Skip to main content

Advertisement

SpringerLink
Log in

Chronic Scrotal Content Pain: a Review of the Literature and Management Schemes

  • Men's Health (R Carrion, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Chronic scrotal content pain (CSCP) is a complex condition with multiple etiologies that requires a thorough understanding of its pathophysiology, workup, and treatment options. We performed a comprehensive and contemporary review to augment our current understanding of CSCP.

Recent Findings

We discuss new advances in CSCP-specific pain questionnaires, modern studies of microscopic spermatic cord denervation and its variations, and novel techniques including electric nerve stimulation and cryoablation in addition to randomized control trials with significant negative findings. We also present literature focusing on the prevention of CSCP secondary to surgical iatrogenic causes.

Summary

The constantly evolving literature of CSCP has led to the significant evolution in its diagnosis and treatment, from oral medications to salvage options after microscopic spermatic cord denervation. With each advance, we come closer to developing a more thorough, evidence-based algorithm to guide urologists in treatment of CSCP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

CSCP:

Chronic scrotal content pain

PVPS:

Post-vasectomy pain syndrome

VAS:

Visual analogue score

MDSC:

Microscopic denervation of the spermatic cord

TENS:

Transcutaneous electrical nerve stimulation

PIQ-6:

Pain Impact Questionnaire-6

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Polackwich AS, Arora HC, Li J, Levine L, Tojuola B, Parekattil S, et al. Development of a clinically relevant symptom index to assess patients with chronic orchialgia/chronic scrotal content pain. Transl Androl Urol. 2018;7(Suppl 2):S163–8 Developed an orchialgia symptom index with domains of pain, sexual symptoms, and quality of life. One hundred thirteen men filled the survey and plans are to prospectively validate this survey.

    PubMed  PubMed Central  Google Scholar 

  2. Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990;143(5):936–9. https://doi.org/10.1016/S0022-5347(17)40143-1.

    Article  CAS  PubMed  Google Scholar 

  3. Hunter CW, Stovall B, Chen G, Carlson J, Levy R, Hunter CW. Anatomy, pathophysiology and interventional therapies for chronic pelvic pain: a review. Pain Physician. 2018;(1):147–67 Available from: http://www.painphysicianjournal.com/current/pdf?article=NTEwNA%3D%3D&journal=110.

  4. Gaudet AD, Popovich PG, Ramer MS. Wallerian degeneration: gaining perspective on inflammatory events after peripheral nerve injury. J Neuroinflammation. 2011;8(1):110 Available from: http://www.jneuroinflammation.com/content/8/1/110.

    PubMed  PubMed Central  Google Scholar 

  5. Calixte N, Brahmbhatt J, Parekattil S. Chronic testicular and groin pain: pathway to relief. Curr Urol Rep. 2017;18(10):1–8.

    Google Scholar 

  6. Parekattil SJ, Gudeloglu A, Brahmbhatt JV, Priola KB, Vieweg J, Allan RW. Trifecta nerve complex: potential anatomical basis for microsurgical denervation of the spermatic cord for chronic orchialgia. J Urol. 2013;190(1):265–70. https://doi.org/10.1016/j.juro.2013.01.045.

    Article  PubMed  Google Scholar 

  7. Thacker MA, Clark AK, Marchand F, McMahon SB. Pathophysiology of peripheral neuropathic pain: immune cells and molecules. Anesth Analg. 2007;105(3):838–47.

    PubMed  Google Scholar 

  8. Dubový P. Wallerian degeneration and peripheral nerve conditions for both axonal regeneration and neuropathic pain induction. Ann Anat. 2011;193(4):267–75.

    PubMed  Google Scholar 

  9. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(SUPPL.3):2–15.

    Google Scholar 

  10. Büntjen L, Hopf JM, Merkel C, Voges J, Knape S, Heinze HJ, et al. Somatosensory misrepresentation associated with chronic pain: Spatiotemporal correlates of sensory perception in a patient following a complex regional pain syndrome spread. Front Neurol. 2017;8(APR):1–6.

    Google Scholar 

  11. Cesmebasi A, Yadav A, Gielecki J, Tubbs RS, Loukas M. Genitofemoral neuralgia: a review. Clin Anat. 2015;28(1):128–35.

