Spermatic Cord Denervation - when to go ahead


I have an appointment with Dr. Williams in late March and am hoping to see Dr. Dellon on the same visit. I left a message for his wife/assistant earlier today.

My current pain level is back to very focused. The RF Ablation of the pudendal did the trick as did the pudendal blocks a year ago. The problem is that the scrotal pain always returns when the pudendal is at bay and vice versa. Maybe more RSD, I don’t know, but I think it’s time to have the scrotal pain examined by a surgeon while the pudendal is at bay.

I’ve spoken to Dr. Williams twice and exchanged messages twice. Small sample, but I really like him a lot.

Lyrica is greatly reducing the scrotal pain. Today was just a “1” other than while I was on the treadmill. Then it was up to a 3 or 4, not horrible, but not where I want to be the rest of my life.

I really appreciate @Acschiro’s advice on denervation. The neurectomy approach seems so much more logical than the SCD approach. I think Dr. P.'s research on SCD gives him a higher probability of finding the needles in the haystack, but I can’t imagine how the urology approach has a high likelihood given the many, many branches they’re dealing with. They can remove them all.


Would damage to the GF that hindered control of the creamster muscle cause an inability to get or maintain an erection?


If this is happening to you call me tonight 5:30 est if it’s just a question let me know and I will reply accordingly.


To my knowledge, GF is independent of erection. That said, elections in general are poorly understood. I’m also learning that there are less consequences to damaging the GF compared to ilioinguinal. The IL runs a lot more of your core muscles and would contribute more to things like back pain, flank pain, abdominal pain.


Just a question in case I’d go thru with neurectomy.


Gf only controls cremaster reflex, lifting testicles. Erection is purely pudendal and sacral plexus. I was worried the radio frequency of pudendal had some side effects.


Talked to Dr. P the other day and he said he published results from 871 spermatic cord denervation (SCD) surgeries with a 75% significant reduction in pain after a 10 year follow-up. Is this to be believed? Furthermore, he told me only about 1% of men end up worse from his SCD surgeries. Again, is this to be believed? I’ve seen people on this site reporting success from reversals, but not from SCD surgery. Has anyone here had success from SCD surgery?


You’ve asked the million-dollar question. Really tough questions.

I would love to see if the 75% figure applies to SCDs done for men with post-vasectomy pain. There are many other conditions causing scrotal pain for which SCD is prescribed. To my knowledge, no one has published stats for these different control groups.

I do think this site is biased. As men heal, they disappear. But, also, I think some men with protracted pain also disappear out of frustration. Hard to tell if the results described here anecdotall are worth trusting vis-a-vis Dr. P.'s statistics.

Before I would entertain SCD, I would also talk with a surgeon such as those at the Dellon Institute about neurectomy to see if that’d be a better alternative. In talking with Dr. Williams there, though he does neurectomy, he’s familiar with SCD and sees pros and cons to each approach. Just suggesting that you explore all options before picking one.

Not easy for any of us to agree or disagree with Dr. P’s. stats. My personal opinion of him as a patient is that he’s a kind, caring man trying to help us. I don’t think he pads his stats for some nefarious reason. My concern about his stats merely relates to whether the 75% success rate across the board applies to the unique, more vexing challenges of PVP patients.


Thanks for your response. That is good thinking, how many of these 871 SCD surgeries where successful on those with testicular pain vs. those groin pain from PVPS. I’ll be sure to ask this to Dr. P. the next time I speak with him.


Hi, I know the hell you are going through. I had pain for 15 months and then threw the kitchen sink at it. I had a reversal which made things worse, then 6 months later, bilateral denervation, series of cord blocks, cryoablation (freezing the nerves), countless meds, and lastly, botox injection into the cord on the worst side. I was investigating testical removal when, 8 weeks after the botox, the pain and symptoms steadily subsided and over approx 4 months were gone. I don’t know which, if any, did it.


Do not ever, ever, ever have spermatic cord denervation surgery done. Ever. It is fucking murder and doctors know it.


Hey @Recovered,

I am going for botox next month. Can you tell me more about what was done and who your provider was? Also, what’s your history? I had asked guys to post a brief narrative in their profiles so we can help identify each other better. Just procedures/therapies with dates and brief notes on how outcomes. Thanks.


very interesting @Recovered. I may need to talk to you as well.


Okay Mike O, I’ll post a history


I will heed your warning.


Glad you’re pain is gone. That’s great news.

I have been doing a number of conservative things to reduce inflammation and heal the nerves. Fortunately, the last 7+ weeks things have improved quite a bit. I am managing pretty well right now, and am cautiously hopeful that things might continue to stay or improve further. At this point there’s no way I’m letting a doctor go anywhere near my guys for fear they will just piss things off.


hey @vasregret just wondering how are you doing these days, hoping you are doing well and as little pain physically and emotionally as possible. Going to see my urologist tomorrow and thinking to ask for a referral to Mount Sinai for Dr Jarvi or Dr. Lo. In conjunction to the constant dull left test pain still not sure if its inflammation/epdidiitmis/granuloma or all 3. But for the last few weeks the groin and upper left thigh pain that radiates to the butt and down the leg am wondering if now am also dealing with nerve issues related to the chronic pain in testie or from the procedure(spermatic cord). The groin pain just start and was never present before…