Department of Urology, Rush University Medical Center, Chicago, IL, USA.
Department of Urology, Rush University Medical Center, Chicago, IL, USA.
Sex Med Rev. 2018 Apr;6(2):328-334. doi: 10.1016/j.sxmr.2017.06.002. Epub 2017 Jul 21.
Post-vasectomy pain syndrome (PVPS) is a challenging problem for the practicing urologist because of its unclear pathophysiology and no clearly established protocol for evaluation or treatment. PVPS is defined as at least 3 months of chronic or intermittent scrotal content pain after a vasectomy procedure once other etiologies for the pain have been ruled out.
To systematically review the current literature on the effectiveness of micro-denervation of the spermatic cord (MDSC) for PVPS.
A systematic literature search using PubMed, Scopus, Medline, Embase, and Cochrane databases for all reports pertaining to PVPS using the Medical Subject Heading terms post vasectomy pain syndrome and micro-denervation of spermatic cord through February 2017.
Scrotal content pain after MDSC for PVPS.
There were nine retrospective studies evaluating MDSC for chronic testicular pain. After omitting repeated series, there were 213 patients who underwent MDSC for chronic orchialgia. Only one study specifically reviewed the outcomes of patients who underwent MDSC for PVPS. In this study, 17 patients underwent MSDC for PVPS, with 13 (76.5%) reporting complete relief of pain at their first follow-up visit. The other four patients had significant improvement in pain and were satisfied with the results. Long-term follow-up data were not available for this study.
MDSC remains a valuable approach with high success rates and should be considered for PVPS that is refractory to medical therapy. MDSC appears to have the most success for patients who experience a temporary relief from a cord block and can significantly improve the patient's quality of life and ability to return to daily activities. Tan WP, Levine LA. Micro-Denervation of the Spermatic Cord for Post-Vasectomy Pain Management. Sex Med Rev 2018;6:328-334.
输精管结扎术后疼痛综合征（PVPS）是临床泌尿科医生面临的一个棘手问题，因为其发病机制尚不清楚，也没有明确的评估或治疗方案。PVPS 被定义为输精管结扎术后至少 3 个月的慢性或间歇性阴囊内容物疼痛，且已排除其他病因引起的疼痛。
系统回顾目前关于精索微神经切断术（MDSC）治疗 PVPS 有效性的文献。
通过 PubMed、Scopus、Medline、Embase 和 Cochrane 数据库系统检索了所有关于使用精索微神经切断术治疗 PVPS 的文献，检索词为“post vasectomy pain syndrome”和“micro-denervation of spermatic cord”，检索时间截至 2017 年 2 月。
MDSC 治疗 PVPS 后阴囊内容物疼痛。
有 9 项回顾性研究评估了 MDSC 治疗慢性睾丸疼痛。剔除重复系列研究后，共有 213 例慢性精索疼痛患者接受了 MDSC 治疗。只有一项研究专门回顾了精索微神经切断术治疗 PVPS 的结果。在这项研究中，17 例患者因 PVPS 接受 MDSC 治疗，13 例（76.5%）患者在首次随访时疼痛完全缓解。其余 4 例患者疼痛明显改善，对结果满意。该研究未提供长期随访数据。
MDSC 仍然是一种有效的方法，成功率高，对于药物治疗无效的 PVPS 应考虑采用。对于那些因精索阻滞而暂时缓解疼痛的患者，MDSC 似乎最有效，并能显著提高患者的生活质量和恢复日常活动的能力。