    PubMed  Google Scholar 

  12. Sakai T, Murata H, Hara T. A case of scrotal pain associated with genitofemoral nerve injury following cystectomy. J Clin Anesth. 2016;32:150–2. https://doi.org/10.1016/j.jclinane.2016.02.022.

    Article  PubMed  Google Scholar 

  13. Rab M, Ebmer J, Dellon A. Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain.pdf. Plast Reconstr Surg 2001;108:1618–1623.

  14. Patel AP. Anatomy and physiology of chronic scrotal pain. Transl Androl Urol. 2017;6(Suppl 1):S51–6.

    PubMed  PubMed Central  Google Scholar 

  15. Oka S, Shiraishi K, Matsuyama H. Microsurgical anatomy of the spermatic cord and spermatic fascia: distribution of Lymphatics, and sensory and autonomic nerves. J Urol. 2016;195(6):1841–7. https://doi.org/10.1016/j.juro.2015.11.041.

    Article  PubMed  Google Scholar 

  16. •• Tan WP, Tsambarlis PN, Levine LA. Microdenervation of the spermatic cord for post-vasectomy pain syndrome. BJU Int. 2018;121(4):667–73 Evaluated outcomes of patients who underwent microscopic cord denervation for post-vasectomy pain syndrome. Twenty-seven patients were studied with overall success rate 71%.

    PubMed  Google Scholar 

  17. Lucas PL, Rose NR. Immunological consequences of vasectomy: I. prospective study through one-year postvasectomy. J Reprod Syst. 1978;1(3):249–55.

    CAS  Google Scholar 

  18. Leslie TA, Illing RO, Cranston DW, Guillebaud J. The incidence of chronic scrotal pain after vasectomy: a prospective audit. BJU Int. 2007;100(6):1330–3.

    PubMed  Google Scholar 

  19. Manikandan R, Srirangam SJ, Pearson E, Collins GN. Early and late morbidity after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years. BJU Int. 2004;93(4):571–4.

    CAS  PubMed  Google Scholar 

  20. Johnson AL, Howards SS. Intratubular hydrostatic pressure in testis and epididymis before and after vasectomy. Am J Phys. 1975;228(2):556–64.

    CAS  Google Scholar 

  21. McGee S. Referred scrotal pain: case reports and review. J Gen Intern Med. 1993;8:694–701.

    CAS  PubMed  Google Scholar 

  22. Simons D, Travell J, Simons L. In: Johnson E, Napora L, editors. Travell & Simons’ myofascial pain and dysfunction: upper half of body. 2nd ed. Baltimore: Lippincott Williams & Wilkins; 1999.

    Google Scholar 

  23. Gozon B, Chu J, Schwartz I. Lumbosacral radiculopathic pain presenting as groin and scrotal pain: pain management with twitch-obtaining intramuscular stimulation. A case report and review of literature. Electroencephalogr Clin Neurophysiol. 2001;41(5):315–8.

    CAS  Google Scholar 

  24. Farrell MR, Dugan SA, Levine LA. Physical therapy for chronic scrotal content pain with associated pelvic floor pain on digital rectal exam. Can J Urol. 2016;23(6):8546–50.

    PubMed  Google Scholar 

  25. Tos P, Crosio A, Pugliese P, Adani R, Toia F, Artiaco S. Painful scar neuropathy: principles of diagnosis and treatment. Plast Aesthetic Res. 2015;2(4):156.

    Google Scholar 

  26. Aljumaily A, Al-Khazraji H, Gordon A, Lau S, Jarvi KA. Characteristics and etiologies of chronic scrotal pain: a common but poorly understood condition. Pain Res Manag. 2017:2–7.

  27. Parekattil SJ, Cohen MS. Robotic surgery in male infertility and chronic orchialgia. Curr Opin Urol. 2010;20(1):75–9.

    PubMed  Google Scholar 

  28. •• Khandwala YS, Serrano F, Eisenberg ML. Evaluation of external vibratory stimulation as a treatment for chronic scrotal pain in adult men: a single center open label pilot study. Scand J Pain. 2017;17:403–7. https://doi.org/10.1016/j.sjpain.2017.10.002Proof-of-concept study in which nine men completed at least 2 weeks of external vibratory stimulation for chronic scrotal content pain. Seventy-eight percent of men achieved some improvement in daily scrotal pain levels with also decrease in frequency of pain.

