Does surgery have a role in management of chronic intrascrotal pain?

To assess the role of epididymectomy in the treatment of chronic postvasectomy and epididymal pain syndrome and to identify the factors that predict the outcome.

A total of 38 patients, aged 20 to 70 years (mean 45), who had undergone epididymectomy for intractable intrascrotal pain, were identified retrospectively from the pathology records. The clinical notes were reviewed, and details on patient demographics, previous vasectomy, investigations, and histologic features were collected and analyzed. The outcome was assessed by routine outpatient clinic review and telephone interview.

Overall, 32% of patients reported resolution of symptoms after epididymectomy; 17 patients had undergone previous vasectomy, and this group was significantly more likely to have ongoing pain. Abnormal examination and ultrasound findings preoperatively did not correlate with a better outcome from surgery.

The results of our study have shown that epididymectomy has a limited role in the management of chronic intrascrotal pain.