Has anyone had Microsurgical Denervation?

Thank you Michael for sharing this good information. I have a few questions:

1. Did you take Percoset every day for pain so you got addicted?
2. Was your scrotal pain caused by a varicocele or something else?
3. Did you have severe pain in your lower back and down your leg?
4. Who did your procedure in California?

Thank you again and all the best to you.

Howard

Hello,

I did respond to your question but the moderator deleted it. Let me try again.

1. I took it every day for 15 years. Yes I did get addicted
2. Not by varicocele. All I known is he did the block test and went ahead with surgery and I have been pain free since.
3. No pain in lower back or legs.
4. Dr. Zamip Prakash Pate. Orlando Florida.

OOOOPS. Dr. Zamip Prakash Patel. I spelled his name wrong on last post.

Hi Michael

A few more questions if you don't mind.

Q1: What were your symptoms before the operation, did you get pain in right testicle, right leg and right foot?

Q2: Before the operation, did you find wearing certain clothing (jeans, trousers) made your testicle pain worst?

Q3: Before the operation, did any of your scans show testicle cysts, or varicoceles?

Q4: Before the operation, did laying down relieve your testicle pain? Waking up in the morning, did you have testicle pain?

Thanks again 😃

Good Day,

Ask me as many questions as you like.

1. I had pain in both testicles. No pain in leg and foot
2. Everything had to be loose. But the pain was always awefull. It felt like my testicle were in a vise 24/7 for 15 years.
3. none
4. It was 24/7. If I woke up in middle of night to pee the pain was right there.

Thank you for your reply Michael, and I'm so glad the cord denervation has worked for you.

I am due to see a specialist at the end of July to discuss the cord denervation operation, but I feel it may not work for me. My scans showed two small cysts and some varicoceles, and I'm sure this is what is causing my pain, but they will not operate due to the high failure rate that surrounds cyst remove (scar tissue etc).

I have pain that goes down my right leg and into my foot, its like there is a piece of string (nerve) connecting my right testicle to the my foot. When the pain starts in the right testicle it then travels down my leg and into my foot within seconds, but if I lay down the pain soon subsides and pretty much goes.

I read somewhere that they don't perform the operation if the pain is felt elsewhere in the body, pain has to be localized within the testicle itself. In my case though, the pain does originate within the testicle, but does travel. I suppose this would indicate a nerve issue, and I think my problem is either a damaged epididymiss or the cyst which is on the epdidymiss.

But my urology team will not operate, as they say these types of operations leave the patient in worst pain., is this true?

Are you saying your doctors do not want to remove the epididymis because they say it will leave in your worse pain? I just spoke with another uro and he feels my pain is caused by my epididymis which he said can easily be removed. He said either I can remove it which he feels is the source of my pain or do the MSCD which just deadens the nerves so I don't feel the pain. He said nerve pain elsewhere in the body is common after a long time ( a year or more).

Hello,

Why dont you have them try the block. Its the only why to know for sure if you can have the surgery. How can the doctor say its something else if you at lease try the block. Who know it may work and than you know you can have the same surgery as me. Not sure what surgery you are talking about that your doc say may leave you with more pain??

Hi Howard, Yes, I have seen three urologists here in the UK, and they have all said the same thing, not to operate. They said its most probably my epididymis at fault, especially as I have a cyst on it (but its small). They have said that history shows a high failure rate, so they don't perform the operation now, not unless there is overwhelming evidence that would give a good clinical reason to do so.

They told me the operation often leaves the patient in worst pain, I have even said to them that I am willing to take the chance, but they still say no. They have said my cyst needs to be larger than 2mm in size for them to remove the epididiymis, how silly does that sound. They even told me that Microsurgical Cord Denervation can leave the patient in worst pain, this is why it was very good to hear about Michaels success.

Hi Michael, My urologists here in the UK said that removing the epididiymis rarely works, that history shows a high failure rate, so they don't perform this operation now, unless there is clear medical evidence of the problem.

Its so upsetting just to be left in pain, where no one wants to help. The UK NHS system is not working for me at all, its such a horrible experience.

Good day my friends..

