Has anyone had Microsurgical Denervation?

Hi dale02723, Does the aching go down your right leg to your foot?

I have an update, my varicocelectomy surgery is booked in for next week, I'm so nervous, its the not knowing if the surgery will work or not, what if I end up in worst pain?

Hope it goes well

Thank you Pauline. I'm actually crapping myself, I was thinking of cancelling, but the pain I have been in these past few days has made me realise I have to do this. I just hope it works and I don't end up in worst pain. How is your son doing?

I'm not surprised that you're scared .Its the unknown .My son has been really bad the last few days .well are waiting for lock down to be eased then I am taking him to a physio locally who will do shock wave treatment which he trialled at the London clinic .They aren't doing treatment till July.We will also be going back to London for botox block .I think he felt better when we were trying treatments .Let us know how it goes .Will be thinking about you .

I'm back home now, an 11 hour day in total, I just hope it's all been worth it. I had a subinguinal varicocelectomy on right side, took an hour in total. The doc tied and cut 4x varicoceles, the incision is low down on the ball sack, I've not had a proper look yet though. Sadly I still have the same pain as before, no change as yet, the doc says to wait until everything settles down. He said he gave me a numbing injection into the cord, not sure which cord he meant though. He doesn't understand why I still have pain in my testicle, he said I should be numb, but I'm not, pain is still there. He said the leg and foot pain must be coming from somewhere else, I one hundred percent disagree with this, I know for sure my pain in my testicle always starts first and radiates down my leg into my foot, its been the same for 14 years, why don't the docs listen? I have a follow up in six weeks time, I hope I'm all cured by then, otherwise its plan B, whatever that is? You would think having pain in the testicle that radiates down my leg and into the top part of my foot would show some sort of red flag, that's a very long nerve for pain to travel along, it sounds like the sciatic nerve is being effected, surely there must be some sort of scan or injection to help find the problem? Good luck for the ultrasound-guided pulsed radiofrequency ablation, I still have this in the pipeline, but I just wish they would give me the MSCD. Best wishes to your son Pauline. xx

What an ordeal poor soul .I hope it works out .We still have the option of the MSCD at the London clinic but I'm scared for him to have this .Keep in touch .

I'm still in pain one week post op, a lot of the bruising and swelling has gone down, but the top and bottom of my testicle is unbelievably painful, far worst than before. I was in hospital for 3 days on morphine, I've also just had a ultrasound earlier today, the results have shown a lot of inflammation, so I've now been put on antibiotics. The surgeons notes state that he found inflammation while performing the op, so there has obviously been something going on in my testicle for sometime. The head and tail of the epididymis has always been tender and painful, and since the varicocele surgery its been ten times worst. I just hope it all settles down, otherwise I'm pushing for testicle removal.

Oh no that's awful .What have they given you to help ? They should have scanned you before .

Hi Pauline and everyone else, hope you are all well... Its been 4 weeks since my varicocelectomy and thankfully I haven't gone insane, but I am somewhat disheartened as I don't think the surgery has worked. Most of the horrific post surgery pain and swelling seems to be going now, but I still have the same painful symptoms as before; sitting walking and wearing jeans trousers is all painful just as before. When I lie down the pain goes, when I wake up in the morning there is no pain, so it is just as before. There is also one worrying symptom that I wounded if any of you guys had any clue about why my spermatic cord that is attached to my right testicle is very thick and solid, its not palpable soft as before, it feels large and swollen; it been 4 weeks now.

Hi That is so disappointing .Ive been wondering how you are .Will you have to go back to your surgeon ? Was this done on the NHS ?

Yes I have a follow up end of the month, so will see what else he can offer, and yes it was done on the NHS. How is your son doing Pauline?

I find it strange how my son doesnt even see a urologist .We asked for a second opinion and the urologist we saw recommended surgery but this was refused by the surgeon . We are starting shock wave treatment on Wednesday and hes going back to the London Clinic for a botox infection next month .The NHS have offered nothing except psychology .Hes hard work very angry .

