I am coming to the conclusion that my pain has a neuropathic origin and I understand that this may have to do with nerve entrapments and, perhaps, this entrapment has been produced by scarring formation of some tissue. This last part I did not understand. The vas deferens is loose inside the scrotum, that is, it is not inside the spermatic cord, right? So where do the scars that end up trapping the nerves occur?
Anybody an opinion about this? I really need to understand where is the scarring forming.
Is that something an ultrasound can find?
Ultrasound wont work. Neither will xrays, mris, etc so don’t waste your copay. When spermatic cord denervation is done it is done with a high powered microscope. This is because there are nerves as fine as human hair in the scrotum. If there’s any damage or scar tissue impeding these nerves, there’s not a great way of diagnosing it. Thats why it’s based solely on your symptoms.
Thanks @Choohooo, and do you know where the scar tissue may form?
Any place they cut, cauterize, clip or stitch
Urologists really don’t respect the scrotum and the complexity of it. This is one of the few areas that vascular surgeons and neurosurgeons can’t really operate. It’s that dense and small. Picture your spermatic like a woman’s ponytail but with blood flow and nerves. They go in with a bovie knife, jerking the vas out like a guitar string with little regard to adjacent structures and finish by melting stuff. The cord is relatively delicate. It’s not a surprise at all that PVPS is chronic in over 15% of patients.