    Article  PubMed  Google Scholar 

  29. Rottenstreich M, Glick Y, Gofrit ON. Chronic scrotal pain in young adults. BMC Res Notes. 2017;10(1):1–5.

    Google Scholar 

  30. Tan WP, Levine LA. Micro-denervation of the spermatic cord for post-vasectomy pain management. Sex Med Rev. 2018;6(2):328–34. https://doi.org/10.1016/j.sxmr.2017.06.002.

    Article  PubMed  Google Scholar 

  31. Tan WP, Levine LA. An overview of the management of post-vasectomy pain syndrome. Asian J Androl. 2016;18(3):332–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Heidenreich A, Olbert P, Engelmann UH. Management of chronic testalgia by microsurgical testicular denervation. Eur Urol. 2002;41(4):392–7.

    PubMed  Google Scholar 

  33. Hu JC, Link CL, McNaughton-Collins M, Barry MJ, McKinlay JB. The association of abuse and symptoms suggestive of chronic prostatitis/chronic pelvic pain syndrome: results from the Boston Area Community Health survey. J Gen Intern Med. 2007;22(11):1532–7.

    PubMed  PubMed Central  Google Scholar 

  34. Levine L. Chronic orchialgia: evaluation and discussion of treatment options. Ther Adv Urol. 2010;2(5–6):209–14.

    PubMed  PubMed Central  Google Scholar 

  35. Benson JS, Abern MR, Larsen S, Levine LA. Does a positive response to spermatic cord block predict response to microdenervation of the spermatic cord for chronic scrotal content pain? J Sex Med. 2013;10(3):876–82.

    PubMed  Google Scholar 

  36. Hanna GB, Byrne D, Townell N. Right-sided varicocele as a presentation of right renal tumours. Br J Urol. 1995;75(6):798–9.

    CAS  PubMed  Google Scholar 

  37. Bonfitto M, Kimura LSM, Godoy JMP, Filho MZ, Spessoto LCF, Junior FNF. Does right-sided varicocele indicate a right-sided kidney tumor? Arch Ital di Urol e Androl. 2019;91(1):53–4.

    Google Scholar 

  38. Street EJ, Justice ED, Kopa Z, Portman MD, Ross JD, Skerlev M, et al. The 2016 European guideline on the management of epididymo-orchitis. Int J STD AIDS. 2017;28(8).

  39. Pischedda A, Fusco F, Curreli A, Grimaldi G, Farina FP. Pelvic floor and sexual male dysfunction. Arch Ital di Urol e Androl. 2013;85(1):1–7.

    Google Scholar 

  40. Myers C, Smith M. Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiother (United Kingdom). 2019;105(2):235–43. https://doi.org/10.1016/j.physio.2019.01.002.

    Article  Google Scholar 

  41. Cohen D, Gonzalez J, Goldstein I. The role of pelvic floor muscles in male sexual dysfunction and pelvic pain. Sex Med Rev. 2016;4(1):53–62. https://doi.org/10.1016/j.sxmr.2015.10.001.

    Article  PubMed  Google Scholar 

  42. Ho KY, Gwee KA, Cheng YK, Yoon KH, Hee HT, Omar AR. Nonsteroidal anti-inflammatory drugs in chronic pain: implications of new data for clinical practice. J Pain Res. 2018;11:1937–48.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Najari B, Robinson B, Paget S, Paduch D. Clinical, radiographic, and pathologic description of IgG4-related perivasal fibrosis: a previously undescribed etiology of chronic orchialgia. Urology. 2014;84(4):748–50.

    PubMed  Google Scholar 

  44. Agarwal MM, Elsi Sy M. Gabapentenoids in pain management in urological chronic pelvic pain syndrome: gabapentin or pregabalin? Neurourol Urodyn. 2017;36(8):2028–33.

    CAS  PubMed  Google Scholar 

  45. Sinclair AM, Miller B, Lee LK. Chronic orchialgia: consider gabapentin or nortriptyline before considering surgery. Int J Urol. 2007;14(7):622–5.

    PubMed  Google Scholar 

  46. Huecker M, Azadfard M, Leaming J. Opioid addiction: StatPearls Publishing; 2020.

  47. Opioid Overdose Crisis. National Institute on Drug Abuse; 2018.

  48. • Bose J, Hedden S, Lipari R, Park-Lee E. Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. 2018. Contemporary 2017 data on substance use and mental health indicators in the United States. Provides up to date information on opioid prescriptions and abuse.

