Blockade of spermatic cord

Specific therapeutic manipulation - blockage of the spermatic cord, consists in the introduction of an anesthetic solution into the zone of the spermatic cord. Thanks to this procedure, it is possible for some time to eliminate the painful feelings in the patient - in case of an inflammatory disease the epididymis and / or testis, during operation on the scrotum.

[1], [2], [3], [4], [5]

Indications for the procedure

Blockade of the spermatic cord, in the first place, is a therapeutic manipulation. Only occasionally it is used for individual diagnostic procedures. The purpose of the blockade is to alleviate the pain that occurs with different painful conditions.

The use of blockage of the spermatic cord is appropriate in acute attacks of renal colic, with exacerbation and subacute period of epididymitis, with an inflammatory reaction in the testicle, as well as during an operative procedure on the scrotum or with scrotal injuries.

Using the blockade of the spermatic cord, the doctor achieves the fastest analgesic effect.

[6], [7], [8], [9]

Preparation

Blockage of the spermatic cord is not an easy procedure, however it does not require special preliminary preparation of the patient. There are only a few important conditions:

• on the day of manipulation, the patient should carefully shave the inguinal region (this should not be done in advance, as skin irritation may occur);
• Before going to the procedure of blockade of the spermatic cord, the patient must take a shower.

No other special training is required.

[10], [11], [12], [13]

Technique of the blockage of spermatic cord

During the procedure, the patient lies on his back.

• The doctor treats the injection site with an antiseptic solution.
• Injection for blockage of the spermatic cord is done by focusing on the root of the scrotum. The cord is held with one hand, and the other hand simultaneously injects the solution into the skin, in order to prevent pain when the drug is inserted deep into the skin layers.
• Further, the elongated needle is inserted into the tissue in depth by 6-8 cm, over the area of the spermatic cord. Do this very carefully, so as not to damage the venous vessel. When the needle is inserted, the syringe piston is partially tightened to make sure that the vessels are not damaged. Further, the anesthetic solution is injected into tissues located around the cord.
• At the injection site, the doctor applies a sterile bandage.

Novokainovaya blockade of the spermatic cord is also known under other names. For example, the blockade of the spermatic cord by Lorin-Epstein - and it is named so because it was first proposed in the 40s of the last century by M. Yu. Loryn-Epstein. The blockade affects the nervous innervation, and the analgesic effect in renal colic is explained by the presence of a friendly principle, which is formed as a result of the phylogenetic relationship between the urethra and the spermatic cord.

Blockage of the spermatic cord with novocaine is often used in renal colic, as its effectiveness is estimated at 70-90%. By the way, with inflammatory processes in the testicle and appendages, the blockade is used less often.

Contraindications to the procedure

It should be noted that the blockade of the spermatic cord has a small number of contraindications:

• blockade does not apply to pediatrics;
• Do not carry out blockade of the spermatic cord with a high likelihood of allergy to local anesthetics;
• blockage of the spermatic cord is canceled if in the zone of the supposed introduction of anesthetic there are visible damages to the integrity of the tissues (scrapes, inflammation, etc.);
• blockage of the spermatic cord can not be carried out with a tendency to bleeding, with clotting disorders, as well as patients with diagnosed mental health problems.

[14], [15], [16]

Consequences after the procedure

The blockage of the spermatic cord for a practicing physician is not difficult. Also, there is no need for auxiliary control measures - for example, during manipulation, the doctor does not use ultrasound or tomographic monitoring. After the doctor leads an anesthetic solution, the patient almost immediately feels relief from pain. The rest of the procedure does not affect the habitual life and life of the patient.

Only in some patients, undesirable reactions can occur immediately after the procedure of blockage of the spermatic cord:

• sweating, lower blood pressure;
• a small hemorrhage in the form of a hematoma (if the needle affects the vessels of the groinlike plexus);
• inflammatory reaction (with poor-quality treatment of skin in the area of injection of anesthetic).

All these consequences are most often stopped on their own and do not require additional doctor intervention. If an inflammatory reaction develops in the injection zone, you should still seek medical help: the doctor will prescribe local and / or systemic anti-inflammatory medication.

[17], [18], [19]

Complications after the procedure

Of course, even the same procedure for different patients can take place in different ways. This also applies to the further development of complications. For example, in most patients, the blockage of the spermatic cord proceeds without serious complications. Some patients may experience a slight feeling of numbness or squeezing: this symptom usually passes without additional help during the first day after the procedure.

After blockage of the spermatic cord, there is a possibility of occurrence of other complications:

• slight transient dizziness;
• general state of excitation;
• increase sweating, blanching of the skin;
• lowering of blood pressure;
• small convulsive muscle contractions;
• allergic manifestations.

The most serious complications occur when the blockage of the spermatic cord is carried out incorrectly or inaccurately, with insufficient aseptic measures. It is also not excluded the introduction of too large a dose of an anesthetic. Usually the condition of an overdose is characterized by a feeling of anxiety and general arousal. The patient has convulsive twitching of the muscles, breathing quickens. In such a situation, emergency medical care is necessary.

[20], [21], [22]

Care after the procedure

No special measures to care for the patient after blockage of the spermatic cord is not necessary. The doctor will monitor the patient's condition after manipulation and release him to his home, or to the ward (if the patient is on sick leave).

There are no specific features in lifestyle or nutrition after blockage of the spermatic cord.

[23], [24], [25], [26]

Reviews

Judging by the reviews, the blockade of the spermatic cord demonstrates a rapid and strong analgesic effect. True, the duration of such an action depends on what kind of anesthetic drug the doctor used. For example, if novocaine was used for blockade, the period without pain will be from half an hour to an hour. If you use strong drugs - for example, ultracaine, then the effect of anesthesia can "stretch" up to six hours.

The blockade of the spermatic cord can be used not only to relieve pain - for example, the addition of antibacterial drugs (penicillins, aminoglycosides, cephalosporins) to the medicinal liquid allows additionally to influence the inflammatory focus. Such an addition can be actively used in the treatment of the inflammatory process of the testicles and / or appendages.

Most patients claim that the blockage of the spermatic cord is a painless but very effective manipulation, so one should not be afraid of such a procedure.