Donate

Please ask questions before Denervation


#21

This is a great post. I brought these points up to Dr. Jarvi a couple weeks ago when he gave the option of denervation and/or removal.

He said something to the effect of 85% being ‘creative writing’ and the numbers were more like 70% get improvement, but they were all short term follow up. They just don’t know what happens when/if the nerves grow back.

He said he’s done denervations on patients where it’s successful on one side, yet does nothing on the other, and they just don’t know why.

He also said Levine in Chicago was a good authority on denervations and research papers.


#22

Keep on mind that neurolysis is Dr P’s version of de-nervation.

It isn’t to be confused with traditional de-nervation, AKA cord stripping (microsurgical de-nervation of the spermatic cord).

Neurolysis, and cord stripping are two completely different animals.


#23

Wait, what, really? I thought the only difference was that Dr. P’s was ‘robotic’


#24

Nope, sorry brother.


#25

And yes, neurolysis is done with the davinci robot.


#26

For those that might be curious if a man can have both traditional de-nervation (cord stripping) and neurolysis?

My answer is, I don’t know. If I had to guess, my answer would be no, but Idk.

I have seen a guy openly contemplate the idea. He had traditional de-nervation first, and it wasn’t much help. He was considering having neurolysis several years after the fact, but I don’t recall him ever doing it. There was likely a reason for that, but once again, idk.

I’ve never seen anyone openly contemplate the idea since, and I suppose this idea could be contemplated in reverse order.


#27

Any place we can get definitions of both with an explanation of the differences? I think many of us were using these as synonyms. I also think that neurolysis may be a broader term for any procedure that interrupts signal transfer along a nerve. So, I THINK (but am not sure) that denervation, cord stripping, and ablation are all forms of neurolysis. That said, I’m VERY open to being corrected and learning.


#28

Far as I always understood things, Dr P named his procedure “targeted neurolysis”. This wasn’t a maybe, or an assumption, I’d say it’s a fact.

When I became the next victim in 2010, and began posting on Yahoo vas pain forum, there had only been several hundred targeted neurolysis procedures done to date then. All of them were done via Dr P, and/or B.

I could give a layman’s example of what is different about traditional de-nervation, vs neurolysis, but I don’t want to spread the slightest bit of misinformation about the differences between cord stripping, and neurolysis.

It is a major difference, and I already hit on that in the pur clinic thread.


#29

I’m not sure about this.

I wouldn’t be the slightest bit surprised if “targeted neurolysis of the spermatic cord” isn’t patented, or patent pending. The terminology alone may be trademarked.


#30

Here’s the Wikipedia definition on what the word “neurolysis” in general means.


#31

I did a Google search trying to find a written difference between cord stripping, and targeted neurolysis, and couldn’t find anything like the detailed descriptions Dr P used to post on Yahoo. He was a frequent poster on that site.

I clearly remember that with targeted neurolysis, much more of you was left intact (lymphs, artery’s, veins, etc). This is why people were comparing neurolysis to a sniper rifle, instead of a shotgun with cord stripping.

I did find numerous YouTube videos on de-nervation of the spermatic cord, including the robotic version, but can’t seem to find anything that gets into the specifics that used to get posted on Yahoo.

Some of the YouTube videos go way back to my early days when Dr P, and B were working at Shands UF (university of Florida) in Gainesville Florida.

Here’s an interesting link.

http://www.urologybook.com/robotic-assisted-microsurgical-targeted-denervation-of-the-spermatic-cord/


#32

@raising4girls, Based on what I’ve posted since you posted this, I’d say you are correct with your assumption about the term neurolysis.

I find it odd that the term “neurolysis” was even used to describe, or name the “robotic targeted de-nervation of the spermatic cord” procedure.

It certainly wasn’t referred to as such back in my early days. It was always “targeted neurolysis”, and referred to as something completely new, and completely different.

Learn something new every day.


#33

I learn something new every day.


#34

Interestingly enough, back in the old school, I had never heard neurolysis described as “robotic microsurgical de-nervation of the spermatic cord”. Not once, not ever. It was always targeted neurolysis, or neurolysis.

Prior to my first reversal with Dr P, I was quoted prices for all available pvps procedures back then (2010). They were, microscopic reversal by hand, microscopic robotic reversal, and neurolysis.

Obviously, there have been several other procedures added to the list since 2010.

As the title of this thread suggests, ask questions before de-nervation.


#35

“Cord stripping” and “skeletonization of the spermatic cord” are also terms you’ll see for the original procedure (Not Dr. P’s). There are also variants of the original procedure where the vas deferens is spared and where it is not.

Dr P referred to his targeted procedure as neurolysis I believe.


#36

Yea, I have heard it refered to by him specifically as neurolysis, and targeted neurolysis.


#37

What you are saying above is interesting, and everyone should be aware of it as well.

I know some variants of traditional de-nervation are not compatible with reversal. Some variants of traditional de-nervation do not preserve the vas deferens.

This preservation of the vas was actually a key selling point, and/or a key benefit of neurolysis. A reversal could be done before, or afterwards.

Given everything posted prior to this, I think it’s fair to say neurolysis isn’t quite as destructive as other variants of de-nervation, but this isn’t to be confused with it’s safer (show me the data).

I know one thing for sure, if the success rates of any version of this are hovering around 85%, I certainly haven’t seen it in these forums.

85~% translates into we should be seeing 8 out of 10 men having a success story with these procedures. If we bump it back to 70%, we should be seeing 7 out of 10 men reporting success.

Call me a pessimist, idk. I certainly don’t see these numbers here, and didn’t see them in the site before this one.


#38

I am not even sure how patency survives a denervation. I know the vas deferens has it’s own blood supply but isolating it like that? Even in Dr. P’s procedure where less tissue is taken he isolates and power washes it to strip away the nerve sheath. Seems to me like that sort of trauma (both procedures) could result in the vas deferens scarring down.