Rush University Medical Center, Chicago, Illinois.
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
J Urol. 2021 Sep;206(3):725-732. doi: 10.1097/JU.0000000000001777. Epub 2021 Apr 19.
The primary aim of our study was to evaluate relief of chronic scrotal content pain after a series of spermatic cord blocks with a combination of local anesthetic and a steroid. Secondary aims were to assess factors associated with a positive response and complications.
We performed a retrospective chart review of patients who underwent spermatic cord block series for chronic scrotal content pain at our practice between 2012 and 2019. Pain scores were compared before and after treatment using an 11-point numerical pain rating scale. We performed univariate analysis to assess differences between responders and nonresponders, and the relationship between symptom duration and response was analyzed by rank-order correlation.
We included 44 men with chronic scrotal content pain present for a median duration of 24 months who underwent a spermatic cord block series. At a median followup of 16 months, 31 patients (70.5%) experienced sustained relief, including 9 patients (20.5%) with complete resolution of pain. There were no differences between responders and nonresponders in terms of symptom duration, perceived etiology, or previous treatments, and there was no association between response and duration of pain. Minor complications occurred in 5 cases (11.4%).
Spermatic cord block series is a safe, minimally invasive treatment for men with refractory chronic scrotal content pain. Response to cord block series appears to be independent of symptom duration, perceived etiology or prior medical and surgical treatments. Future studies should be conducted to evaluate long-term durability and predictors of success.
我们研究的主要目的是评估一系列精索阻滞联合局麻药和类固醇治疗慢性阴囊内容物疼痛的缓解效果。次要目的是评估与阳性反应和并发症相关的因素。
我们对 2012 年至 2019 年在我们诊所接受精索阻滞系列治疗的慢性阴囊内容物疼痛患者进行了回顾性图表审查。治疗前后使用 11 分数字疼痛评分量表比较疼痛评分。我们进行了单变量分析，以评估应答者和无应答者之间的差异，并通过秩相关分析评估症状持续时间与反应之间的关系。
我们纳入了 44 名慢性阴囊内容物疼痛持续时间中位数为 24 个月的男性患者，他们接受了精索阻滞系列治疗。在中位数为 16 个月的随访中，31 名患者（70.5%）持续缓解，其中 9 名患者（20.5%）疼痛完全缓解。应答者和无应答者在症状持续时间、感知病因或既往治疗方面无差异，且反应与疼痛持续时间之间无关联。5 例（11.4%）出现轻微并发症。
精索阻滞系列是治疗难治性慢性阴囊内容物疼痛男性患者的一种安全、微创的治疗方法。对精索阻滞系列的反应似乎与症状持续时间、感知病因或既往的医疗和手术治疗无关。未来的研究应评估长期耐久性和成功的预测因素。
