Chronic Scrotal Pain Syndrome: Management among Urologists in Switzerland

Strebel, Raeto T.; Leippold, Thomas; Luginbuehl, Thomas; Muentener, Michael; Praz, V.; Hauri, D.

doi:10.1016/j.eururo.2005.01.003

Cited by 57 publications

(45 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, this treatment neither eliminated nor improved their symptoms sufficiently, which is reflected by the multiple consultations with different doctors. Thus, the treatment of the symptoms summarized as CSPS is a challenging problem for urologists (Nickel et al, 2002;Nickel, 2003;Strebel et al, 2005;Strom & Levine, 2008). This perception is supported by our data, demonstrating that CSPS has a considerable impact on the quality of life of afflicted patients.…”

Section: Discussionsupporting

confidence: 69%

See 1 more Smart Citation

Chronic scrotal pain syndrome (CSPS): the widespread use of antibiotics is not justified

et al. 2012

View full text Add to dashboard Cite

SUMMARYData supporting the widespread use of antibiotics in patients with chronic scrotal pain syndrome (CSPS) are not available. Therefore, the aim of this study was to investigate the presence of bacteria in the genitourinary tract in patients presenting with CSPS. From July 2005 to July 2007 we prospectively enrolled patients presenting with CSPS in our outpatient clinic. The evaluation consisted of a detailed patient's history, physical examination and ultrasound examination of the scrotum. A blood and urinalysis, a Meares-Stamey four-glass test for bacterial cultures and PCR testing for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis and Neisseria gonorrhoeae as well as a semen culture were performed. We assessed the symptom severity with the chronic epididymitis symptom index (CESI) score according to Nickel et al. (J Urol 2002, 167:1701; based on the NIH-CPSI). A total of 55 eligible men (median age 34 years) with CSPS were enrolled in the study. The median CESI score was 17 (range 4-26). The majority of patients (n = 39; 71%) were seen by a general practitioner or an urologist before. Of these, 25 patients (64%) were treated with antibiotics and 26 (67%) with non-steroidal anti-inflammatory drugs, respectively. A significant bacterial colony count in at least one specimen was detected in 21 of 55 patients (38%). The predominantly detected microorganisms were an Alpha-haemolytic Streptococcus (11 patients) and coagulase-negative staphylococci (10 patients). Thus, only in 12 of 55 (22%) patients isolated bacteria were considered to be of clinical relevance. No factor or condition predictive for a bacterial aetiology for CSPS could be identified. In our microbiological assessment of patients presenting with CSPS we found no evidence for the widely held belief that CSPS is predominantly the result of a chronic bacterial infection. We therefore conclude that the widespread use of antibiotic agents in the treatment of patients with CSPS is not justified.

show abstract

Section: Discussionsupporting

confidence: 69%

“…In a recent survey among Swiss urologists, 98% considered infections to play a role in the aetiology of CSPS (Strebel et al, 2005). Accordingly, up to 82% of patients with CSPS are treated with an antibiotic agent.…”

Section: Introductionmentioning

confidence: 99%

Chronic scrotal pain syndrome (CSPS): the widespread use of antibiotics is not justified

et al. 2012

View full text Add to dashboard Cite

show abstract

“…[13] described the type of cases seen in Switzerland, and it is obvious from their description that these patients undergo a lot of testing, may have invasive procedures, get treated for a length of time, and incur a lot of expense, and yet the 'recurrence rates for conservative treatment are estimated high which is in contradiction to the presumed aetiology. Therefore, further evaluation of this poorly described disease complex is required. '…”

Section: Discussionmentioning

confidence: 97%

A new approach to the treatment of non‐specific male genital pain

Naim

Ende

2011

BJU International

View full text Add to dashboard Cite

OBJECTIVES • To review the literature and the generally accepted unsatisfactory management of chronic genital pain in men. • To refer such patients for Journey psychotherapy and record the outcomes of such treatment. PATIENTS AND METHODS • We describe an alternative psychotherapeutic approach in the treatment of such men, whereby deep‐seated emotions are considered an underlying cause in the expression of chronic genital pain. • Eleven men with refractory chronic genital pain were counselled, and given one Journey process, lasting 2–3 h. • They were followed up for up to 4 years in some cases, and their outcomes recorded. • No further treatment was undertaken in this time. RESULTS • Of the 11 cases, four had significant pain relief, four had partial relief of their symptoms, and three did not (or may have had some relief but were lost to follow‐up). CONCLUSION • Chronic genital pain syndromes are common and often debilitating. Patients are subject to an array of investigations that usually identify non‐specific abnormalities at best. Treatment is usually aimed at symptomatic control as underlying organic pathology is rarely identified. Patients have been given multiple courses of antibiotics even in the absence of identifiable organisms, anti‐inflammatory drugs in the absence of proven inflammation, and narcotic analgesics in an attempt to control chronic pain. Occasionally surgery, such as orchidectomy, has been performed to remove the painful organ, without satisfactory results. We therefore looked for an alternative approach that had the promise of a more satisfactory outcome. • Given the usual psychotherapeutic requirement of lengthy periods of therapy, and given that each patient only had one session, we find the above results remarkable and very encouraging. • With this experience, we now offer this approach early to avoid wasting time and money, and would persist with further therapy sessions especially in those with partial relief of their pain.

show abstract

“…In China, although there are no exact answer how many cases occur yearly, it does be the cause of 2.5-4.8% of urologic clinic visits [13,14].…”

Section: Discussionmentioning

confidence: 99%

A Clinical Study on Microsurgical Denervation of Spermatic Cord for Refractory Chronic Orchialgia

et al. 2019

View full text Add to dashboard Cite

Objectives: Microsurgical denervation of the spermatic cord (MDSC) is a treatment option for chronic orchialgia (CO) refractory to conservative treatment. Studies showed specific nerve fibers as the possible cause of CO. We aimed to present the outcomes of ligation of these nerves using targeted MDSC. Methods: We retrospectively reviewed 30 cases who underwent targeted MDSC from August 2014 to February 2018. Patients included were under strict criteria. Pain was assessed preoperatively and postoperatively using a subjective visual analog scale (VAS) and objectively with the standardized and validated Pain Impact Questionnaire-6 (PIQ-6) score. Results: Data were available on 28 cases at repercussion. During a median follow-up of 12 months (range 10–29), 25 cases (89.2%) showed a significant reduction in pain and 3 (9.8%) had no change in pain by subjective VAS scoring. Of cases with a significant reduction in pain, 15 (53.5%) had complete resolution and 19 (67.9%) had a 50% or greater reduction. Objective PIQ-6 analysis showed a significant reduction in pain in 78.6% of patients at 6 months postoperatively, in 82.1% at 1 year, in 82.1% at 2 years. Conclusions: Targeted MDSC is an effective, minimally invasive approach with potential long-term durability in patients with refractory CO.

show abstract

Chronic Scrotal Pain Syndrome: Management among Urologists in Switzerland

Cited by 57 publications

References 17 publications

Chronic scrotal pain syndrome (CSPS): the widespread use of antibiotics is not justified

Chronic scrotal pain syndrome (CSPS): the widespread use of antibiotics is not justified

A new approach to the treatment of non‐specific male genital pain

A Clinical Study on Microsurgical Denervation of Spermatic Cord for Refractory Chronic Orchialgia

Contact Info

Product

Resources

About