{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:21:33Z","timestamp":1788344493798,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T00:00:00Z","timestamp":1518134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,4]]},"abstract":"\n Objective<\/jats:title>\n \n To evaluate the outcomes of patients who underwent microdenervation of the spermatic cord (\n MDSC<\/jats:styled-content>\n ) for post\u2010vasectomy pain syndrome (\n PVPS<\/jats:styled-content>\n ) at our institution.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective study of all patients who underwent\n MDSC<\/jats:styled-content>\n for\n PVPS<\/jats:styled-content>\n by a single surgeon between March 2002 and October 2016 was performed. Pain was documented using the numerical rating scale (\n NRS<\/jats:styled-content>\n ). Spermatic cord block (\n SCB<\/jats:styled-content>\n ) was performed on all patients, and success was defined as\n NRS<\/jats:styled-content>\n score \u22641 for >4 h. All patients had failed medical therapy prior to\n MDSC<\/jats:styled-content>\n . All previous procedures for\n PVPS<\/jats:styled-content>\n had been performed elsewhere. Surgical success was defined as a postoperative\n NRS<\/jats:styled-content>\n score of \u22641.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 27 patients with 28 scrotal units underwent\n MDSC<\/jats:styled-content>\n for\n PVPS<\/jats:styled-content>\n . The median (1st quartile; 3rd quartile) follow\u2010up was 10 (2; 16.5) months. The median (range) duration of pain prior to surgery was 57 (8\u2013468) months. Pain was bilateral in 14 (52%), left\u2010sided in eight (30%) and right\u2010sided in five patients (19%). Data on\n SCB<\/jats:styled-content>\n were available for 23 patients, with a success rate of 96%. The median (range) preoperative pain\n NRS<\/jats:styled-content>\n score was 7 (2\u201310). The median (range) pain score after\n SCB<\/jats:styled-content>\n on the\n NRS<\/jats:styled-content>\n scale was 0 (0\u20135). The median (range) postoperative pain score on the\n NRS<\/jats:styled-content>\n was 0 (0\u20139). Overall success was achieved in 20 of 28 testicular units (71%). Patients with involvement of multiple structures in the scrotum (i.e. testis, epididymis, spermatic cord) had a success rate of 81% and were more likely to have a successful surgery (\n P<\/jats:italic>\n < 0.001). Five patients had failed a prior epididymectomy and three had failed a vaso\u2010vasostomy for\n PVPS<\/jats:styled-content>\n ; this had no correlation with the success of\n MDSC<\/jats:styled-content>\n (\n P<\/jats:italic>\n = 0.89).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The\n MDSC<\/jats:styled-content>\n procedure is a reasonably successful, durable and valuable approach for\n PVPS<\/jats:styled-content>\n , especially when pain involves multiple structures in the scrotum (testis, epididymis, spermatic cord).\n MDSC<\/jats:styled-content>\n was equally efficacious in patients who had previously failed a procedure for\n PVPS<\/jats:styled-content>\n . No patient had a worsening\n NRS<\/jats:styled-content>\n score after\n MDSC<\/jats:styled-content>\n . This is the largest study to date evaluating\n MDSC<\/jats:styled-content>\n for the treatment of\n PVPS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14125","type":"journal-article","created":{"date-parts":[[2018,1,20]],"date-time":"2018-01-20T02:02:41Z","timestamp":1516413761000},"page":"667-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Microdenervation of the spermatic cord for post\u2010vasectomy pain syndrome"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-781X","authenticated-orcid":false,"given":"Wei Phin","family":"Tan","sequence":"first","affiliation":[{"name":"Division of Urology Rush University Medical Center Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N.","family":"Tsambarlis","sequence":"additional","affiliation":[{"name":"Division of Urology Rush University Medical Center Chicago 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