MP89-20 TARGETED ROBOTIC ASSISTED MICROSURGICAL DENERVATION OF THE SPERMATIC CORD FOR THE TREATMENT OF CHRONIC SCROTAL CONTENT PAIN: SINGLE CENTER, LARGE SERIES REVIEW.

Abstract

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2017MP89-20 TARGETED ROBOTIC ASSISTED MICROSURGICAL DENERVATION OF THE SPERMATIC CORD FOR THE TREATMENT OF CHRONIC SCROTAL CONTENT PAIN: SINGLE CENTER, LARGE SERIES REVIEW. Nahomy Calixte, Bayo Tojuola, Ibrahim Kartal, Ahmet Gudeloglu, Jamin Brahmbhatt, and Sijo Parekattil Nahomy CalixteNahomy Calixte More articles by this author , Bayo TojuolaBayo Tojuola More articles by this author , Ibrahim KartalIbrahim Kartal More articles by this author , Ahmet GudelogluAhmet Gudeloglu More articles by this author , Jamin BrahmbhattJamin Brahmbhatt More articles by this author , and Sijo ParekattilSijo Parekattil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2818AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Microsurgical denervation of the spermatic cord (MDSC) is a treatment option for chronic scrotal content pain that is unresponsive to conservative treatments. A recent study has shown specific nerve fiber abnormalities (Wallerian degeneration) in the cord as a potential cause for this pain. Our goal was to assess outcomes of a more targeted technique in ablating only these abnormal nerves when performing MDSC: targeted robotic assisted microsurgical denervation of the spermatic cord (RMDSC). METHODS Retrospective review of 772 patients who underwent RMDSC by two fellowship trained microsurgeons from October 2008 to July 2016. Selection criteria were as follows: chronic testicular pain (>3 months), failed standard pain management treatments and negative urologic workup. Targeted ligation of tissues containing the trifecta location of nerves with Wallerian degeneration was performed: the cremasteric muscle fibers, the peri-vasal sheath and the posterior spermatic cord lipomatous tissues. The primary outcome measure was level of pain. Pain was assessed preoperatively and postoperatively using two assessment tools: a) the subjective visual analog scale (VAS) and b) an objective standardized externally validated pain assessment tool (PIQ-6, QualityMetric Inc., Lincoln, RI). RESULTS Median age was 41 years. Median operative duration (robot console time) was 20 minutes (15-80). Median follow up was 24 months. Subjective VAS patient pain outcomes: 84% significant reduction in pain (50% complete resolution – 425 patients, 34% reported a greater than 50% reduction in pain – 291 patients). Objective PIQ-6 outcomes: significant reduction in pain in 67% of patients at 6 months and 68% at 1 year post-op. CONCLUSIONS Targeted robotic assisted microsurgical denervation of the spermatic cord is a safe and viable treatment option for patients with chronic scrotal content pain refractory to conservative measures. Further studies are warranted. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1209 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Nahomy Calixte More articles by this author Bayo Tojuola More articles by this author Ibrahim Kartal More articles by this author Ahmet Gudeloglu More articles by this author Jamin Brahmbhatt More articles by this author Sijo Parekattil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...