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Urology/MDSPC your thoughts.


I've got a Brief one for ya Stephen. After what courses, or what time period is it reasonable for a patient suffering from chronic orchialgia to consider micro denvervation of the spermatic cord. I've been through the antibiotics and nearly every test, since no cause has been determined I am strongly considering moving on to a nerve block.

I'm curious as to what criteria usually merits this procedure.

I have a long history of muscle strains, tears, and general aches that I think may be tied into this condition rather than some infection which has not been evident.

I see the new literature supports 75-90% success rates in patients that respond to the nerve block even partially, wondering what your thoughts are on the usefulness of this for someone who has had no resolution.


This is usually a personal decision by the patient.  Since you've tried the conservative measures, a nerve block is not unreasonable.  A surgical exploration of the testicle is another option which might include removal of the testicle.  Unfortunately, even this does not guarantee relief from the pain.

Once we've tried simpler means of treatment, the decision is up to the aptient as the choice often comes down to live with the pain or have a surgery.  You shoudl discuss this with a local urologist.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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