  49. • Theisen K, Jacobs B, Macleod L, Davies B. The United States opioid epidemic: a review of the surgeon’s contribution to it and health policy initiatives. BJU Int. 2018;122(5):754–9 Provides input on the surgeon’s contribution to the opioid epidemic in the USA.

    PubMed  Google Scholar 

  50. •• Welk B, McClure JA, Clarke C, Vogt K, Campbell J. An opioid prescription for men undergoing minor urologic surgery is associated with an increased risk of new persistent opioid use. Eur Urol. 2020;77(1):68–75. https://doi.org/10.1016/j.eururo.2019.08.031Examined persistent opioid use after post-operative opioid prescription for low acuity urologic surgery. Retrospective study with 32,174 patients who filled prescription for opioid pain medications after minor urological surgery (mostly vasectomy). Significantly higher long-term opioid use and overdose with patients who filled opioid prescriptions.

    Article  CAS  PubMed  Google Scholar 

  51. Patil S, Kamtikar S. Treatment of post-operative orchialgia with therapeutic unilateral penile and spermatic cord block. Indian J Anaesth. 2012;56(3):315–6.

    PubMed  PubMed Central  Google Scholar 

  52. • Farag A, Basha M, Amin S, Elnaidany N, Elhelbawy N, Mostafa M, et al. Tramadol (opioid) abuse is associated with a dose-and time-dependent poor sperm quality and hyperprolactinaemia in young men. Andrologia. 2018;50(6) Study with 30 participants that determined that tramadol use is associated with poor sperm quality, hyperprolactinamia, and hypergonadotropic hypogonadism.

  53. Ziegelmann MJ, Farrell MR, Levine LA. Evaluation and management of chronic scrotal content pain-a common yet poorly understood condition. Rev Urol. 2019;21(2–3):74–84.

    PubMed  PubMed Central  Google Scholar 

  54. Cohen SP, Foster A. Pulsed radiofrequency as a treatment for groin pain and orchialgia. Urology. 2003;61(3):645.

    PubMed  Google Scholar 

  55. Basal S, Ergin A, Yildirim I, Goktas S, Atim A, Sizlan A, et al. A novel treatment of chronic orchialgia. J Androl. 2012;33(1):22–6.

    PubMed  Google Scholar 

  56. •• Hetta DF, Mahran AM, Kamal EE. Pulsed radiofrequency treatment for chronic post-surgical orchialgia: A double-blind, sham-controlled, randomized trial: three-month results. Pain Physician. 2018;21(2):199–205 Evaluated the analgesic efficacy of pulsed radiofrequency (PRF) applied to the ilioinguinal nerve and the genital branch of the genitofemoral nerve. Seventy percent of participants (35 treated with PRF) with 80% success rate versus 23% in sham.

    PubMed  Google Scholar 

  57. Gibson W, Wand BM, O’Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database Syst Rev. 2017;2017(9).

  58. •• Tantawy SA, Kamel DM, Abdelbasset WK. Does transcutaneous electrical nerve stimulation reduce pain and improve quality of life in patients with idiopathic chronic orchialgia? A randomized controlled trial. J Pain Res. 2018;11:77–82 Investigated how effective transcutaneous electrical nerve stimulation (TENS) is in pain reduction and quality of life in chronic scrotal pain. Seventy-one patients were randomly assigned; 36 received TENS. TENS associated with significant reduction in pain sustained at 2-month follow-up and also improved quality of life.

    PubMed  Google Scholar 

  59. McJunkin TL, Wuollet AL, Lynch PJ. Sacral nerve stimulation as a treatment modality for intractable neuropathic testicular pain. Pain Physician. 2009;12(6):991–5.

    PubMed  Google Scholar 

  60. Kiritsy MP, Siefferman JW. Spinal cord stimulation for intractable testicular pain: case report and review of the literature. Neuromodulation. 2016;19(8):889–92.

    PubMed  Google Scholar 

  61. Nouri KH, Brish EL. Spinal cord stimulation for testicular pain. Pain Med. 2011;12(9):1435–8.

    PubMed  Google Scholar 

  62. Hassanain M, Murphy P. Dorsal root ganglion stimulation for the treatment of bilateral intractable chronic testicular pain. Neuromodulation. 2019;22(1):115–6.

