Many men suffer from chronic testicular pain. When there is not a clear identifiable anatomic cause or infection, it is thought to be due to microanatomic changes in nerve structure that cause this pain. Traditionally this has been managed with a minor surgical procedure termed a microsurgical spermatic cord denervation (MSCD). This was traditionally performed by a very meticulous, involved microsurgical technique that essentially skeletonized the spermatic cord. With the identification of the trifecta nerve complex, 3 sets of nerve branches, that have been shown to be responsible for this type of testicular pain, a targeted spermatic cord denervation was developed. Dr. Kavoussi changed his technique from the skeletonization to the targeted technique when this data became available about the 3 responsible nerve branches. Dr. Kavoussi published a research study comparing the two techniques in his own patients and found that the targeted technique resulted in equivalent pain resolution and improvement rates as the conventional technique but with a less challenging microsurgery, with potentially less risk to important microscopic anatomic structures, and less operative time for patients under anesthesia. For his work with this important scientific publication, he received the 2021 outstanding paper award from the medical journal.
