I agree with MikeO, don't rule them out. Remember there are different types. Most Pain Management docs offer several nerve blocks, the Ilioinguinal and Genitofemoral most common for guys like us. Some PM docs also do spermatic cord blocks, but I haven't found one, at least not one under anesthesia, which is why I like Dr. Parekatill's approach.
I have a good experience with Dr. P's cord block. Hurt like the dickens days 2-5, but once the steroid kicked in, I got good relief (50-75%) that lasted about 3 months. He had encouraged me to get a series of blocks, but I was too busy. I'm planning to start over in October and visit him again in December and again in early 2018 if needed.
Don't rule out nerve blocks. They're less invasive and less risky than surgery. I'd also argue that they're less risky than downing oral medications for months on end. Getting pain medication directly to the source without going through the digestive tract has some advantages.
I had spinal fusion at L5/S1 and have had 2 flare-ups of sciatic pain since the surgery. Both times, the flare-ups were calmed down by epidural steroidal injections. Similar principle, I think.