    PubMed  Google Scholar 

  63. Strebel RT, Leippold T, Luginbuehl T, Muentener M, Praz V, Hauri D. Chronic scrotal pain syndrome: management among urologists in Switzerland. Eur Urol. 2005;47(6):812–6.

    PubMed  Google Scholar 

  64. Chen T, Ball R. Epididymectomy for post-vasectomy pain: histological review. Br J Urol. 1991;68(4):407–13.

    CAS  PubMed  Google Scholar 

  65. •• Calixte N, Tojuola B, Kartal I, Gudeloglu A, Hirsch M, Etafy M, et al. Targeted robotic assisted microsurgical denervation of the spermatic cord for the treatment of chronic orchialgia or groin pain: a single center, large series review. J Urol. 2018;199(4):1015–22. https://doi.org/10.1016/j.juro.2017.10.030Examined outcomes of ligation of spermatic cord trifecta nerves using a technique of targeted robotic-assisted microsurgical denervation of the spermatic cord. Retrospective study of 772 patients with results showing 83% reduction in pain sustained at 4-year follow-up.

    Article  PubMed  Google Scholar 

  66. •• Kavoussi P. Validation of targeted microsurgical spermatic cord denervation: comparison of outcomes to traditional complete microsurgical spermatic cord denervation. Asian J Androl. 2019;21(July):1–4 Validated the effectiveness of targeted microsurgical spermatic cord denervation of the trifecta nerve complex. Forty-three patients with trifecta dissection versus 39 underwent complete skeletonization of spermatic cord. No statistically significant difference in resolution of pain, partial improvement of pain, or failure to respond rates. Significant decrease in operating room time with trifecta approach was noted.

    Google Scholar 

  67. Smith-Harrison LI, Smith RP. Vasectomy reversal for post-vasectomy pain syndrome. Transl Androl Urol. 2017;6(I):S10–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  68. Nangia AK, Myles JL, Thomas AJ. Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation. J Urol. 2000;164(6):1939–42.

    CAS  PubMed  Google Scholar 

  69. Lee JY, Cho KS, Lee SH, Cho HJ, Cho JM, Oh CY, et al. A comparison of epididymectomy with vasectomy reversal for the surgical treatment of postvasectomy pain syndrome. Int Urol Nephrol. 2014;46(3):531–7.

    PubMed  Google Scholar 

  70. Levine LA, Hoeh MP. Evaluation and Management of Chronic Scrotal Content Pain. Curr Urol Rep. 2015;16(6):1–8.

    Google Scholar 

  71. Costabile R, Hahn M, McLeod D. Chronic orchalgia in the pain prone patient: the clinical perspective.pdf. J Urol 1991;146:1571–1574.

  72. •• Calixte N, Kartal IG, Tojuola B, Gudeloglu A, Etafy M, Brahmbhatt JV, et al. Salvage ultrasound-guided targeted cryoablation of the perispermatic cord for persistent chronic scrotal content pain after microsurgical denervation of the spermatic cord. Urology. 2019;130:181–5. https://doi.org/10.1016/j.urology.2019.04.027Examined efficacy of ultrasound-guided targeted cryoablation of the peri-spermatic cord as a salvage treatment for patients who failed spermatic cord denervation. Two hundred seventy-nine cases underwent salvage cryoablation of genitofemoral, ilioinguinal, and inferior hypogastric nerves medial and lateral to spermatic cord at external inguinal ring level. Seventy-five percent reduction in pain with VAS. Fifty-three percent reduction in pain with PIQ-6 at 1 month, increased to 64% by 5-year follow-up.

    Article  PubMed  Google Scholar 

  73. Group CS. Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. Arch Intern Med. 1991;151(11):2225–9.

    Google Scholar 

  74. Group CS. Effect of treatment with capsaicin on daily activities of patients with painful diabetic neuropathy. Capsaicin Study Group. Diabetes Care. 1992;15(2):159–65.

    Google Scholar 

  75. Watson C, Tyler K, Bickers D, Millikan L, Smith S, Coleman E. A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. Clin Ther. 1993;15(3):510–26.

