Testicular pain is a fairly common condition treated by urologists. Frequent causes include infection of the testicle (orchitis) or epididymis (epididymitis), post surgical pain, trauma, tumors, hernia, torsion (twisting of the testicle), varicocele, hydrocele or spermatocele. Most of these conditions are easily diagnosed and treated. Occasionally the pain, even when treated appropriately becomes chronic. In up to 25% of patients with chronic testicular pain, no cause can be found.

Initially patients with this condition undergo diagnostic tests such as scrotal ultrasound and initial treatment is usually conservative, consisting of antibiotics and anti-inflammatory medications. When these treatments do not resolve the problem surgery is sometimes undertaken. Past Surgical treatment options included orchiectomy (removal of the testicle) or epididymectomy (removal of the epididymis) These are radical approaches and did not relieve the pain in a substantial number of patients.

A new surgical technique has been developed to help men with chronic testicular pain that have not responded to conservative medical treatments. This procedure known as Microsurgical denervation of the spermatic cord or "cord stripping" entails making a small incision (2 inches) in the groin and under the operating microscope separating all the structures in the spermatic cord including the veins, nerves and vas deferens. The arteries to the testicle and lymphatics are left intact. This is very similar to the microsurgical varicocele repair except the vas is cut as well as the veins. Complete pain relief can be expected in 75% of appropriately selected patients and partial relief in 9%. The procedure is performed in an outpatient facility and takes 45 minutes. Recovery time is between 2 and 5 days.

Microsurgical spermatic cord denervation offers a successful treatment option for those men with chronic testicular pain while preserving the testicle