Scrotal Pain Research Articles

Recidiverende testiculaire torsie 27 jaar na eerdere orchidopexie: casusbespreking

Recurrent testicular torsion 27 years after previous orchidopexy: a case report A recurrent testicular torsion after a previous orchidopexy is a rare phenomenon that requires a high index of suspicion to avoid misdiagnosis and delayed treatment. This case intends to emphasize the importance of considering a recurrent testicular torsion in the differential diagnosis of acute scrotal pain, regardless of the patient’s age. The case involves a 45-year-old man with a history of a bilateral testicular fixation for a testicular torsion at the age of 18. The patient presented with recurrent testicular pain, despite the fact that both testes previously had been fixed to the scrotal wall. This case illustrates that a recurrent testicular torsion can manifest even when the testis is fixed to the scrotal wall. This emphasizes the importance of including a recurrent testicular torsion in the differential diagnosis of acute scrotal pain. Furthermore, during the surgical intervention particular attention should be given to ensuring a proper fixation of both testes using non-absorbable sutures at a minimum of 2 points to reduce the risk of a recurrent torsion. A recurrent testicular torsion following a previous orchidopexy is a rare condition that requires vigilance in case of acute scrotal pain. This case report reinforces the need for a thorough examination and emphasizes the importance of safe testicular fixation during surgery to minimize the risk of recurrence. The threshold for surgical exploration should always be kept low, even after a previous orchidopexy.

Clinical, Pathological and Immunohistochemical Characteristics of Patients with Primary Testicular Lymphoma Undergoing Orchiectomy: A Systematic Review and Meta-Analysis.

Primary testicular lymphoma (PTL) is a rare and aggressive malignant tumour with no specific clinical symptoms. Large-scale evidence-based medical evidence to guide preoperative diagnosis is lacking at present. This study aimed to analyse the clinical, pathological and immunohistochemical characteristics of patients with PTL undergoing testicular resection surgery. Literature on the clinical characteristics of patients with PTL undergoing orchiectomy was retrieved from databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Data. The search covered all available records from the inception of these databases until December 31, 2023. Data extraction was followed by a meta-analysis using Stata 15.0 software. A total of 22 articles and 475 cases of PTL were included. The meta-analysis revealed that 58.1% of patients with PTL undergoing orchiectomy were under 60 years old, and 41.9% were 60 years or older. The lesion is mostly located on the right side (55.1%). Common symptoms included testicular swelling and falling swelling (91.3%), hydrocele testis (31.0%) and testicular pain (23.0%). Ann Arbor stages I-IV accounted for 53.3%, 16.7%, 14.8% and 15.7%, respectively. Diffuse large B-cell lymphoma (DLBCL) cases were higher at 95.5% than NK/T-cell lymphoma cases at 8.2%. Amongst DLBCL cases, 69.3% were non-germinal centre B-cell (GCB) subtype, and 27.6% were GCB subtype. Immunohistochemistry markers showed 95.9% CD3 negative, 94.9% CD10 negative, 94.4% CD20 positive, 88.4% multiple myeloma oncogene-1 (MUM-1) negative, 73.6% B-cell lymphoma-6 (BCL-6) negative and 66.5% BCL-2 positive. Laboratory findings indicated that 70.4% of patients had a tumour proliferating cell nuclear antigen (Ki67) index of ≥80%, 36.0% had increased serum lactate dehydrogenase level and 22.9% had increased serum β2-microglobulin level. PTL is rare, and it often occurs in elderly male patients. Common symptoms include testicular swelling and falling swelling, and the common histological type is DLBCL. Diagnosis should be based on histopathological characteristics and immunohistochemical examination.

Acute Scrotum in Children

Acute Scrotum in Children

A Comparative Study between Laparoscopic Varicocelectomy and Open Varicocelectomy in the Treatment of Varicocele

Background: Varicocele is a vein anomaly affecting 15% of adult males, with prevalence increasing to 35% in men seeking infertility evaluation and 81% in those with secondary infertility. It is primarily due to a prevalent and remediable factor. Objective: The objective of this study is to do a comparative analysis of the post-operative outcomes between open inguinal varicocelectomy and laparoscopic varicocelectomy. Methods: The present investigation was undertaken within the surgical department of (Hospital name) over a duration of two years, spanning from December 2019 to December 2021. This study employed a prospective design and involved the inclusion of a cohort comprising 50 patients diagnosed with clinically severe varicocele. The participants were allocated into two distinct groups. Group A consisted of 25 individuals who underwent laparoscopic surgery, while Group B consisted of 25 individuals who received an open approach. Results: In our study comprising a cohort of 50 patients, we observed a range of ages from 20 to 49 years. Among these patients, 19 reported experiencing scrotal pain, 25 exhibited testicular swelling, and 7 presented with infertility. The mean operation time for laparoscopic varicocelectomy was 48 minutes, while for open surgery it was 57 minutes. Interestingly, we found that the postoperative analgesic requirement was similar in both groups. Furthermore, the average duration of hospital stay was 35.6 hours for laparoscopic procedures and 50.6 hours for open procedures. The duration of the operative procedure in Laparoscopic Varicocelectomy was found to be 17.25 ± 2.1 minutes in cases where the condition was unilateral, whereas it was 29.32 ± 2.8 minutes in situations where the condition was bilateral. The average length of surgery for unilateral cases in Open Varicocelectomy was found to be 42.5 ± 3.4 minutes, whereas for bilateral presentations, it was 67.25 ± 2.5 minutes. The observed difference between the two groups was found to be statistically significant, with a p-value of less than 0.001 . The recurrence rate was higher in laparoscopic group. Conclusion: Laparoscopic varicocelectomy offers similar outcomes to open techniques, with minimal morbidity and shorter hospitalization periods. It treats bilateral varicoceles without extra incisions and has a higher recurrence rate, but overall patient satisfaction makes it a preferred surgical technique. Keywords: laparoscopic varicocelectomy, Open varicocelectomy, Infertility.

