Chronic Scrotal Content Pain: an Updated Review on Diagnosis and Management

Abstract

To provide a review on the diagnosis and management of chronic scrotal content pain (CSCP). We cover the anatomy relevant to the scrotum, pathophysiology related to pain, and discuss medical and surgical options. We investigated the impact this condition has on patients and quantified the significant burden on quality of life. Our review found that among centers that manage chronic scrotal content pain regularly, medical management consistently includes scrotal rest/ice, NSAIDs, tricyclic anti-depressants, or neuropathic pain modulators. Among surgical options, microdenervation of the spermatic cord in some series provides > 90% relief in scrotal pain. With regard to quality of life, we found that in some series, more than half of patients experience a significant reduction in sexual function and marital relationship. Furthermore, these patients are often caught in a vicious cycle whereby pain and diminished sexual function aggravate each other. Our findings demonstrate that clinicians who manage this condition regularly are using very similar approaches, thus facilitating a standardized approach for this condition, which carries a significant burden on quality of life.