Chronic Scrotal Pain
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Purpose of Review
Chronic scrotal pain (CSP) is a common yet poorly understood condition, with significant impacts on overall quality of life. Many patients will have sought evaluation and management from multiple providers in an attempt to find a solution for their pain.
Despite many emerging treatments for CSP and further understanding of the potential etiologies and pathophysiological basis of the condition, its natural history is poorly understood. It is also important to recognize the psychosocial impact of CSP and consider formal referral for psychological evaluation and treatment if the patient endorses significant psychiatric responses to pain. It is important to also recognize the neuropathic component of pain that may arise in patients with CSP. Neuropathic medications show promise as a narcotic-sparing pharmacological intervention. There are promising surgical options for CSP including microsurgical denervation of the spermatic cord.
This article highlights the current best practice recommendations on the evaluation and management of chronic scrotal pain.
KeywordsChronic scrotal pain Men’s health
Compliance with Ethical Standards
Conflict of Interest
Christopher Wu and Keith Jarvi each declare no potential conflicts of interest.
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.• Devine CJJ, Schellhammer PF. The use of microsurgical denervation of the spermatic cord for orchialgia. Trans Am Assoc Genitourin Surg. 1978;70:149–51. The first documented report in literature describing microsurgical denervation of the spermatic cord as a procedure for chronic scrotal pain. PubMedGoogle Scholar
- 6.•• Jarvi KA, et al. A Canadian Urological Association best practice statement on chronic scrotal pain. Can Urol Assoc J. 2018; https://doi.org/10.5489/cuaj.5238. The first national best practices guideline published using current best evidence on the evaluation and management of chronic scrotal pain.
- 9.• 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;2017:2–6. The first published report on the potential etiologies of chronic scrotal pain in men presenting to a multidisciplinary orchialgia clinic. May provide insight into potential management strategies for this challenging patient population. CrossRefGoogle Scholar
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