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Laurence A Levine - One of the best experts on this subject based on the ideXlab platform.
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does a positive response to Spermatic Cord block predict response to microdenervation of the Spermatic Cord for chronic scrotal content pain
The Journal of Sexual Medicine, 2013Co-Authors: Jonas S Benson, Michael R Abern, Stephen Larsen, Laurence A LevineAbstract:ABSTRACT Introduction Microdenervation of the Spermatic Cord (MDSC) has been demonstrated to be an effective treatment for men with intractable scrotal content pain. Aim This study evaluates the correlation between a positive response to a Spermatic Cord block with local anesthetic and the subsequent surgical outcome following MDSC. Main Outcome Measures Pre- and post-Cord block pain and pre- and post-MDSC pain. Methods A retrospective review of 74 patients (77 testicular units) who underwent MDSC from 2006 to 2010 was performed. Pre- and post-Spermatic Cord block pain scores based on a 0–10 visual analog scale (VAS) were compared with pre- and post-MDSC pain scores. A positive response to the block was defined as greater than or equal to 50% temporary reduction of pain based on VAS. Results The average patient age was 42 years with a mean follow-up of 10 months. The mean duration of symptoms before surgery was 69 months. Mean pre-Cord block pain score was 8 with an 89% average decrease in pain following the block. Mean post-MDSC pain score was 2 with an average decrease of 73%. The level of temporary improvement from the Cord block appeared to be a useful predictor of sustained improvement with MDSC ( P = 0.05). Positive response to Spermatic Cord block was an independent predictor of MDSC response ( P = 0.03). Conclusions Men with chronic orchialgia who have a positive response to a Spermatic Cord block are likely to have durable and complete resolution of symptoms after undergoing MDSC. The amount of pain relief obtained after the Cord block correlates with pain relief after undergoing a MDSC. Men with chronic orchialgia who desire surgical correction should undergo a preoperative Spermatic Cord block as part of their complete evaluation. The result of the Cord block can help guide the practitioner and the patient toward definitive surgical management via MDSC. Benson JS, Abern MR, Larsen S, and Levine LA. Does a positive response to Spermatic Cord block predict response to microdenervation of the Spermatic Cord for chronic scrotal content pain? J Sex Med 2013;10:876–882.
Jonas S Benson - One of the best experts on this subject based on the ideXlab platform.
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does a positive response to Spermatic Cord block predict response to microdenervation of the Spermatic Cord for chronic scrotal content pain
The Journal of Sexual Medicine, 2013Co-Authors: Jonas S Benson, Michael R Abern, Stephen Larsen, Laurence A LevineAbstract:ABSTRACT Introduction Microdenervation of the Spermatic Cord (MDSC) has been demonstrated to be an effective treatment for men with intractable scrotal content pain. Aim This study evaluates the correlation between a positive response to a Spermatic Cord block with local anesthetic and the subsequent surgical outcome following MDSC. Main Outcome Measures Pre- and post-Cord block pain and pre- and post-MDSC pain. Methods A retrospective review of 74 patients (77 testicular units) who underwent MDSC from 2006 to 2010 was performed. Pre- and post-Spermatic Cord block pain scores based on a 0–10 visual analog scale (VAS) were compared with pre- and post-MDSC pain scores. A positive response to the block was defined as greater than or equal to 50% temporary reduction of pain based on VAS. Results The average patient age was 42 years with a mean follow-up of 10 months. The mean duration of symptoms before surgery was 69 months. Mean pre-Cord block pain score was 8 with an 89% average decrease in pain following the block. Mean post-MDSC pain score was 2 with an average decrease of 73%. The level of temporary improvement from the Cord block appeared to be a useful predictor of sustained improvement with MDSC ( P = 0.05). Positive response to Spermatic Cord block was an independent predictor of MDSC response ( P = 0.03). Conclusions Men with chronic orchialgia who have a positive response to a Spermatic Cord block are likely to have durable and complete resolution of symptoms after undergoing MDSC. The amount of pain relief obtained after the Cord block correlates with pain relief after undergoing a MDSC. Men with chronic orchialgia who desire surgical correction should undergo a preoperative Spermatic Cord block as part of their complete evaluation. The result of the Cord block can help guide the practitioner and the patient toward definitive surgical management via MDSC. Benson JS, Abern MR, Larsen S, and Levine LA. Does a positive response to Spermatic Cord block predict response to microdenervation of the Spermatic Cord for chronic scrotal content pain? J Sex Med 2013;10:876–882.
Shuen-kuei Liao - One of the best experts on this subject based on the ideXlab platform.
