Chronic Testicular Pain: An Overview

Granitsiotis, Paraskeve; Kirk, D.

doi:10.1016/j.eururo.2003.11.004

Cited by 98 publications

(69 citation statements)

References 29 publications

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“…Scrotal pain could be due to either referred pain or idiopathic pain, and the testicular causes of pain include infection, tumor, testicular torsion, varicocele, hydrocele, spermatocele, trauma, or previous surgical intervention (12). Organs and body structures that share nerve pathways with scrotal structures, such as the ureter, the prostate or the hip, can cause referred pain in this area (12,13). Scrotal US is an important component of the evaluation of patients with scrotal pain (14).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of scrotal calculi and its relationship to pain

Tan

Ozcan²,

Karaoğlanoğlu³

et al. 2011

Diagn Interv Radiol

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303T he presence of scrotal calculi is a relatively rare condition that is characterized by the presence of freely mobile calcified bodies between the layers of the tunica vaginalis of the testes, which are often found in patients who have been referred for scrotal ultrasound (1). The etiology of the scrotal calculi is uncertain. However, inflammatory changes within the remnants of the appendix, testis or epididymis may play a role in the development of these types of calculi (1, 2). There are a limited number of studies on scrotal calculi in the literature, and most of these are case reports. Furthermore, to our knowledge, no clinical trial has focused on whether there is a relationship between scrotal calculi and pain.The purpose of this large series study was to determine the frequency of scrotal calculi in men who were referred for scrotal ultrasound, and to identify any associated pathologic conditions in order to investigate whether any relationship exists between the presence of scrotal calculi and pain. Materials and methodsThis research was approved by the institutional human ethics committee at our hospital. A retrospective review of the radiology data processing system database revealed the existence of 4084 ultrasonography (US) scrotal reports from 3435 men between January 2008 and February 2011.US examinations were performed using US equipment with a 9-14 MHz linear probe (Logic9, GE Healthcare, Milwaukee, Wisconsin, USA) and with an 8-14 MHz linear probe (Technos MPX, Esaote, Genoa, Italy). US examinations were performed by two radiologists who were experienced in ultrasound techniques. The examinations were performed while the patient was lying in the supine position. The scrotum was immobilized prior to the application of a small amount of gel, and the US scans were performed in the transverse, longitudinal and multiple oblique planes. In this study, the patient information and the US findings were obtained from the US reports. These reports had been recorded in the radiology information system and we evaluated each of the scrotal US reports.Scrotal calculi were defined as typical round or oval echogenic foci with or without acoustic shadowing that were located between the layers of the tunica vaginalis of the testes (Fig. 1). Additionally, scrotal abnormalities, such as the presence of hydrocele or varicocele, or any other testicular or epididymal abnormalities that were reported during the scrotal US examination, were noted.Following the identification of scrotal calculi from the US reports, a total of 67 patients were contacted by phone, and 40 patients were interviewed. Subsequently, patients were asked whether they had any scrotal PURPOSEThe purpose of this study was to determine the frequency of scrotal calculi in men referred for scrotal ultrasonography (US), to identify any associated pathologies, and to investigate if any relationship exists between scrotal lithiasis and pain. MATERIALS AND METHODSThis was a retrospective study in which 4084 scrotal US examinations in 3435 men were eval...

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Section: Discussionmentioning

confidence: 99%

Prevalence of scrotal calculi and its relationship to pain

Tan

Ozcan²,

Karaoğlanoğlu³

et al. 2011

Diagn Interv Radiol

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“…A history of trauma, possibly on the job injury, back pain, other chronic pain, and psychiatric disorders should be elicited. Chronic intermittent torsion, tumor, retroperitoneal fibrosis, periarteritis nodosa, epilepsy, self-palpation orchitis, aneurysms of the common iliac artery, intervertebral disc protrusion, diabetic neuropathy, gout, 5 and pudendal nerve entrapment 6 have been listed as potential causes of orchialgia. Vasectomy may have been performed long ago and questions should be asked directly to establish a possible cause.…”

Section: Discussionmentioning

confidence: 99%

The Use of Testosterone in the Treatment of Chronic Postvasectomy Pain Syndrome: Case Report and Review of the Literature

Pienkos

2007

Military Medicine

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The purpose of this article is to describe a simple, intellectually reasonable, initial treatment for all subacute and chronic postvasectomy scrotal pains. The use of intramuscular testosterone cypionate in a dose of 400 mg monthly for 3 months is described for patients suffering from painful sperm granuloma at the vasectomy site or in the epididymis, circumventing the need for other medical or surgical approaches. Excellent results have been achieved in patients and a representative case is illustrated. The rationale for this approach based on endocrinological and immunological mechanisms is described.

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“…Pain syndromes without specific causes, including orchalgia, urethral syndrome, prostatodynia, proctodynia and others, are well described, and a multidisciplinary approach to management has been recommended [1][2][3][4][5][6]. Urological investigations are aimed at excluding organic pathology to exclude conditions such as epididymitis, epididymal cysts, varicoceles, hydroceles and of course testicular tumours.…”

Section: Introductionmentioning

confidence: 99%

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

Naim

Ende

2011

BJU International

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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.

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Chronic Testicular Pain: An Overview

Cited by 98 publications

References 29 publications

Prevalence of scrotal calculi and its relationship to pain

Prevalence of scrotal calculi and its relationship to pain

The Use of Testosterone in the Treatment of Chronic Postvasectomy Pain Syndrome: Case Report and Review of the Literature

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

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