I know how you are feeling about no help. It was like that for me for 15 year. So many doctors and no help. Medicine caught up with the problem after 15 years with a young 33 year old doctor who saved my life with a cure.

My question is, why will they not do the block for you?? There is not much to the procedure. I had other medical problems in my life time. I had a few doctors miss diagnose my heart problems. I would be dead if it wasn't for another doctor to find out the correct problem. Removing the epididlymis is not the same as the denervation of the spermatic cord

I have talk to many people in the UK with the same problem and up set with the medical system.

I wonder if there is any chance you can contract Dr. Patel and send him your records. He may help you out. It never hurts to ask. Plus mention my name.

So many different stories from so many urologists and we as patients are stuck in the middle. Yesterday I spoke with another uro who has many papers on scrotal pain and he said he thinks my problem is chronic epididimytis and he could either remove it surgically or do the MSCD procedure. He said both are "easy" procedures and either one will fix my problem. I think I am going for the MSCD.

Hi Michael, and thanks. 😃

Yes they will do the nerve block, I'm seeing the pain management team at the end of this month for that. Then I'm seeing a specialist to talk about the MSCD procedure at the end of July, lets hope its all good news.

Awesome. Please keep me updated. I will pray for you to be heal in Jesus name. If you are on another blog please share my info.

Contract me anytime for anything.

Talk to you soon,

Michael

Let me know how you get on Howard. 😃

I believe my epididymis is not working correctly, damaged, broken (even the cyst could be playing its role). When I stop and think about my symptoms, everything seems to point towards the epididymis, because if I don't have sex for say 4 days, I get the horrendous ache/pain and swelling. Then after sex I will still have the horrendous ache/pain for an hour or so, but this soon goes...

However! If on a good day where the right testicle pain is just a mild ache, and I go and put on a pair of trousers or jeans, and go to sit down, the ache can soon start within seconds, then it turns into pain. The ache then goes down my right leg and into my foot, this can then cause me to limp as it gets very painful, I also feel shooting pains down my leg and foot.

Do you get this Howard?

Yes - my symptoms are very similar to yours.

I've been reading and thinking about this a lot. There are many possible sources for our scrotal nerve pain. We cannot be certain where the pain is coming from.

But we can be certain of 2 things: The nerve pain starts some where below the spermatic cord in the epididimys/testicle/scrotum and ends in our brains.

So we can either refuse to "receive" the nerve message in our brains by taking Percoset and other drugs that dull our perception of the nerve pain (and the rest of the world) or we can stop the message from being sent in the first place by cutting the nerve "line" in the spermatic cord with an MSCD procedure. Then it really does not matter how the nerve pain is being created because the signal will never be sent to the brain or elsewhere in our body like our back and leg.

So that is what I will do probably in the Fall when my doctor gets back from summer vacation. I live in Canada and it takes time to get fit in.

But you should get the test nerve blocks with Lidocaine. I did it and it helped a lot for a day or two and I am certain it will help you too so you will be a good candidate for the MSCD.

The stimulus is somewhere, and mine is most certainly in the right testicle. The pain always starts in the testicle at the head and tale of the epididymis, its extremely tender to touch. It feels like the epididymis tube is swelling with sperm, which is swelling against the cyst or nerve. After sex the pain can often subside, feels like the tube has become empty, but then there has been incidences after sex where I have been in excruciating pain, sex can also make the pain worst.

Yes - you described my problem exactly. Also when I am in a lot of stress I get scrotal pain too. I think under stress the scrotum contracts and pulls up and that aggravates the nerves. I have little doubt you will respond well to a cord block and then the MSCD. You must insist on it or maybe you can a doctor in Europe if not the UK who will do it,

Hello Howard,

Your explanation was spot on. Wish you all the best. Please keep us updated.

Michael

To make matters more complicated, I have also noticed after a bowel movement I can often get a ache in the right testicle, leg and foot, this would indicate a hernia, but they say my ultrasound scan does not show a hernia. On examination they say my right side abdomen is tender, its been tender ever since the testicle pain started. I guess this is why they say the pain may not be coming from my testicle, why they don't want to remove the epididymis.

