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Having cord neurolysis in the morning. Have some questions


#1

–Hello, all. In the morning, I am having cord neurolysis to hopefully relieve nearly eight years of testicular pain. I’ve had two cord blocks, both of which were successful, but only helped with the pain for a half a day or so. I have been reading this forum and have read several horror stories about this procedure not only NOT working, but how the pain is worse. Now I am more anxious about the surgery, lol. My urologist said success rate is right at 90%, but now I question that. He did say if this procedure does not work, a bilateral orchiectomy could be scheduled, but I don’t want to think too much about losing my testicles. Can you guys that have had cord neurolysis performed please let me know if your pain got worse, better, or no change? If it didn’t help, or got worse, did you have bilateral orchiectomy, and did it help or no? When the Urologist mentioned having my testicles potentially removed, it wasn’t until I left his office and sat down in the pickup it “sunk in” how traumatic that could be. Thanks for your help.


#2

Hey 2010,

What led to your pain initially?

You are correct in your observation that we’ve not seen much success with that procedure here.

Why would he suggest bilateral removal? That makes little sense based on what you posted.


#3

Hi. I have no idea what led to me having the pain. The pain just sort of slowly appeared years ago. I know this site is about post vasectomy pain, but I have not had a vasectomy. I posted in this forum because so many guys seem to have testicle and/or groin pain. I guess I didn’t know where else to turn, especially the day before the surgery, lol. I have no idea why the Urologist suggested what he suggested, and I guess I figured he knew what he was talking about. I really hope the neurolysis works…am sick of always hurting, and sick of having to rely on pain meds that only partially work. Thanks for replying.

Edit:. A year or two ago, I had a varicocelectomy on the left side. I thought that would help with the pain, but it didn’t. Also, a scrotal ultrasound was performed (after the varicocelectomy), but nothing was found that would cause pain to the testicles.


#4

No worries. I figured your pain might be idiopathic. Is it in one or both testicles?


#5

It’s in both, but the left one hurts a bit more than the right one.


#6

That’s really curious it’s bilateral. My pain is mostly confined to my cords where I was cut and burned and mostly on the left. I dont have testicular pain but can imagine that’s tough. Are u getting neurolysis only on the left?


#7

No, it is going to be on both sides.


#8

We’re you warned that neurolysis could make you worse?


#9

@painsince2010 I dont have a useful opinion on the neurolysis, but i can comment on your decision to post. This site is open to any person that needs help with testicular pain whether traumatic or idiopathic. As treatment plans tend to be similar, I welcome any dialogue. I would say if your doctor hasn’t prepared you that things could get worse, i would have a detailed conversation tomorrow with him before the procedure. Make sure you have a support system with you, wife, sibling, child, etc so they can help you make sense of what he’s saying. Keep a pen and paper handy tonight and anytime you think of a question, write it down, and present it to them tomorrow before they give you any anti anxiety medicines in preop. Make sure you are comfortable with proceeding and have all questions answered before they give you any medicine. Almost always, people forget everything they want to ask when put on the spot. Keep us posted. Good luck man.


#10

Hi. No, I wasn’t told about the pain potentially becoming worse, only that there was a 90% success rate. Hopefully, that won’t be an issue.


#11

Thanks. I don’t really know what to ask the Dr. tomorrow, but I sure will try to think of something.


#12

Can you tell us who’s doing your surgery or where it’s being done?


#13

A doctor in Paris, TX.


#14

Did you have a cord block first as a diagnostic?

Either way, people on this forum here are down on denervation because it seems to have a lower success rate with men who have damaged nerves from vasectomy. The running theory is that it works better for men like you with idiopathic pain.

That said, I still may roll the dice if some other trials don’t work.

Thanks for coming here. I certainly wish you the best.


#15

Thanks. Yes, I have had two cord blocks. One fairly recently, and the first one was several years ago.


#16

It is unusual that u r getting both sides done at once. I think for neurolysis that’s the first I’ve ever seen that done like that. Usually it’s one side at a time to see if it helps.


#17

It’s weird how denervation has such high success rates in the literature…yet it’s a total roll of the dice for PVPS guys it seems. It’s also weird how we hear of guys getting worse one this forum, yet most (maybe all) of the denervation papers say ‘no one got worse.’

If there’s one thing I’ve noticed, it’s that every single denervation paper includes idiopathic or infectious chronic scrotal pain patients with PVPS patients in the success rates.

I have only found ONE article about denervation that specifically targets PVPS patients

…and it’s only 17 patients with a 76.5% success rate, with presumably a short-term follow up. That’s hardly a good sample size.

This layman’s theory on denervation and PVPS is that most of us have suffered some sort of nerve injury/damage and further damaging nerves is less likely to help due to either centralization or I don’t know. Just a thought.

I think the OP has much higher chances of success.


#18

I’m back. Still kind of hard to move about, but feeling better. I can’t tell the surgery is going to help me or not as I still have similar pain, but it might just be the pain from the two incisions, and the bruising. I have a follow-up in three to four weeks (I not made the appointment for the follow-up, but Monday I will). Not feeling worse, fortunately, and no numbness.


#19

Thanks for the update and please keep us posted. Good that you’re not worse. Always tough to tell so close to the surgery date because of the pain the surgery itself can cause.

There’s a lot of skepticism on SCD on this forum, rightly or wrongly. The more feedback we can get, pro or con, is very helpful and appreciated.

I’m undergoing RF ablation of my GF nerve in a few weeks under the idea that it’s less invasive even if only a temporary fix. To my knowledge, no one has reported on RF ablation here, just cryo ablation. I plan to post my experiences, good or bad, to contribute to the group’s knowledge.


#20

Thanks for coming back. Please keep us updated as to your progress.