The use of microsurgical denervation of the spermatic cord for orchialgia

Orchialgia is a term that can only lead to confusion with regard to symptoms and etiology of the symptoms. It implies testicular discomfort or testicular pain that is intrascrotal. Testicular pain per se probably is appreciated in the lower abdomen and internal ring and not in the testicular body. Therefore, true orchialgia, namely testicular pain of unknown etiology, would be more appropriately described as lower abdominal pain (in the absence of any inflammatory ailments), which is worsened by testicular pressure or palpation. Treatment of the patient with orchialgia has been a difficult and often unrewarding clinical situation. Return to gainful activity without significant use of analgesics is the desired goal. Microsurgical testicular denervation has been used in 2 patients in an effort to achieve this goal without sacrifice of the testes.