What Can We Do for Chronic Scrotal Content Pain?

Tan, Wei Phin; Levine, Laurence A.

doi:10.5534/wjmh.17047

Cited by 21 publications

(18 citation statements)

References 61 publications

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“…Other techniques used to treat PVPS include resecting the vasectomy site or sperm granuloma, laparoscopic denervation of the spermatic cord, vaso‐vasostomy, epididymectomy, resection of the genitofemoral nerve and, in severe circumstances, orchiectomy through an inguinal approach. The reported success rates range from 55 to 100% (Table ); however, these studies had small sample sizes, making the results difficult to duplicate in larger studies . There has only been one study to date that has specifically evaluated the success rate of spermatic cord denervation for PVPS.…”

Section: Discussionmentioning

confidence: 99%

Microdenervation of the spermatic cord for post‐vasectomy pain syndrome

2018

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The MDSC procedure is a reasonably successful, durable and valuable approach for PVPS, especially when pain involves multiple structures in the scrotum (testis, epididymis, spermatic cord). MDSC was equally efficacious in patients who had previously failed a procedure for PVPS. No patient had a worsening NRS score after MDSC. This is the largest study to date evaluating MDSC for the treatment of PVPS.

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Section: Discussionmentioning

confidence: 99%

Microdenervation of the spermatic cord for post‐vasectomy pain syndrome

2018

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“…Although these studies suggest that CSP is a common condition, further studies are needed to confirm the true incidence and prevalence of the condition in the general population. Certain groups of men have a higher incidence of CSP: (1) post-vasectomy pain affects from 1% to 15% of men after their procedures [12,13], (2) an estimated 10% of men with varicocele experience CSP related to that condition [14] and (3) CSP has been reported in as many as 3% to 6% of patients after repair of inguinal hernia [15].…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…Other non-surgical techniques include pulsed radiofrequency of the spermatic cord and the genital branch of the genitofemoral nerve for PVPS if the patient receives temporary relief from an SCB. Acupuncture is rarely mentioned, being reported only in some small non-randomised trials [ 2 , 16 ]. Finally, the least mentioned non-surgical techniques are transcutaneous electrical stimulation (TENS) and vibratory stimulation [ 16 ].…”

Section: Reviewmentioning

confidence: 99%

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A Review of the Management of Chronic Scrotal Pain

Moubasher

Waqar

Raison

et al. 2020

Cureus

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Chronic scrotal pain (CSP) is a common and poorly understood medical condition that significantly affects individuals’ quality of life. Many patients seek evaluation and management of their symptoms from multiple physicians. Our review aims to address diagnostic modalities, clinical evaluation, and surgical and non-surgical management. We conducted a computerised detailed search of the PubMed, Medline, Embase and Cochrane databases for reports pertaining to CSP using the Medical Subject Headings keywords ‘chronic scrotal pain’, ‘testicular pain’ and ‘orchialgia’, and we included in the review those that fulfilled the inclusion (adult male with CSP presenting with the criteria of CSP ) and exclusion (extra-scrotal pain) criteria. After the direct causes of CSP were identified by reviewing the clinical evaluations (history taking and examination are mandatory) and the diagnostic evaluations (urine analysis is crucial and ultrasound can be helpful), the most-used medical and non-surgical treatments for CSP were tricyclic antidepressants (success rate of up to 66.6%) and spermatic block (success rate of more than 90%), and the most-used surgical procedure was microsurgical denervation of the spermatic cord (success rate of up to 70%). The evidence currently available remains rare and of low quality, making it difficult to strongly recommend individual treatment options. However, multimodal treatment modalities using physical therapy and psychotherapy may help patients and provide useful tools for coping with this condition. There are also useful non-surgical and surgical options for CSP that depend on the patient’s state, the severity of the complaint and what options have already been tried.

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“…Patients complaining of CTP have often been evaluated by multiple providers from different disciplines but often are left with an unexplained etiology for their complaint. The most up-to-date guidelines on the diagnosis and management of CTP are based on expert opinion derived from small cohort studies (Tan & Levine, 2017). This study aims to provide a better picture of an overlooked cause, proposed pathophysiology, and relevant treatment options of testicular pain.…”

Section: Male Sexual and Reproductive Health -Case Reportmentioning

confidence: 99%

Taming of the Testicular Pain Complicating Lumbar Disc Herniation With Spinal Manipulation

Chu

2020

Am J Mens Health

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Degenerative disease of the lumbar spine is often ignored as a potential cause of testicular pain because the exact link between the two remains uncertain. This article reports the case of a 60-year-old man with a 3-year history of low back pain and unexplained right testicular pain for 2 years. Painful symptoms were negatively affecting his social, physical, and sexual functions. After failure to achieve pain relief through multiple types of therapy, the patient sought chiropractic treatment for his condition. Lumbar spine magnetic resonance imaging (MRI) revealed disc protrusion at the L1/L2, L3/L4, and L4/L5 segments causing thecal sac indentations. Due to the absence of direct testicular causes, the medical impression was chronic testicular pain (CTP) complicating lumbar disc disease. The patient experienced regular improvement in his low back and testicular pain with complete resolution of both after 8 weeks of chiropractic treatment. This article describes an overlook of the etiology of this patient’s testicular pain and a successful option in treating the patient. CTP has multifactorial etiology. An excellent treatment outcome depends heavily on recognizing the origin of the pain.

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What Can We Do for Chronic Scrotal Content Pain?

Cited by 21 publications

References 61 publications

Microdenervation of the spermatic cord for post‐vasectomy pain syndrome

Microdenervation of the spermatic cord for post‐vasectomy pain syndrome

A Review of the Management of Chronic Scrotal Pain

Taming of the Testicular Pain Complicating Lumbar Disc Herniation With Spinal Manipulation

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