MP31-11 WHAT IS THE PREDICTIVE VALUE OF A SPERMATIC CORD BLOCK PRIOR TO TARGETED MICROSURGICAL DENERVATION OF THE SPERMATIC CORD?

Abstract

You have accessJournal of UrologyInfertility: Therapy (MP31)1 Sep 2021MP31-11 WHAT IS THE PREDICTIVE VALUE OF A SPERMATIC CORD BLOCK PRIOR TO TARGETED MICROSURGICAL DENERVATION OF THE SPERMATIC CORD? Sijo Parekattil, Ahmet Gudeloglu, Onuralp Ergun, Alex Galante, Mohammed Etafy, and Richard Mendelson Sijo ParekattilSijo Parekattil More articles by this author , Ahmet GudelogluAhmet Gudeloglu More articles by this author , Onuralp ErgunOnuralp Ergun More articles by this author , Alex GalanteAlex Galante More articles by this author , Mohammed EtafyMohammed Etafy More articles by this author , and Richard MendelsonRichard Mendelson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002035.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Targeted microsurgical denervation of the spermatic cord (TMDSC) has been shown to be a treatment option for men with intractable orchialgia/scrotal content pain. The standard of care is to perform a spermatic cord block to assess if there is any temporary relief in the pain prior to performing TMDSC. This study assesses the predictive value of a spermatic cord block (SCB) with local anesthetic in determining post-TMDSC outcomes. METHODS: A retrospective review of 1387 TMDSC cases (1220 patients, 167 bilateral cases) from October 2008 to February 2021 was performed. An analysis of how the patients who had temporary relief in their pain (greater than 50% reduction) after a spermatic cord block correlated to their final outcome after TMDSC was performed. The outcome after TMDSC was graded as complete relief (CR) in pain, greater than 50% reduction in pain (PR) or no response (NR), defined as <50% reduction in pain. This outcome was based on preop and post-op measurements of pain using a validated quality of life metric (COSI & PIQ-6) and the visual analogue pain score (VAS). RESULTS: The positive predictive value (PPV) of a patient having a response to SCB and then achieving CR or PR was 87%, and achieving CR alone was 40%. The negative predictive value (NPV) of a patient who did not have any relief with SCB, and then achieving NR after TMDSC was 52%. CONCLUSIONS: This study illustrates that if a patient has no response to SCB, TMDSC is less likely to help reduce pain in these patients. However, a positive response to SCB confers a high likelihood of significant reduction in pain after TMDSC. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e559-e559 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sijo Parekattil More articles by this author Ahmet Gudeloglu More articles by this author Onuralp Ergun More articles by this author Alex Galante More articles by this author Mohammed Etafy More articles by this author Richard Mendelson More articles by this author Expand All Advertisement Loading ...