Objective To assess the incidence of chronic postwas brief and was not defined as CPTP, while 20 (19%) patients had pain for >3 months; 33 (31%) vasectomy testicular pain (CPTP) and evaluate the use of denervation of the spermatic cord in its management.patients required analgesics to control the pain. Of the 17 patients who underwent spermatic cord denerPatients and methods A retrospective postal survey of 560 patients (mean age 36 years, range 25-55; mean vation, 13 reported complete relief of pain at their first follow-up visit and were discharged. Four patients had time since vasectomy 19 months, range 8-39) who underwent vasectomy between July 1992 and a significant improvement in the symptom score and were satisfied with the results. December 1994 was carried out to determine the incidence of CPTP. A prospective study was conducted Conclusions There is a small but significant incidence of CPTP and patients should be warned of this possibility in a further group of 17 patients (mean age 43 years, range 34-60), who had had CPTP for at least one when counselled before operation. Denervation of the spermatic cord seems to be a viable surgical option for year, to evaluate the effectiveness of nerve stripping of the spermatic cord in relieving pain.patients with CPTP who fail to respond to conservative measures. Results Of 396 replies, 108 (27.2%) patients complained of some testicular pain following their vasectomy Keywords Vasectomy, complications, chronic pain, denervation operation. In 88 (82%) of these 108 patients the pain denervation of the spermatic cord in the management

Chronic post-operative pain following LIHR is more prevalent than recurrence. Pre-operative pain, surgery for recurrent inguinal hernias (following anterior repair) and younger age at surgery predict development of CPP. Identification of 'high-risk' patients may improve management, reducing morbidity and cost.

Occult rectal prolapse is a condition of young adults which causes problems in diagnosis. Symptoms consist of tenesmus and the passage of blood and mucus associated with constipation and straining at stool. The rectal prolapse often remains unrecognized for a long time because demonstration of the prolapse is difficult. There are characteristic changes in the rectum on clinical examination and these should alert the clinician to the diagnosis. Treatment of the prolapse relieves the symptoms.

Surgical outcomes in lower volume hospitals are comparable with those reported by larger centres.