PMID: 19935985Nov 26, 2009Paper

Sacral nerve stimulation as a treatment modality for intractable neuropathic testicular pain

Pain Physician
Tory L McJunkinPaul J Lynch

Abstract

Chronic testicular pain, or "chronic orchalgia," is defined as testicular pain 3 months or longer in duration that significantly interferes with the daily activities of the patient. For patients failing to respond to conservative treatment, microsurgical denervation of the spermatic cord, epididymectomy, and vasovasostomy have all shown a degree of relief. However, these are all invasive procedures and no treatment has proven efficacy when these options fail. We present a case of a male who presented with over a decade of chronic right-sided testicular pain secondary to recurrent epididymitis. Before arriving at our clinic the patient had an epididymectomy performed with no appreciable improvement in pain. Initially ilioinguinal, iliohypogastric, and genetofemoral nerve blocks; right-sided S1, S2, and S3 transforaminal epidural steroid injections (TFESIs) with inferior hypogastric blocks; and right-sided T12-L1, L1-L2, and L2-L3 TFESIs all failed to provide pain relief. After conservative therapies had failed, a sacral nerve stimulation trial was done via a caudal epidural approach. The permanent implant has provided the patient with sustained 80% decrease in pain at 4 months status post permanent sacral nerve stimulation impla...Continue Reading

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