I agree Pauline, I had to wait 14 years to get the NHS to do something, and now I wish they never had, it seems everything is a gamble when it comes to chronic testicle pain; not enough is known about the condition I guess... I hope the shock wave treatment goes well, is that similar to the Pulse Radio Frequency, did your son get any relief from the radio frequency nerve block he had done in London?

It was shock wave treatment he had in London .Just one trial session but he felt it helped so its worth a try .Fraction of the cost of the London Clinic .I will let you know .Take care x

I don't want to put all my eggs in one basket just yet, but today is the first day that I've had some relief from the pain since the surgery. It would be amazing if the varicocele surgery is actually working, time will tell I guess.

Lets hope . My boy has a psychiatrist and a clinical psychologist now .He has morphine ,Gabapentine and Prozac . I am on anti depressants .The NHS is hopeless for anything out of the ordinary . Im rooting for you .

I'm sorry to hear this Pauline, I too was offered psychological help; both my wife and I. It angers me that the doctors think this is the answer to everything, we all know chronic pain can have a negative effect on a persons mental state; but with so many men now suffering chronic testicle pain, more must be done to treat this condition. Stay strong both of you.

What do you guys know about antibiotics that are given for mens testes? I am on the second course of Ciprofloxacin and its taken the pain away, I feel great. The same thing happened two weeks ago, but once I finished the course the pain came back. This also happened at least three times over the years, every time I get given Ciprofloxacin the pain stops, but as soon as I finish the course the pain just comes back within a couple of weeks???

Well! after a pain free day yesterday, I am now back in pain again, the pain started as soon as I got dressed and sat down. I just don't understand it???

I'm in a real bad place, this testicle pain is winning, I have no fight left in me. It is now 5 weeks post op since the varicocele surgery, and the surgery hasn't worked, in fact it has made the pain worst in some aspects. I cant even put on underwear anymore without it making the pain worst, I cant go out anymore, my life is pretty much over. The only time I get relief from this testicle pain is when I lay down, and I cant spend the rest of my life laying down. I've had some pain free days while I was on the antibiotics, but now I've finished the course the pain has come back again, and I certainly cant live on the strong nsaids/opioids, they don't work anyway. The UK NHS are useless, I might as well talk to myself, they don't care, they just leave me in pain; I really don't know what I'm going to do. I feel my life is coming to an end, my quality of life is so very poor, all because of a testicle; doesn't that sound ridiculous? I cant live like this, the pain is just too much.

I feel so sad for you .Dont give up .There has to be a solution .Will they let you have the anti biotics for longer if they helped , why do they help there must be something in them that that you need . Have a consultation with London Andrology and ask them what they think ask to do it online as you cant travel with the pain .Keep strong xx

Hi Pauline, I have an appointment with my surgeon tomorrow, I just hope he has some answers, as I cant go on like this; it's a living hell. I'm 99.9% sure the problem is the epididymis, I only have to touch the top or bottom and the pain is instant. I don't know why the antibiotic's help, but I can't stay on them because they can cause some serious harm to the body long term. How is your son doing?

We are going to london andrology to have botox spermatic cord block next month .If it doesnt help dont know what next .We all have no life and he is in a lot of pain poor kid .

I hope the spermatic cord block works for him, I'm going to ask my surgeon that I have this done. I was meant to have the pulse radio frequency ablation next month, but this was cancelled due to covid, even though my surgery still went ahead, crazy really. It sounds like we are in the same boat when it comes to using the NHS, nothing seems to get done, and if it does, it tends to be in a backwards formation. Keep us updated, good luck, we all certainly need some good luck.

Hi Pauline, I had my follow up this morning, they've now said it's best that they remove my testicle, I didn't even have to ask. He said the varicocele surgery that I had six weeks ago where the surgeon popped out my testicle and had it in his hand, he saw inflammation in and around the testicle and a epididymal cyst, so now they've offered to cut the testicle off; as anything else would most probably not work. He also said that I had a spermatic cord block during the varicocele surgery, and because I still had pain in my testicle, leg and foot when I came round from the anaesthesia, they say MSCD would most probably not work, that its best if they just cut everything and remove the testicle.

