Introduction: Microscopic denervation of the spermatic cord (MSCD) is an effective treatment for men with intractable scrotal content pain (SCP). For patients not interested in preserving fertility, some advocate ligation of the vas deferens during MSCD while others prefer stripping. This multicenter study sought to compare these two techniques in the aim of determining which intervention provides better pain relief. Methods: A retrospective chart review of 59 patients who underwent MSCD for SCP (> 3 months duration, no structural abnormalities and no history of vasectomy or other scrotal surgery) from 2020-2022 was performed. Patients’ demographics including history of prior surgical procedures was recorded. Response to surgery was evaluated as either complete resolution of pain, partial resolution of pain or no improvement in pain. Results: 59 patients underwent MSCD with a median age of 35 (IQR 25-37) years and median duration of pain of 18 months (IQR 12-32). 37 patients (62%) underwent stripping of the vas while 22 (38%) underwent ligation. Five patients (13%) had prior inguinal surgery in the stripping group compared to 11 (50%) in the ligation group. There was no significant difference between the groups regarding suspected etiology. There was no significant difference in response to MSCD between the 2 groups (stripping: 68% complete and 27% partial response; ligation: 82% complete, 18% partial response, p =0.36). There were no serious post-operative complications in either group (Table 1). Conclusions: In men with intractable chronic SCP with no interest in preserving fertility, ligation or stripping of the vas deferens seems to yield comparable outcomes with regards to pain resolution. Both techniques are safe with no reports of serious post-operative complications. SOURCE OF Funding: None
