Spermatic Cord Block Series as a Minimally Invasive Therapy for Chronic Scrotal Content Pain.

PURPOSE The primary aim of our study was to evaluate relief of chronic scrotal content pain after a series of spermatic cord blocks with a combination of local anesthetic and a steroid. Secondary aims were to assess factors associated with a positive response and complications. MATERIALS AND METHODS We performed a retrospective chart review of patients who underwent spermatic cord block series for chronic scrotal content pain at our practice between 2012 and 2019. Pain scores were compared before and after treatment using an 11-point numeric pain rating scale. We performed univariate analysis to assess differences between responders and non-responders, and the relationship between symptom duration and response was analyzed by rank-order correlation. RESULTS We included 44 men with chronic scrotal content pain present for a median duration of 24 months who underwent spermatic cord block series. At a median follow-up of 16 months, 31 patients (70.5%) experienced sustained relief, including nine patients (20.5%) with complete resolution of pain. There were no differences between responders and non-responders in terms of symptom duration, perceived etiology, or previous treatments, and there was no association between response and duration of pain. Minor complications occurred in 5 cases (11.4%). CONCLUSIONS Spermatic cord block series is a safe, minimally invasive treatment for men with refractory chronic scrotal content pain. Response to cord block series appears to be independent of symptom duration, perceived etiology or prior medical and surgical treatments. Future studies should be conducted to evaluate long-term durability and predictors of success.