics: Emergencies; Humans; Male; Orchiopexy; Spermatic Cord; Spermatic Cord Torsion; Testis; Time Factors; Young Adult
PubMed: 29072248
DOI: 10.4103/njcp.njcp_358_16