Spinal Cord Stimulation for Testicular Pain

Abstract

Testicular pain may be difficult to treat particularly in patients unable to tolerate opioid analgesics. In cases that have failed conservative therapy, a trial of spinal cord stimulation should be explored.

Spinal Cord Stimulation for Intractable Testicular Pain: Case Report and Review of the Literature

“…Few treatments for chronic testicular pain have been shown to achieve total pain relief. Several trials have evaluated microsurgical denervation of the spermatic cord, orchiectomy, epididymectomy, and other treatment , but there are only two other case reports of SCS for testicular pain . To our knowledge this is the first case of chronic testicular pain due to tubercular epididymitis treated successfully with SCS.…”

Recent advances in cancer pain management

“…Notably, this was a much higher percentage response to spinal cord stimulation than for their overall response (56%). Other studies have shown efficacy of spinal cord stimulation in post thoracotomy pain for lung carcinoma [54], back pain related to carcinoma [55], leg pain [56,57] and groin/testicular pain [58,59]. Whilst more studies are needed, spinal cord stimulation appears to be a promising therapy for intractable cancer pain.…”

Chronic Testicular Pain in Adult Men

“…However, after treatment many are able to return to work (Doubleday et al, 2003;McJunkin et al, 2009;Nouri & Brish, 2011;Rosendal et al, 2012).…”

“…A visual analog scale is used to measure intensity. Only three of the research articles (Ciftci et al, 2011;de Oliveira et al, 2009;Misra, Ward, & Coker, 2009) and four of the case reports (McJunkin, Wuollet, & Lynch, 2009;Nouri & Brish, 2011;Rosendal, Moir, de Pennington, Green, & Aziz, 2012;Rowell & Rylander, 2012) include the quality of CTP. Sinclair, Miller, and Lee (2007) offer support for a neuropathic origin of CTP and are the first to show that neuromodulating medications decrease pain in chronic orchialgia.…”

“…The pain is described as "sharp, shooting" (McJunkin et al, 2009), "burning, stabbing, with radiation" (Nouri & Brish, 2011), "continuous, sharp, with radiation and hyperesthesia" (Rosendal et al, 2012), "incapacitating" (Choa & Swami, 1992), and as a "constant dull ache" (Rowell & Rylander, 2012). Central vertebral disc protrusion, thoracolumbar dysfunction, muscle spasms, or sacroiliac joint dysfunction (Doubleday et al, 2003;Jemelik, Penickova, & Vyborny, 1992) is documented in men with CTP, offering a potential pathophysiological etiology for their complaints of neurologic pain sensations.…”