    CAS  PubMed  Google Scholar 

  76. • Gudin J, Fudin J. A narrative pharmacological review of buprenorphine: a unique opioid for the treatment of chronic pain. Pain Ther. 2020;9(1):41–54. https://doi.org/10.1007/s40122-019-00143-6Provides thorough updates on buprenorphine’s mechanism of action including pharmacokinetics and pharmacodynamics as well as trends in its usage.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Nicol A, Hurley R. Alternatives to opioids in the pharmacologic management of chronic pain syndromes: a narrative review of randomized, controlled, and blinded clinical trials. Anesth Analg. 2017;176(3):139–48.

    Google Scholar 

  78. Blonk MI, Koder BG, Bemt PMLA, va. den Huygen FJPM. Use of oral ketamine in chronic pain management: a review. Eur J Pain. 2010;14(5):466–72. https://doi.org/10.1016/j.ejpain.2009.09.005.

    Article  CAS  PubMed  Google Scholar 

  79. Niesters M, Martini C, Dahan A. Ketamine for chronic pain: risks and benefits. Br J Clin Pharmacol. 2014;77(2):357–67.

    CAS  PubMed  PubMed Central  Google Scholar 

  80. •• Dockray J, Aljumaily A, Lau S, Jarvi KA. A randomized, double-blind, controlled trial shows that onabotulinum toxin a nerve blocks do not provide improved pain control in men with chronic scrotal pain. J Urol. 2020;203(4):767–72 Double-blind randomized control trial evaluating the use of onabotulinum toxin A to chemically denervate the testis in spermatic cord blocks to treat chronic scrotal content pain. Sixty-four men participated with 32 in the treatment arm (lidocaine and onabotulinum A) versus 32 (lidocaine alone). No difference in outcomes was noted. Significant placebo effect noted in the open trial arm.

    PubMed  Google Scholar 

  81. Ronka K, Vironen J, Kokki H, Liukkonen T, Paajanen H. Role of orchiectomy in severe testicular pain after inguinal hernia surgery: audit of the Finnish Patient Insurance Centre. Hernia. 2015;19:53–9.

    CAS  PubMed  Google Scholar 

  82. Alfieri S, Amid PK, Campanelli G, Izard G, Kehlet H, Wijsmuller AR, et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia. 2011;15(3):239–49.

    CAS  PubMed  Google Scholar 

  83. Ducic I, Dellon AL. Testicular pain after inguinal hernia repair: an approach to resection of the genital branch of genitofemoral nerve. J Am Coll Surg. 2004;198(2):181–4.

    PubMed  Google Scholar 

  84. Srivastava A, Kapoor R, Srivastava A, Ansari M, Singh M, Kapoor R. Orchialgia after laproscopic renal surgery: a common problem with questionable etiology. Are There Any Predictors? World J Urol. 2013;31(5).

  85. Sureka S, Srivastava A, Agarwal S, Srivastava A, Sachin A, Singh S, et al. Prevention of orchialgia after left-sided laparoscopic donor nephrectomy—a prospective study. J Endourol. 2015;29(6):696–9.

    PubMed  PubMed Central  Google Scholar 

  86. Shapiro EI, Silber SJ. Open-ended vasectomy, sperm granuloma, and postvasectomy orchialgia. Fertil Steril. 1979;32(5):546–50. https://doi.org/10.1016/S0015-0282(16)44357-8.

    Article  CAS  PubMed  Google Scholar 

  87. Moss W. A comparison of open-end versus closed-end vasectomies: a report on 6220 cases. Contraception. 1992;46(6):521–5.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Building Q10-1, Cleveland, OH, 44195, USA

    Paul J. Oh, Petar Bajic & Scott D. Lundy

  2. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Matthew Ziegelmann

  3. Division of Urology, Rush University Medical Center, Chicago, IL, USA

    Laurence A. Levine

Authors
  1. Paul J. Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Petar Bajic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Scott D. Lundy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthew Ziegelmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laurence A. Levine
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Petar Bajic.

Ethics declarations

Conflict of Interest

Paul J. Oh, Petar Bajic, Matthew Ziegelmann, and Laurence Levine declare no potential conflicts of interest. Scott D. Lundy discloses participation as a consultant for Wolters Kluwer.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Men’s Health

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oh, P.J., Bajic, P., Lundy, S.D. et al. Chronic Scrotal Content Pain: a Review of the Literature and Management Schemes. Curr Urol Rep 22, 12 (2021). https://doi.org/10.1007/s11934-020-01026-6

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11934-020-01026-6

Keywords

Search

Navigation