[Chronic testicular pain: A multidisciplinary challenge].

Area of Science:

• Urology
• Pain Management
• Surgical Innovation

Background:

• Chronic testicular pain accounts for up to 5% of urology consultations.
• Identifying an organic cause allows targeted treatment in 50-75% of cases.
• Chronic idiopathic orchialgia requires multidisciplinary management when etiology is unclear.

Purpose of the Study:

• To evaluate the effectiveness of microsurgical denervation for chronic testicular pain.
• To highlight the role of spermatic cord blocks in patient selection.

Main Methods:

• Initial diagnostic workup to identify organic causes.
• Conservative management for chronic idiopathic orchialgia.
• Spermatic cord block to confirm testicular pain origin and assess response.
• Microsurgical denervation of the spermatic cord for eligible patients.

Main Results:

• Conservative treatment is effective in only 4-15% of patients.
• Spermatic cord block provides temporary pain relief and identifies responders.
• Microsurgical denervation achieved significant pain relief in 77-100% of responders.

Conclusions:

• Microsurgical denervation is a highly effective treatment for chronic testicular pain in selected patients.
• Spermatic cord block is a valuable diagnostic tool for predicting treatment success.
• A stepwise approach, including diagnostic blocks and targeted surgery, improves outcomes for chronic testicular pain.