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Klatskin Tumor with Spermatic Cord Metastasis:
2015Co-Authors: Shuen-kuei LiaoAbstract:Malignant Spermatic Cord tumor is quite uncommon. Metastatic Spermatic Cord tumor is even rarer. Here we report a case of metastatic Spermatic Cord tumor from a common hepatic duct tumor (Klatskin tumor). A 38-year-old man presented with right scrotal enlargement and chronic testicular pain. He had a Klatskin tumor (cholangiocarcinoma) stage IIIa, and underwent an extended right hepatectomy with resection of the extrahepatic bile duct, and portal vein and reconstruction by Roux-en-y hepatico-jejunostomy one year before this pre-sentation. Scrotal ultrasound revealed a moderate hydrocele with clean content. Scrotal exploration showed turbid fluid and a fibrotic hyperemic Spermatic Cord. Excision biopsy of the Spermatic Cord was done, and the pathology revealed adenocarcinoma. The primary cholangiocarcinoma tumor and the Spermatic Cord tumor showed identical histologic pat-terns. Klatskin tumor with Spermatic Cord metastasis was diagnosed. To our knowledge, this case represents the first such report in the literature. (Chang Gung Med J 2009;32:104-7
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Klatskin tumor with Spermatic Cord metastasis: a case report.
Chang Gung medical journal, 2009Co-Authors: Ying-hsu Chang, Cheng-keng Chuang, Shuen-kuei LiaoAbstract:Malignant Spermatic Cord tumor is quite uncommon. Metastatic Spermatic Cord tumor is even rarer. Here we report a case of metastatic Spermatic Cord tumor from a common hepatic duct tumor (Klatskin tumor). A 38-year-old man presented with right scrotal enlargement and chronic testicular pain. He had a Klatskin tumor (cholangiocarcinoma) stage IIIa, and underwent an extended right hepatectomy with resection of the extrahepatic bile duct, and portal vein and reconstruction by Roux-en-y hepatico-jejunostomy one year before this presentation. Scrotal ultrasound revealed a moderate hydrocele with clean content. Scrotal exploration showed turbid fluid and a fibrotic hyperemic Spermatic Cord. Excision biopsy of the Spermatic Cord was done, and the pathology revealed adenocarcinoma. The primary cholangiocarcinoma tumor and the Spermatic Cord tumor showed identical histologic patterns. Klatskin tumor with Spermatic Cord metastasis was diagnosed. To our knowledge, this case represents the first such report in the literature.
J B Ortizlopez - One of the best experts on this subject based on the ideXlab platform.
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Spermatic Cord liposarcoma a diagnostic challenge
Hernia, 2006Co-Authors: L G Vazquezlavista, C Perezpruna, C H Floresbalcazar, Gilberto Guzmanvaldivia, E Romeroarredondo, J B OrtizlopezAbstract:Spermatic Cord liposarcoma (SCL) is a rare medical condition; to our knowledge there have been fewer than 100 cases reported in the literature worldwide. As a group, para-testicular tumors are relatively uncommon, and they must be differentiated from tumors of testicular origin with extension to the Spermatic Cord and its elements. SCL should be suspected in patients experiencing recurrent hernias of the inguinal region. Herein we present two cases of SCL recently diagnosed at our hospital. In both instances, the preoperative diagnosis was inguinal hernia.
Stephen Larsen - One of the best experts on this subject based on the ideXlab platform.
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does a positive response to Spermatic Cord block predict response to microdenervation of the Spermatic Cord for chronic scrotal content pain
The Journal of Sexual Medicine, 2013Co-Authors: Jonas S Benson, Michael R Abern, Stephen Larsen, Laurence A LevineAbstract:ABSTRACT Introduction Microdenervation of the Spermatic Cord (MDSC) has been demonstrated to be an effective treatment for men with intractable scrotal content pain. Aim This study evaluates the correlation between a positive response to a Spermatic Cord block with local anesthetic and the subsequent surgical outcome following MDSC. Main Outcome Measures Pre- and post-Cord block pain and pre- and post-MDSC pain. Methods A retrospective review of 74 patients (77 testicular units) who underwent MDSC from 2006 to 2010 was performed. Pre- and post-Spermatic Cord block pain scores based on a 0–10 visual analog scale (VAS) were compared with pre- and post-MDSC pain scores. A positive response to the block was defined as greater than or equal to 50% temporary reduction of pain based on VAS. Results The average patient age was 42 years with a mean follow-up of 10 months. The mean duration of symptoms before surgery was 69 months. Mean pre-Cord block pain score was 8 with an 89% average decrease in pain following the block. Mean post-MDSC pain score was 2 with an average decrease of 73%. The level of temporary improvement from the Cord block appeared to be a useful predictor of sustained improvement with MDSC ( P = 0.05). Positive response to Spermatic Cord block was an independent predictor of MDSC response ( P = 0.03). Conclusions Men with chronic orchialgia who have a positive response to a Spermatic Cord block are likely to have durable and complete resolution of symptoms after undergoing MDSC. The amount of pain relief obtained after the Cord block correlates with pain relief after undergoing a MDSC. Men with chronic orchialgia who desire surgical correction should undergo a preoperative Spermatic Cord block as part of their complete evaluation. The result of the Cord block can help guide the practitioner and the patient toward definitive surgical management via MDSC. Benson JS, Abern MR, Larsen S, and Levine LA. Does a positive response to Spermatic Cord block predict response to microdenervation of the Spermatic Cord for chronic scrotal content pain? J Sex Med 2013;10:876–882.
