Volume : 5, Issue : 2, February - 2016

Idiopathic Orchialgia: treatment by sequential cord block

Bhavinder Arora

Abstract :

<p> Background: Chronic orchalgia is defined as the pain in testis of at least three months duration. This pain be a continuous ache or episodic in nature. In about 1/4 of patients presenting with orchialgia have no obvious cause and are said to be suffering from idiopathic chronic neuralgia. Many treatment options are available from medical therapy to surgical options. Medical therapy produces transient relief only. Most of these patients are young males and refuse for surgery. Trifecta nerve cord block given is a good minimum invasive option and can be performed as office procedure. Material and Methods: This prospective study was carried out on 100 patients presenting orchialgia. Causes of inflammation, cyst and tumour were ruled out by clinical examination, laboratory work up and ultrasonography of scrotum. Out of 100 cases studied only 75 were found to be suffering from idiopathic orchialgia. Cord was given using a mixture of Lignocaine and methyl prednisolone at three weeks interval thrice only in a sequential manner. Results: The results of sequential cord blocks were very good in 72 patients giving a pain relief period of one year. These patients never reported back with orchialgia. Conclusion: Idiopathic chronic orchialgia is common problem but difficult to treat. Medical therapy is of no avail. The minimum invasive technique of trifecta cord block using Lignocaine and Methyl- prednisolone injection in a sequential manner relieves the pain in most of the patients</p>