Blockade of the spermatic cord is a medical manipulation involving the introduction of an anesthetic into the scrotum. It is carried out in order to eliminate pain for a while, for example, during a surgical intervention.
Anatomical reference
The spermatic cord is a strand that occurs along the path of the gonads in the scrotum. It originates on the inside of the opening of the inguinal canal. The size of the duct is no more than 20 cm. Its main components are:
- venous tangle;
- bundles of nerves;
- vas deferens;
- lymphatic vasculature;
- network of arteries and veins.
The spermatic cord has several functions. It supplies the testicles with blood and is responsible for diverting seminal fluid directly to the vas deferens.
Indications for prescription
Blockade of the spermatic cord is a medical manipulation. Only in some cases it is used in the course of diagnostic procedures. She isused to relieve pain syndrome characteristic of various diseases.
The main indications for blockade of the spermatic cord are the following conditions:
- orchitis;
- epididymitis;
- renal colic;
- urolithiasis;
- traumatic injuries of the genitals.
Also, this procedure is used as one of the components of local anesthesia during surgery in the area of the testicles, their appendages.
Preparatory stage
The blockade of the spermatic cord does not require specific preparation. Before carrying out manipulations, the skin at the injection site is treated with a 70% solution of alcohol or another antiseptic. If the procedure is prescribed to relieve pain due to inflammation of the epididymis or itself, the hair in the inguinal region and on the scrotum is not shaved. When it is used as conduction anesthesia, it will be necessary to carry out hygienic manipulations a day before the operation.
Technique
During the actual procedure, the patient remains in the supine position.
- First, the doctor treats the area to be punctured with an antiseptic solution.
- Injection for the blockade is performed, focusing on the root of the scrotum. The doctor fixes the cord with one hand, and makes a direct puncture with the other.
- An elongated needle is slowly inserted 6-8 cm deep. All manipulations must be carried out with extreme caution so as not to injure the venous vessel. When inserting a needletighten the plunger of the syringe. Then the pain medication is injected directly.
- The doctor applies a sterile dressing to the affected area.
Many people know this procedure under the name "blockade of the spermatic cord according to Lorin-Epstein". The technique of its implementation involves the use of "Novocaine" or "Ultracaine" as an anesthetic. In the first case, the duration of the blockade is about an hour, and in the second it lasts up to 6 hours. "Ultracain" is often combined with an antibacterial drug to stop the inflammatory process.
The procedure itself was proposed by M. Yu. Lorin-Epshtein. Subsequently, it was named after his last name. Its action for pain in the scrotum, provoked by inflammation of the testicle or its appendages, is explained by the blockade of nerve bundles in this area. In the case of renal colic, the analgesic mechanism is due to a completely different principle. This is a friendly-sedative effect, which is manifested due to the phylogenetic relationship of the ureter and spermatic cord.
In the fair sex, an analogue of this procedure, which provides an analgesic effect in renal colic, is the blockade of the round ligament of the uterus.
Rehabilitation period
The rehabilitation period does not imply specific features. Immediately after the manipulation, the doctor should examine the patient. If the result is positive, he sends the man home or to the ward if the latter is on a stationarytreatment.
Possible contraindications
The technique of blockade of the spermatic cord involves medical manipulations. Therefore, this procedure has certain contraindications:
- age of the patient (blockade is not used in pediatrics);
- high chance of allergic reaction to anesthetic drug;
- presence of skin lesions in the injection area;
- bleeding disorder;
- diagnosed mental disorders.
In each case, the need for blockade of the spermatic cord is considered individually.
Consequences and complications of the procedure
For an experienced doctor, blockade is usually not difficult. In addition, the procedure itself does not require auxiliary control measures. We are talking about MRI and ultrasound diagnostics. After the injection of the anesthetic solution, the patient, as a rule, immediately feels pain relief. Otherwise, the Lorin-Epstein blockade of the spermatic cord does not affect the lifestyle of a man.
Only in some patients, the procedure is accompanied by the following undesirable consequences:
- lower blood pressure, increased sweating;
- hemorrhage in the form of a hematoma;
- inflammatory reaction at the puncture site.
The above reactions usually go away on their own within a few days. However, upon the appearanceinflammation, it is better to consult a doctor for additional examination.
Of course, the same procedure in different patients can proceed in a special way. This also applies to the likelihood of further development of complications. In most men, they rarely occur. A slight sensation of pressure or numbness should not be cause for concern.
The most serious complications occur when the blockade of the spermatic cord according to Lorin is performed inaccurately or illiterately, with insufficient aseptic measures. Also, their occurrence is not excluded in the case of the introduction of an excessively large dose of an anesthetic drug. The state of overdose is usually accompanied by feelings of restlessness and arousal. The patient has convulsive twitching of muscles, rapid breathing. In such situations, emergency medical attention is required.
Patient testimonials
According to the feedback from patients, the blockade of the spermatic cord allows you to quickly get rid of pain. However, their duration is largely determined by the drug used as an anesthetic. In addition, the procedure itself is rarely accompanied by complications, and the rehabilitation period does not require special precautions. Immediately after the manipulations, the patient can go home and do their usual activities.
Such a blockade can be used not only to eliminate the painful syndrome. For example, the addition of antibacterial drugs from the group of penicillins or aminoglycosides to the solution can additionally influence the focus of inflammation. It's activeused in medical practice in the treatment of inflammatory processes in the testicles or their appendages.
However, it is worth noting that the blockade is not a medical procedure that can cure the disease. It is used exclusively to suppress the pain syndrome for a while, which allows the doctor to carry out other diagnostic or therapeutic measures. Only in some cases, with renal colic, one blockade is enough for the stone to move from the ureter and into the bladder.
Negative feedback is extremely rare. As a rule, they are associated with incorrect or poor-quality procedures. For example, the wrong choice of point for the blockade of the spermatic cord can lead to a lack of a positive analgesic effect or even cause complications. Therefore, before treatment, it is necessary to carefully choose not only the clinic, but also the doctor. If there are significant contraindications, it is better to refuse manipulation.
