The aetiology, pathophysiology and management of chronic orchialgia

Masarani, M; Cox, Robert A.

doi:10.1046/j.1464-410x.2003.04094.x

Cited by 65 publications

(48 citation statements)

References 12 publications

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“…Similarly reduced rauwolscine sensitivity was observed in the isolated vas of a mutant mouse strain (D79N) which harbours a malfunctioning ∝-2a adrenoceptor. These results suggest that vas deferens of subjects who present with intractable chronic testicular pain exhibit a reduction in the pre-junctional autoinhibition mechanism [5][6][7][8].…”

Section: Review Articlementioning

confidence: 99%

“…Antibiotics are administered on the presumption that the pain may be secondary to some unindentifi ed infection. Non-steroidal antiinfl ammatory drugs are prescribed along with the antibiotics; they reduce the local infl ammatory process and thereby relieve the pain [8]. Alpha-adrenergic antagonists A trial of α-1 blocker should be given to patients who do not respond to conservative management and wish to avoid the surgical options.…”

Section: Non-surgical Managementmentioning

confidence: 99%

“…Although patient number was limited, the authors reported that all 4 patients with chronic orchialgia had complete and lasting pain relief. Orchiectomy If the medical or more invasive measures fail to control the pain, inguinal orchiectomy is recommended for these unfortunate patients [1,5,8,20]. Davis et al in an interesting study compared the results of inguinal versus scrotal orchiectomy for intractable testicular pain and reported 73% complete pain relief following inguinal orchiectomy versus 55% pain relief following scrotal procedure [1].…”

Section: Open Surgical Interventionmentioning

confidence: 99%

“…Consequently, they recommended proceeding directly to orchiectomy if surgical treatment is considered. Since orchiectomy is permanent and has an unpredictable response, many do not agree and suggest that it should be avoided [8].…”

Section: Open Surgical Interventionmentioning

confidence: 99%

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Idiopathic chronic orchialgia — a frustrating issue for the clinician and the patient

Singh

Sinha

2008

Indian J Surg

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Chronic testicular pain represents a management dilemma to clinicians and remains a very frustrating clinical problem. In nearly 25% of patients there is no obvious cause for idiopathic chronic orchialgia. Chronic testicular pain may occur at any age but the majority of patients are in 20-30 years of age group. The desired goal of the treatment is to allow the patient return to routine activity without signifi cant use of analgesics. There is very little published material, in urology, about the etiology and treatment of idiopathic chronic orchialgia but situation is not bleak since many treatment options do exist which can allow the patient enjoy life with mechanisms for coping with pain. A multidisciplinary team approach is required, so that the patient can benefi t from the different treatment options available at present.

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Section: Review Articlementioning

confidence: 99%

Section: Non-surgical Managementmentioning

confidence: 99%

Section: Open Surgical Interventionmentioning

confidence: 99%

Section: Open Surgical Interventionmentioning

confidence: 99%

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Idiopathic chronic orchialgia — a frustrating issue for the clinician and the patient

Singh

Sinha

2008

Indian J Surg

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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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