Blockade of the spermatic cord

A specific therapeutic manipulation – blockade of the spermatic cord, consists of the introduction of an anesthetic solution into the spermatic cord area. Thanks to this procedure, it is possible to eliminate painful sensations in the patient for some time – in case of inflammatory disease of the epididymis and/or testicle, during surgery on the scrotum.

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Indications for the procedure

The blockade of the spermatic cord is primarily a therapeutic manipulation. Only occasionally is it used in certain diagnostic procedures. The purpose of the blockade is to relieve pain that occurs in various painful conditions.

The use of a spermatic cord block is appropriate in the case of an acute attack of renal colic, during an exacerbation and in the subacute period of epididymitis, during an inflammatory reaction in the testicle, as well as during surgery on the scrotum or in case of scrotal injuries.

By blocking the spermatic cord, the doctor achieves the fastest possible pain-relieving effect.

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Preparation

Spermatic cord block is not a simple procedure, but it does not require any special preliminary preparation of the patient. There are only a few important conditions:

• On the day of the procedure, the patient must carefully shave the groin area (this should not be done in advance, as it may cause skin irritation);
• Before going for the spermatic cord block procedure, the patient should take a shower.

No other special preparation measures are required.

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Technique spermatic cord blockages

During the procedure, the patient lies on his back.

• The doctor treats the injection area with an antiseptic solution.
• The injection for blocking the spermatic cord is done, focusing on the root of the scrotum. The cord is held with one hand, and with the other hand the solution is simultaneously injected into the skin in order to prevent pain when the drug is injected deep into the skin layers.
• Next, the elongated needle is inserted into the tissues 6-8 cm deep, above the spermatic cord area. This is done very carefully so as not to damage the venous vessel. When inserting the needle, the syringe plunger is partially pulled back to make sure that the vessels are not damaged. Next, the anesthetic solution is injected into the tissues located around the cord.
• The doctor applies a sterile bandage to the injection area.

Novocaine blockade of the spermatic cord is also known by other names. For example, the Lorin-Epstein blockade of the spermatic cord is so named because it was first proposed in the 1940s by M. Yu. 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 of the urethra and the spermatic cord.

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

Contraindications to the procedure

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

• the blockade is not used in pediatrics;
• do not perform a spermatic cord block if there is a high risk of allergy to local anesthetics;
• the blockade of the spermatic cord is cancelled if there is visible damage to the integrity of the tissues (abrasions, inflammation, etc.) in the area of the proposed administration of the anesthetic;
• A blockade of the spermatic cord should not be performed in patients with a tendency to bleeding, with blood clotting disorders, or in patients with diagnosed mental health disorders.

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Consequences after the procedure

The blockade of the spermatic cord is not difficult for a practicing physician. There is also no need for additional control measures - for example, during the manipulation, the doctor does not use ultrasound or tomographic control. After the doctor administers the anesthetic solution, the patient feels pain relief almost immediately. Otherwise, the procedure does not affect the patient's usual life and everyday life.

Only some patients may experience adverse reactions immediately after the spermatic cord block procedure:

• sweating, decreased blood pressure;
• small hemorrhage in the form of a hematoma (if the needle touches the vessels of the pampiniform plexus);
• inflammatory reaction (due to poor quality treatment of the skin in the area where the anesthetic is administered).

All of the above consequences are usually relieved on their own and do not require additional intervention from a doctor. If an inflammatory reaction develops in the area where the drug is injected, you should still seek medical help: the doctor will prescribe local and/or systemic anti-inflammatory treatment.

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Complications after the procedure

Of course, even the same procedure may be different for different patients. This also applies to the further development of complications. For example, in most patients, the blockade of the spermatic cord proceeds without serious complications. Some patients may experience a slight feeling of numbness or compression: this symptom usually goes away without additional assistance during the first 24 hours after the procedure.

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

• slight transient dizziness;
• general state of excitement;
• increased sweating, pale skin;
• lowering blood pressure;
• small muscle spasms;
• allergic manifestations.

The most serious complications occur when the blockade of the spermatic cord is performed incorrectly or carelessly, with insufficient aseptic measures. It is also possible that too much painkiller has been administered. Usually, the overdose state is characterized by a feeling of anxiety and general agitation. The patient experiences convulsive twitching of the muscles, and breathing becomes more frequent. In such a situation, emergency medical care is required.

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Care after the procedure

No special measures for patient care after the spermatic cord block are required. The doctor will monitor the patient's condition after the procedure and send him home or to the ward (if the patient is undergoing hospital treatment).

There are no special lifestyle or dietary requirements after a spermatic cord block.

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Reviews

According to reviews, the spermatic cord block demonstrates a fast and strong pain-relieving effect. However, the duration of such an effect depends on the pain-relieving drug used by the doctor. For example, if novocaine was used for the block, the pain-free period will be from half an hour to an hour. If strong drugs were used, such as ultracaine, the pain-relieving effect can “stretch” up to six hours.

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

Most patients claim that spermatic cord blockade is a painless but very effective procedure, so there is no need to be afraid of such a procedure.