I think thats awful that they know you are desperate .They could have removed it there and then or asked your wife. The spermatic cord block doesnt work immediately they should know that .I have everything crossed for you x

Now I know they will remove the testicle I don't mind waiting, at least I can try and be certain that I am making the right decision if I wait some more weeks to see if the varicocele surgery has worked or not. I've had hardly any pain these past 3 days, but when the surgeon examined me today by pressing on the testicle it caused the pain to start, so this must show that the testicle is the trigger point.

At long last a solution . Its heart breaking to wait so long .I wish the best result for you and your family

Thank you Pauline. I've been thinking about what my surgeon said last week, he reckons my best option is to have a Orchiectomy as it cuts everything, I guess its the subinguinal orchiectomy. He said he would most probably go in through the scrotum and cut high up as it has better results for scrotal pain, but my worry is... I don't think they cut the ilioinguinal nerve during an orchiectomy, what if my pain problem is the ilioinguinal nerve that is carrying my pain, if they don't cut this nerve I could still be in pain???

This is the confusion bit, or unless I failed to understand what my surgeon said, he said that Microsurgical Cord Denervation doesn't always work, they cant make sure they cut all the nerves as some they cant even see which gets left behind. BUT! I've read that during the Microsurgical Cord Denervation procedure the ilioinguinal nerve gets cut and tucked away safely.

So it seems the MSCD procedure cuts more nerves than Orchiectomy, as MSCD also cuts the ilioinguinal nerve, if I have my information correct. The only down side from MSCD is if they cut the vas, as this is basically like having a vasectomy, it can cause back pressure and make the epi congested. I've read they can strip back the outer layers of the vas to cut the nerves instead of cutting it totally, this then preserves the vas to avoid the epi getting congested.

I would have thought my surgeon would rather try the MSCD procedure first before doing a Orchiectomy, I understand the MSCD procedure was invented to help preserve the testicle and to avoid going straight for Orchiectomy. I get ache and pain in both my testicles which also radiates down both legs, so I may end up needing both testicles removed, you would think they would try the MSCD procedure first???

My surgeon seems such a lovely guy, he seems very caring and confident, I have no cause for concern really; but I'm so confused.

Sorry to interfere, but as I reserched that during MSCD surgeon is using Doppler U S which is specific to proper identification of nerves. You may opt. to go for this first if surgeon and your health system agrees.

It seems to me there is such a lack of expertise in this subject that we are stuck with who we can find and what they can offer rather expert advise . Why not contact Howards Doctor .He relied to me and my be able to advise .Ill look up his details .

It was Dr Levine but I cant find his email now . Howard will give you it .He was very helpful to me .

Thank you Pauline, What annoys me with the NHS is they don't really tell you much about anything, they are always negative and rarely helpful. I saw a different surgeon last week and he was a lot more positive, he is the one to recommend Orchiectomy. I need to find out if cutting the cord to remove the testicle is better than MSCD, because when I had the subinguinal varicocelectomy seven weeks ago, the surgeon said he gave me a spermatic cord block during the procedure, but when I woke up from the anaesthesia I still had pain in testicle and leg; so the surgeon said MSCD wouldn't work. My worry is the fact that if I didn't respond to the spermatic cord block, how will removing the testicle stop my pain if all they do is cut the cord, when I didn't respond to the block? Unless cutting the whole cord and removing part of it along with the testicle cuts everything, where the spermatic nerve block only numbs part of it and MSCD only cuts/strips a small part of it.

Hi Pauline, how is your son? It has now been 3 months since my varicocele operation, and there's been a small improvement in my pain, but not enough for me to live a better quality of life. I'm still booked in to have right side Orchiectomy, but no date set as yet due to covid. However, I'm now booked in to have the ultrasound-guided pulsed radio-frequency ilioinguinal nerve block, I wonder if it will work, did you say your son had this done?

Hi

Sorry to hear you are still struggling .I am trying to get that for him now .Please can you tell me where you will it and how you got referred .My boy is nearly 17 so every where I go we are blocked by his age even though he has had pain for 18 months and is 6ft 1 .Keep in touch .

