Evidence map›Paper›PMID 38639020›Full record

ArticleAndrology2025

Stripping versus ligation of vas deferens in microscopic denervation of spermatic cord in men with chronic orchialgia: A multicenter study.

Adnan El-Achkar, Muhammed Hammad, David Barham, Chad A Service, Darshan Patel, Tung Chin Hsieh, Jesse Mills, Reza Kianian, Sriram Eleswarapu, Matthew Ziegelmann and 10 more

Open access · hybridAbstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Andrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 91% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 9 institutions in 2 countries.

Adnan El-AchkarDepartment of Urology, American University of Beirut, Beirut, Lebanon.ORCID 0000-0002-3656-4217
Muhammed HammadDepartment of Urology, University of California Irvine, Orange, California, USA.ORCID 0000-0001-5396-1364
David BarhamDepartment of Urology, University of California Irvine, Orange, California, USA.
Chad A ServiceDepartment of Urology, University of California San Diego, San Diego, California, USA.
Darshan PatelDepartment of Urology, University of California San Diego, San Diego, California, USA.
Tung Chin HsiehDepartment of Urology, University of California San Diego, San Diego, California, USA.
Jesse MillsDavid Geffen School of Medicine, UCLA, Los Angeles, California, USA.
Reza KianianDavid Geffen School of Medicine, UCLA, Los Angeles, California, USA.
Sriram EleswarapuDavid Geffen School of Medicine, UCLA, Los Angeles, California, USA.
Matthew ZiegelmannDepartment of Urology, Mayo Clinic, Rochester, Minnesota, USA.
Ryan SmithDepartment of Urology, University of Virginia, Charlottesville, Virginia, USA.
Darren BrykDepartment of Urology, University of Virginia, Charlottesville, Virginia, USA.
Helen L BernieDepartment of Urology, Indiana University, Indianapolis, Indiana, USA.
Melissa EgertDepartment of Urology, Indiana University, Indianapolis, Indiana, USA.
Omer RaheemDepartment of Urology, University of Chicago, Chicago, Illinois, USA.
Kiarad FendereskiDepartment of Urology, University of Utah, Salt Lake City, Utah, USA.
Kelli GrossDepartment of Urology, University of Utah, Salt Lake City, Utah, USA.
Alex PastuszakDepartment of Urology, University of Utah, Salt Lake City, Utah, USA.
James HotalingDepartment of Urology, University of Utah, Salt Lake City, Utah, USA.
Faysal YafiDepartment of Urology, University of California Irvine, Orange, California, USA.
University of Utah · USUniversity of California, Irvine · USUniversity of California, Los Angeles · USUniversity of California San Diego · USIndiana University Indianapolis · USUniversity of Virginia · USAmerican University of Beirut · LBMayo Clinic · USUniversity of Illinois Chicago · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMicrodenervation of the spermatic cord (MSCD) is an effective treatment modality for men with intractable scrotal content pain. For patients not interested in preserving fertility, some centers advocate ligation of the vas during denervation, while others prefer stripping of the vas deferens to preserve the vasal artery, hence preserving vasculature to the testis and possibly decreasing post-operative congestion pain.

objectiveTo compare outcomes of patients with chronic orchialgia, who underwent MSCD by either stripping or ligating the vas deferens. MATERIALS AND

methodsA retrospective chart review of 85 patients who underwent MSCD from 2017-2023 was performed. Patients' demographics including history of prior surgical procedures were recorded. Response to surgery was evaluated as either complete resolution of pain, partial resolution of pain, or no improvement in pain.

resultsEighty-five patients underwent MSCD with a median (interquartile range, IQR) age of 36 (25.5-46.5) years and median duration of pain of 16 (6-31) months. Thirty-seven patients underwent stripping of vas, while 48 underwent ligation of vas during MSCD. Median follow up was 12 months. Twenty-one (43.5%) patients had prior inguinal scrotal surgery in the ligation group compared to 5 (13.5%) in the stripping group, p = 0.003. The etiology of pain was similar between the groups. The response to MSCD between the two groups was similar, 67.6% of patients who underwent stripping had complete resolution of pain versus 66.7% of those who had ligation (p = 0.968), with similar rates of post-operative complications (p-value = 0.132).

conclusionsIn men with intractable chronic scrotal content pain with no interest in preserving fertility, ligation, or stripping of the vas deferens yields similar outcomes with regard to pain resolution. Both techniques are safe with no reports of any testicular atrophy.

Indexed as

Chronic PainDenervationSpermatic CordTesticular DiseasesVas DeferensAdultHumansLigationMaleMiddle AgedRetrospective StudiesTreatment Outcomechronic scrotal painligation of vasmicroscopic denervation of spermatic cordsurgical techniquetreatment outcomes

Identifiers

PMID38639020
PMCPMC11815535
OpenAlexW4394957479

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.