Chronic orchialgia: epidemiology, diagnosis and evaluation

Sigalos, John T.; Pastuszak, Alexander W.

doi:10.21037/tau.2017.05.23

Cited by 44 publications

(43 citation statements)

References 32 publications

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“…Chronic orchialgia/scrotal contents pain is common, poorly understood and under-studied ( 6 ). A significant barrier to the scientific evaluation of a condition and its treatment is the lack of a standardized and validated way to assess and quantify symptoms.…”

Section: Discussionmentioning

confidence: 99%

Development of a clinically relevant symptom index to assess patients with chronic orchialgia/chronic scrotal content pain

Polackwich¹,

Arora²,

Li³

et al. 2018

Transl. Androl. Urol.

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BackgroundThe purpose of this study was to develop a candidate symptom index for men with an established diagnosis of chronic orchialgia.MethodsBased on interviews with patients and providers, we developed a 70-item questionnaire that focused on seven areas of orchialgia symptoms: pain, location, urinary symptoms, sexual dysfunction, medical history and quality of life (QOL) impact. The questionnaire was completed by patients at two medical centers. Cluster analysis was performed with the software package R (3.2.1).ResultsA total of 113 men completed the survey. Median symptom duration was 12 months (range, 3–336 months). Outside the testicle, pain was felt in the spermatic cord (66%), groin (66%), penis (24%), suprapubic region (38%), flank (31%), thigh (32%), abdomen (36%) and perineum (35%). Bother scores were high only for testicle and spermatic cord pain. Urinary frequency was common (54%) but not bothersome. Sexual dysfunction was common: 55% had erectile dysfunction, 56% had decreased libido and 39% had painful ejaculation with high bother for all. By cluster analysis, QOL parameters clustered tightly with minimal pain level, pain at night, burning pain, distribution to spermatic cord and groin, erectile dysfunction and premature ejaculation.ConclusionsMen with chronic orchialgia have a high incidence of associated symptoms. Most bothersome symptoms with highest QOL impact include burning pain, pain at night, radiation to groin and spermatic cord, erectile dysfunction and low libido. Based on these findings, we have created a candidate orchialgia symptom index with domains of pain, sexual symptoms and QOL that will undergo prospective validation.

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Section: Discussionmentioning

confidence: 99%

Development of a clinically relevant symptom index to assess patients with chronic orchialgia/chronic scrotal content pain

Polackwich¹,

Arora²,

Li³

et al. 2018

Transl. Androl. Urol.

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“…Chronic orchialgia or chronic scrotal content pain (CSP) is seen in about 2.5–4.8% of all urology clinic visits. 1 This can be a frustrating condition to treat for patients and urologists alike. Many common causes of testicular pain can usually be identified with a thorough physical examination and history.…”

Section: Introductionmentioning

confidence: 99%

<p>Management of Chronic Orchialgia: Challenges and Solutions – The Current Standard of Care</p>

Parekattıl¹,

Ergun²,

Güdeloğlu³

2020

RRU

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Introduction Chronic scrotal content pain (CSP) or chronic orchialgia can be debilitating for patients and difficult to treat. There is a paucity of structured treatment algorithms to approach this difficult condition. Methods A review of the literature was performed. Conservative treatment options are presented and then targeted surgical interventions that the urologist may perform are then presented in a structured algorithm format. Many of these patients may obtain a significant reduction in pain with some of these treatments. Results This review presents the pathophysiology, a new assessment tool, and various treatment options available for CSP patients, such as targeted spermatic cord blocks, targeted and standard microsurgical denervation of the spermatic cord (77–100% success rates), ultrasound-guided peri-spermatic cord and ilioinguinal cryoablation (59–75% success rates), scrotox (botox) (56–72% success rates), targeted ilioinguinal and iliohypogastric peripheral nerve stimulation (72% success rate), radical orchiectomy (20–75% success rate), targeted robotic-assisted intra-abdominal denervation (71% success rate) and vasectomy reversal (69–100% success rates). Conclusion A structured and evidence-based approach to help urologists manage patients with chronic orchialgia or scrotal content pain is presented.

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“…Moreover, Scrotal Pain Syndrome, Testicular Pain Syndrome, Epididymal Pain Syndrome, Postvasectomy Scrotal Pain Syndrome, Penile Pain Syndrome, and Urethral Pain Syndrome are all classified as Urological Pain Syndromes. Again, in many articles authors refer to these syndromes as “Chronic Orchialgia” or “Chronic Scrotal Syndrome” [ 5 , 6 ]. Gynaecological Pain Syndromes include Vulvar Pain Syndrome (also termed “Vulvodynia”), Vestibular Pain Syndrome, Clitoral Pain Syndrome, Dysmenorrhea, and Endometriosis-Associated Pain Syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic Scrotal Pain is as well a likely underestimated syndrome, with reported prevalence ranging between 2,5 and 5% [ 5 , 6 , 32 , 33 ]. It is as well accompanied by poor psychosocial, sexual, and QoL outcomes and thus represents a considerable burden for patients.…”

Section: Introductionmentioning

confidence: 99%

Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation

Passavanti

Pota

Sansone

et al. 2017

Pain Research and Treatment

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Chronic Pelvic Pain (CPP) and Chronic Pelvic Pain Syndrome (CPPS) have a significant impact on men and women of reproductive and nonreproductive age, with a considerable burden on overall quality of life (QoL) and on psychological, functional, and behavioural status. Moreover, diagnostic and therapeutic difficulties are remarkable features in many patients. Therefore evaluation, assessment and objectivation tools are often necessary to properly address each patient and consequently his/her clinical needs. Here we review the different tools for pain assessment, evaluation, and objectivation; specific features regarding CPP/CPPS will be highlighted. Also, recent findings disclosed with neuroimaging investigations will be reviewed as they provide new insights into CPP/CPPS pathophysiology and may serve as a tool for CPP assessment and objectivation.

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Chronic orchialgia: epidemiology, diagnosis and evaluation

Cited by 44 publications

References 32 publications

Development of a clinically relevant symptom index to assess patients with chronic orchialgia/chronic scrotal content pain

Development of a clinically relevant symptom index to assess patients with chronic orchialgia/chronic scrotal content pain

<p>Management of Chronic Orchialgia: Challenges and Solutions – The Current Standard of Care</p>

Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation

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