I have also noticed, when I was a heavier build (250lb) the ache/pain was not as bad, now my weight is 170lb the pain is worst, and I believe its the lack of fat cells that surround my organs/nerves. Fat cells must work like bubble-wrap and protect nerves and organs, but now I've dropped the weight and weigh less my organs and nerves come into contact more often, and are easily stimulated... I could obviously be wrong.

Thank you Michael and for your important advice. I pray for you too.

Howard

You need be careful with hernias - I've had them over the years (inguinal ones) from pushing too much due to constipation and from sports. Be sure you don't ever get constipated.

Having said that, the nerves around the bowel region are all connected to the groin and testicular region and prostate region so it could be that pooping will aggravate the scrotal nerve pain. Again this a reason to do the MSCD. I also have had the problem you describe and still do if I do not take a laxative like Benefiber or colace or metamucil.

With denervation is there numbness or lack of sensitivity? Obviously need some nerves or feeling to prevent or know if there is an injury. Or does everything just feel normal?

Good Day,

After the surgery everthing feels normal. Its that when I am having sex I am not as sensitive. Not because of the surgery but I think damage from the pain in the nerves. There is a up side on that for your partner. But besides that everything works like it should. Plus you can were anything, sit, ride bike!!!!!! ect.

Hi Howard, I'm now learning towards varicoceles, the more I do each day brings on the heavy ache which soon turns to pain. I have also noticed on some occasions when getting an erection I end up in horrible heavy aching in my testicle and down my leg, this then effects me standing, sitting and walking.

If my problem is caused by varicoceles, can the MSCD operation work, if so? how does the operation stop the pain?

UPDATE! My ilioinguinal nerve block did not work, I'm so annoyed.

Where do I go now?

Hello, I have a question. Is the Ilioinguinal nerve the same as the spermatic cord nerve? I google it and it seems it is different. If it is different than why the nerve block on the Ilioinguinal nerve. My block was on the spermatic cord, both sides.

Hi Michael, Yes I think its the same, the Ilioinguinal nerve is in the spermatic cord.

The bit I don't understand is... my pain seems to be coming from the top of the right testicle, the head of the epididymis is so painful (the epididymis wraps around the back of the testicle).

So, I wonder what it means why the nerve block has not worked for me, and the fact that the head of the epididymis is so painful. Should the nerve block have worked on the epididymis, or is having a cyst on the head of the epididymis a red marker to why the block didn't work?

Hello We5t, I did some more research and the Ilioinguinal is not the same as the Spermatic Cord. The content of the cord is Vas deferens, Testicular artery, Testicular viens, Testicular lymph vessels, Autonomic nerve, Processus vaginalis and other structures. The block I received is in the Spermatic Cord. It work on me and than the doctor cuts some nerves. I dont know which ones he cut but they were in the cord. The Epidiymis wrap around the back of the testis. It has a different function than nerves. You need them to block the Spermatic cord. I bet than you will get the results you are praying for. Research the Ilioinguinal. Not sure what your talking about a cyst? Friends out there. May be you can help and make sure I am right.

There is still hope

Hi Michael, Well! I'm confused, I reckon you could be correct, the spermatic cord block and ilioinguinal nerve block may well be two different procedures. How do we find out, the internet doesn't explain it very well, where is Howard when you need him. 😃

Where was your injection site? my injection site was high up just under the bellybutton over on the side, from looking at some internet photos it shows the spermatic cord block injection is lower down in the groin area.

It looks like a spermatic cord block is performed to numb the epididymis and blood vessels etc, that is what I need as I feel my pain is coming from the epididymis itself.

So what did I have done, what is a ilioinguinal nerve block?

Hello, Google spermatic cord anatomay or Ilioinguinal anatomay. The epidiymis pain you are having is the same I had but my feeling were that I had a vise on my whole groin. It was 24/7 in pain. The spermatic cord is were your leg meets your body. The v shape on each side that goes next to your groin. The surgery was at the same place. I hope you understand were. The anatomay will help. For sure you need to have the doctor do a block on the spermatic cord. Where do you live.

