Case series: The use of spermatic cord block in maximising patient comfort during ultrasound-guided percutaneous core-needle biopsy of the testicle.

INTRODUCTION/PURPOSE: Percutaneous core-needle biopsy of the testicle has been shown to be a safe and effective method of obtaining tissue for histological analysis and can be considered in specific clinical scenarios. While the use of spermatic cord block has been shown to be effective in pain relief in the emergent setting and as an anaesthetic option for inguinal surgery, its use in percutaneous core-needle biopsy has not been well described. Through this case series, we present our experience and technique of ultrasound-guided percutaneous core-needle biopsy using spermatic cord block in the setting of indeterminant testicular masses.

METHODS: Our departmental biopsy database was reviewed to identify patients who underwent percutaneous core-needle biopsy of the testicle from March 2010 to July 2022 and who also received spermatic cord block during the procedure.

RESULTS: Three patients were identified who met the search criteria. All three patients presented for the evaluation of indeterminant testicular mass and had a known non-testicular primary cancer diagnosis at the time of biopsy. All three biopsies were performed using a combination of spermatic cord block, moderate sedation, and local anaesthetic. Biopsies were obtained using an 18-gauge spring-loaded device with 4-5 core samples obtained during each procedure. All biopsies were well tolerated without significant pain or post-procedure complications.

DISCUSSION: Ultrasound-guided percutaneous core-needle testicular biopsy using spermatic cord block is a safe and effective option in sampling indeterminate testicular masses while maintaining patient comfort.

CONCLUSION: The inclusion of a spermatic cord block in combination with local anaesthetic and moderate sedation has become standard practice in our institution, as we believe this maximises patient comfort and safety resulting in a better patient experience.