Just had a phone consult with Dr. P. These aren’t verbatim, but they are to the best of my recollection and note taking skills. Hope he doesn’t mind the post. I definitely recommend the consult.
Why do some unilateral orchiectomy patients experience pain migrating to the good testicle or side after surgery?
It’s a type of phantom pain. We have research that shows the nerves in the stump where the cut is made start firing. There’s cross talk between the two sides in the spine.
If I have orchiectomy, would a radical, inguinal procedure make it less likely that I would have pain or complications after the surgery?
Yes. Going through the scrotum is more likely to produce pain.
If I have unilateral orchiectomy, what are the odds I would need TRT?
Varies by patient. For me, it would be 50/50.
After unilateral orchiectomy, would long-term TRT shut off the remaining testicle?
Yes, with time.
I didn’t experience any pain relief from a cord block, which is why I haven’t done denervation.
You should also have a good result from a cord block before orchiectomy. If you don’t experience pain relief from a cord block and then have orchiectomy, I’m concerned you could end up with phantom pain.
How much of PVPS is psychosomatic?
All pain to a certain extent is psychosomatic. The goal is to break the cycle of constant pain.
Can I come to Florida by myself and have your procedures?
Yes, we have a butler service to assist people who come by themselves.
On the forum, it seems a lot of denervation guys have had more problems than orchiectomy guys.
You’re only seeing a small sample. People with bad outcomes are more likely to go online. I’ve done 2,500 denervations with many good results.
Do you think my hip problem could be related to my PVPS?
It could be. The pelvic area has hyper-sensitive nerves. They are cross-linked.