Google what is Illioinguinal nerve.

Keep me up to date.

So it appears the Illioinguinal nerve is inside the spermatic cord, are we sure the block is not the same procedure?

I'm due to go back to see the doc who performed the Illioinguinal nerve block, he did say if it doesn't work, that he has some other ideas in mind, I wonder what they are???

I'm also due to go see a specialist at the end of next month to discuss the MSCD procedure, but he's going to say I'm not a good candidate as I didn't respond to the Illioinguinal nerve block.

I live in the UK.

I was sent this link...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503921/

This bit is interesting...

Multiple techniques for MSCD have been described over the years. The procedure was first reported in 1978 (38). In regards to incision site selection, there are essentially two approaches: the traditional inguinal approach or a sub-inguinal approach. Both options have been described with good success and each has their relative strengths (39-41). The inguinal approach, as described by Devine et al. in their original 1978 paper, allows the surgeon to bury the proximal segment of the ilioinguinal nerve after being severed to reduce the risk of neuroma formation while the subinguinal approach may be more comfortable for some surgeons as this approach is similar to that for microscopic varicocelectomy. The non-muscle splitting nature of the subinguinal incision has led to this approach being the modality of choice in this operation. Both have been described with good results (4,18).

Great information. So my question is were did they perform your block on you body. I still thing the ilioinguinal is not in the Spermatic cord. It gets to the testit another route. But I still can be wrong.

I had to go to A&E today because my testicle and leg pain was so bad, I had trouble walking.

I saw a doctor who reckons my pain may not have nothing to do with my right testicle, he reckons the problem could be Allodynia. He reckons a new MIR is needed as my last one was seven years ago, he also said I need to seea neurologist.

I still believe the pain is something to do with cysts on the epididymis, or the varicoceles that I have, could even be a spermatocele.

The doc said its not the epididymis at fault or the testicle as they would not cause leg or foot pain. He said there is no nerve that joins the testicle to the legs or the feet.

Hello,

I hope you are feeling better. I thought you had pain on both your testicles. Well I guess it changes everything we are talking about. But the doc said the pain in the leg or legs, is not the cause from the pain from testicle. So which testicle has pain, left or right. Is the pain in the leg the same side as the testicle. So I still think you should get a block in the spermatic cord. I guess it is a process to make sure if the block works or not. Well, I am not a doctor, just my thought. Hope you get well soon. Please keep us up to date.

Hi there, I've had mild pain in left testicle and let leg a few times over these past 12 months, but its my right testicle and right leg that suffers the most. The right one aches and gets painful every single day, but when the left one starts aching the right one stops, is that what yours did?

Hey, Nope, the pain I get is a squeeze like a vice that gets hold of me 24/7 for 15 years. No pain in legs. The pain is so bad I would think of killing my self because what ever pain med they gave me only took it from an 9 to a 8. So I am not sure what is going on with you. I have been on other blogs and everyone had the same problem as me. You are the first for me. I wish I could be of help.

Hi, My pain is not 24/7, it only happens through the day, but if I lay down on my back the pain goes or becomes very mild (a very dull ache). When I get up in the mornings there is no pain, but after a shower and putting on clothes the dull heavy ache starts in the right testicle, and is felt in my right leg and foot. Then within 10 minutes the heavy ache gets painful, the pain is felt in my right testicle, leg and foot for the rest of the day, gets so painful I end up limping (its been like this for 12 years).

Hey Michael, I think the nerve block I had is actually working, I seem to have a reduction in the pain.

On the 6th day after the nerve block I felt some relief, the pain seems to be less again today. But I have found if I stand on my feet too much or sit down for too long the pain still gets bad, but generally the pain feels less. The pain specialist who performed the Illioinguinal nerve block did say it can take some days to notice an improvement, so I reckon he's correct.

Did your spermatic cord block work straight away, or did it take a few days to see an improvement?

Hello, It work around 6 hours after block. The doctor said it should work with in 12 of block if that is were the problem was. I was pain free for 24 hours like the doc said will happen. Had surgery 3 days later. Its awesome the pain is gone. Question, do you have to have the block all the time to be pain free, or will they do surgery?