Hi I realise I have not replied correctly .He did have that nerve block but Im not sure how it was given he was in theatre as he had an investigation of his urinary tract at same time .It didnt help him though .I want him to have the ultra sound radio frequency ablation procedure ..I have contacted a surgeon in America who does this .I would take my son there but he doesnt think he could travel that far it would be too painful . I would prefer him to have it here but cant find anyone to do it .I think its because hes under 18 .

I think you need more advise about that before you go ahead .Maybe contact Howards surgeon ?

Hi Pauline,

I'm pretty sure they do that at hertfordshire pain consultants. Have you looked them up?

Thanks,

Paul

Hi Yes but they dont treat under 18s .

Pauline

Hi Mr. Pauline:

I can understand the pain and discomfort being faced by your son. If you need to get it done near to Britain and much cheaper but high quality surgery then pm me so I will send you the name and information.

Hi Pauline, I had the Ilioinguinal pulse radio frequency ablation nerve block done last week, it was a quick and easy procedure, they heat up the nerve to 42 degrees and send electric pulses down the nerve, they also injected a steroid. No good news at yet, at present the procedure has actually made my pain worst, I just hope it all settles down. I guess I could say the Ilioinguinal nerve may well be the cause to my original pain condition, because having the nerve injected has obviously aggravated the original problem. The pain in my testicle and leg is much worst, so this nerve may well be the culprit.

Oh no thats awful .What now ?

I guess I need to wait a bit longer to see if the nerve block works or not, it's not unusual for nerve blocks to initially make pain worst before making it better, it's something to do with inflammation. I guess I wait a couple of weeks to see what happens and then decide if I should request a laparoscopic triple neurectomy of the ilioinguinal, iliohypogastric and genitofemoral nerves, cutting the nerves seems the way to go. I am booked in to have a simple orchiectomy, but no date set as yet, but since the pulse RF nerve block has got me thinking the ilioinguinal nerve is the culprit, it's the same pathway of pain. All the docs tell me my pain is neuropathic, so a triple neurectomy would make more sense than having a orchiectomy, I can always opt for the orchiectomy if the triple neurectomy doesn't work. I should know more when I have my follow up.

Hi Just wondering how you are ? Have you had the surgery yet

Hi Pauline, and Hi to everyone else who is following this thread, sorry that I have not been posting lately. November I had unilateral simple orchiectomy on right side, the operation was a walk in the park, I had no pain, no swelling and no bruising, the surgeon done a marvellous job. I woke up from the surgery with no pain at all, and for the first 4 weeks of recovery was the same, then week 5 it all changed. I got horrendous pain the same as before, the pain wasn't at the epididymis though, it was through the whole scrotum in around the cord. I had a simple orchiectomy where they remove the testicle and just part of the cord, a radical is when they remove all the cord, so this pain I have now which is the same as before with the same trigger when wearing jeans or trousers and sitting down may well be because the cord has been left behind. My original urologist said he would remove all the cord as to make sure to address the neuropathy element by cutting with high ligation, but I had a different surgeon perform the operation who did not ligate the cord high up, so I still have the cord in my scrotum. Also since the surgery I seem to have pain coming from the scrotal skin on the right side, the skin seems to be triggering the pain when touched. My remaining left testicle has also been getting painful since the orchiectomy, it could be due to the extra stress of it having to take up the slack and do the work of two, who knows? I am waiting to see the surgeon to ask them to remove the cord, and may op for having the left one removed along with the whole scrotum, or have a triple neurectomy to cut the 3 main nerves. Surely something has to work, how can a guys testicles cause so much pain and not get fixed, my life has been on hold for 15 years and so far I have had two surgery's with no success, I just need someone who knows what they are doing so I can get my life back. Please god, make this happen...

Hello I tried to reply yesterday but have had difficulty getting on the site .

I dont know what to say .I feel so sad for you .Its horrendous . You must have been so happy in those first weeks then this .

The pain management team that my son used to see said that sometimes surgery of any kind doesnt always help with nerve pain and theres a risk of it getting worse or the nerves can react in an unpredictable way but when youre desperate you have to try .

Sending you a big hug .

How you getting on now We5t?