Chronic orchalgia is a frustrating clinical problem for both the patient and the physician. We present a 17-year-old boy with a bilateral idiopathic chronic intractable orchalgia with failed conservative treatment. For 2 years, he suffered from severe attacks of scrotal pain that affected his daily activities and caused frequent absence from school. Ultrasound-guided pulsed radiofrequency ablation (PRF) of the genital branches of the genitofemoral nerve performed after local anesthetic nerve block confirmed the diagnosis and yielded 6 weeks of symptom relief. Seven-month follow-up revealed complete satisfactory analgesia. The use of PRF is an effective and non-invasive approach to treat intractable chronic orchalgia.

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We present a case of a terminally ill cancer patient with metastasis who was suffering from inadequate pain control despite high doses of systemic opioid administration. In addition, her quality of life was significantly impaired due to opioid-induced troublesome side effects. In the situation as above, intrathecal opioid administration has established as a safe and effective therapeutic option with a positive benefit-risk ratio. This case reports a novel technique, where an intravenous port catheter was used to administer intrathecal opioid.