Better days ahead for you.

My son is 15 and his story is much the same .He has had testicle pain since April 19 .He has had 4 rounds of anti biotics which made no difference and has had nerve block which eased spasms but did not resolve pain .He was seen by a urologist who planned to do the MDSC but then changed his mind as my son is now very depressed and he feels if its not a sucess and his pain increases then he could be left with no where to turn .He is on morphine ptegabalin and just been prescribeda newnerve med havent got the name to hand starts with D .We aldo live in the UK.

So sorry to hear this happening to your young guy. Has he had an MRI to help determine what causing the pain? (Swelling, cyst, tumor, veriocele hydrocele, infection etc)

Sounds like you may have good specialist, although second opinion can't hurt.

It has taken me 9 months and 4-6 urologists just to find some that knows what micro denervation is and trained to do it. Will be another 6 months before I actually have it.

If the MDSC does not work then nothing is lost at all. The last resort is just to remove the offending testicle. That also is not as bad as it sounds. He can still have children ok on one testicle and the removed one is replaced by an artificial one that looks and feels the same as the original one. Good luck.

He has had a CT scan and MRI just waiting for results .The op is off the table just now .His age is a factor they want to wait to see if the pain management team can help first .Its so hard to see him in such pain and he has missed so much school .

Ask for a Botox injection. It provided me with 4 months of almost pain-free living and is done the same way as the Lidocaine injection. I will have my second injection of Botox next week.

I will thankyou .Its so difficult to get to see anyone .Is available in the UK ?

I don't know as I live in Canada. It is also difficult to see a doctor here but please ask him when you have a chance. The Botox has made a big difference for me but it is not a permanent solution. Good luck.

@We5t - I agree with you on fat/muscle. I have very little fat in the under carriage, although average weight overall. So when sitting, there is pressure into the pelvic floor, testicles, epididmitis etc. I joke with my pelvic PT person that I need fat injections into the rear. 😃

i had microdenervation surgery for lower left testicle pain. it worked in that less testicle pain but now have abdominal bloating distention and pressure that wasn't prevalent prior to surgery. Imaging at first didn't catch inguinal canal hernia. Had hernia repair June 8th and I'm more miserable than ever. The bloating abdominal pressure and distention had not gone away. Sex makes things hurt and feels weird. Now I have prickly gassy feeling along with bloating emanating from the left groin. I'm laying on my back as I type this. Mesh was used. I'm losing weight because of the pressure on my abdominals.

peace brothers I'm just reading over you alls conversations. im currently going through an epidimal blockage that cannot be treated, that i must find a treatment for the pain.

1. i had a spermatocele removed due to size.
2. 6 months after spermatic seal was removed and epididymal obstruction appeared in the same vicinity.
3. it was an epididymal blockage that was backing up into my testicle.
4. he cannot be treated and causes my left testicle to hurt during ejaculation and afterwards I have pelvic pain and need some type of pain treatment.

how are you fellas fairing????

after the surgery did everything work properly down there still???

im thinking about having the denervation procedure on my left testical do to an untreatable epidimal blockage.

what to u mean a bloating abdominal pressure why do u have that??? is it from the procedure?

This is crazy. I too had a micro denervation on my left testicle in June of this year for pain that was going on for months. The pain was better but a few weeks after surgery I started with the stomach bloating and distention. I also had bad diarreaha, belching constantly, reflux etc. After going to primary doc with no relief I ended up at GI. I just had an endoscopy and colonoscopy which only showed mild case of gastritis. They have not ruled out H pylori yet and i go back for a follow up on wednesday. Just crazy to read exactly what happened to me.

I am now back to having severe testicle pain in both testicles. It feels like my nuts are in a vice that keeps getting tighter and tighter. Pretty much the same as before my surgery. I do feel like the majority of it is coming from the other testicle but it radiates between both. I have another appointment setup with the doctor who did my denervation surgery to be rexamined for current pain. Will update when i get results.

Im 35 years old. Had no symptoms other than one day having bad pain and my left testicle drop much farther down than normal. Hope this helps someone else going through the same thing.