Robotic Microsurgical Targeted Denervation of Spermatic Cord

This video shows technique of robotic microsurgical denervation of the spermatic cord. This procedure maybe useful in men with chronic groin or scrotal content pain (CGSCP). Chronic groin or scrotal content pain is defined as unilateral or bilateral, intermittent or constant pain and lasts more than 3 months. Since the symptoms can originate from the inguinal canal, spermatic cord, testis or paratesticular structures such as the epididymis the term “chronic scrotal content pain” is preferred over chronic orchialgia or testicular pain. The pain can also originate from the groin and therefore the term CGSCP is used to cover the entire disease entity. Potential etiologies of CGSCP include vasectomy, varicocele, trauma, hernia repair, and inguinal or scrotal surgery. Management of CGSCP starts with ruling out all possible causes such as ureteral stones, infection or back problems (lumbar disk hernia) with history, physical exam, and imaging. Then medical treatment such as analgesics, anti-inflammatories and anticonvulsants are started. A spermatic cord nerve block can also be attempted. If pain relief cannot be achieved with these non-invasive options, Microsurgical Denervation of Spermatic Cord is then offered as a minimally invasive surgical option. Author: Sijo Parekattil MD; Jamin Brahmbhatt MD; Ahmet Gudeloglu MD.