• Mael Zuercher, Lisa Nicole D'Alessandro, Stephen Charles Brown, Armando Lorenzo, and David Levin.
• Department of Anesthesia and Pain Medicine, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada. mael.zuercher@gmail.com.
• Can J Anaesth. 2021 Nov 1; 68 (11): 1690-1694.

PurposeChronic scrotal content pain, chronic orchialgia, or testicular pain can present after trauma, vasectomy, and hernia repair, among other triggers. Microsurgical denervation of the spermatic cord is an option for definitive pain control. While this practice is established in adult urology, access to diagnostic intervention and definitive denervation surgery is limited in the pediatric population.Clinical FeaturesWe report a case of definitive resolution of testicular pain with microsurgical denervation of the spermatic cord in a pediatric patient with post-traumatic chronic orchialgia that significantly reduced his daily activities and worsened his anxiety prior to this treatment. The patient underwent attempts at conservative medication-based management, followed by diagnostic spermatic cord nerve block before definitive denervation surgery.ConclusionsThe incidence of chronic pain in pediatrics is substantial and is estimated to be around 20%. Orchialgia remains difficult and problematic to treat. Mental health diagnoses such as anxiety and depression are also significantly associated with chronic pain. Following consideration and implementation of steps for all these concerns, a diagnostic block and microsurgical denervation led to successful resolution of chronic testicular pain in a pediatric patient.© 2021. Canadian Anesthesiologists' Society.

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