A Comprehensive Review on Hydrocele

Hydrocele rupture is circumstances which is seen hardly ever. In this paper, we have studied about the treatments, diagnosis and other topics related with it. It is an irregular build up of fluid in the tunica vaginalis between the parietal and visceral layers. It is a very widespreadstate that causes scrotal mass and pain in men, rupture of Hydrocele is astrangecircumstance in regular clinical practice. In the modern journalism less than 10 cases have been reported. Ambroise Pare wrote a description of hydrocele testis as early as the fifteenth century. Varicocelectomy ranks second in the most common causes of hydrocele in teenagers. It is arises from an imbalance of secretion and reabsortpion of fluid from the tunica vaginalis. In the simple wording it is a kind of enlargement in the skin pouch that houses the testicles, the scrotum. The best treatment for Hydrocele is a surgical course of action which is also recognized as hydrocelectomy [it is a removal of sac lining].

Testicular Traction Technique with Intact Cremasteric Reflex, a Novel Approach for Manual Detorsion: Case Report.

Recognizing testicular torsion is extremely important in patients presenting to the emergency department (ED) with acute scrotal pain. Traditional manual detorsion techniques are frequently employed by emergency physicians but are not always successful. Delays in detorsion increase the risk of testicular infarction and infertility, and the need for orchiectomy. Novel techniques such as the testicular traction technique have been described as a potential solution for difficult-to-detorse testicles. Our case report describes a 20-year-old male with no significant past medical history who presented to a rural ED with acute, atraumatic testicular pain secondary to testicular torsion with an intact cremasteric reflex. After confirming the diagnosis using Doppler ultrasound, manual detorsion using the traditional "open book" technique was attempted and unsuccessful. The patient was subsequently successfully detorsed using the novel testicular traction technique. The testicular traction technique is a safe, rapid, and effective primary or adjunctive technique in manual testicular detorsion. Given the time-sensitive nature of testicular torsions, adjunctive techniques play a crucial role in managing challenging detorsions, particularly in resource-limited rural settings with limited access to urologic services. Although it is commonly thought that the cremasteric reflex is absent in testicular torsions, it may be present in rare circumstances, and its presence should not be an absolute in ruling out torsion.

Postoperative Complications of Laparoscopic versus Open Varicocelectomy

Background: Varicocele, characterized by the dilation and swelling of testicular veins, significantly impacts male infertility and semen quality, affecting 10-15% of the male population. Surgical intervention is essential to alleviate these effects, with various techniques available, including laparoscopic and open subinguinal varicocelectomy. Objective: This study aimed to compare postoperative complications between laparoscopic and open subinguinal varicocelectomy to determine the superior approach in terms of patient outcomes and complications. Methods: A randomized controlled trial was conducted, involving 130 patients admitted to Hayatabad Medical Complex, Peshawar, from November 10, 2021, to July 31, 2022. Participants, presenting with symptoms of scrotal heaviness, testicular swelling, pain, and infertility, were randomly assigned to either the laparoscopic (Group L, n=70) or open subinguinal (Group O, n=60) varicocelectomy groups. Preoperative assessments included medical history, clinical examination, and necessary tests. Informed consent was obtained from all participants. Exclusion criteria included patients with malignancy, diabetes (BSR > 200 mg/dl), or unstable hemoglobin levels (Hb < 10 mg/dl). Postoperative complications, including wound erythema, hydrocele, epididymitis, and bruising, were documented and analyzed using SPSS version 25, with a significance level set at P ≤ 0.05. Results: The mean age of Group L was 27.3 years (±2.3), and Group O was 25.2 years (±3.5) (P = 0.042). Postoperative complications were significantly lower in Group L compared to Group O. Wound erythema was observed in 1.42% of Group L and 8.3% of Group O (P = 0.05). Hydrocele occurred in 2.8% of Group L versus 10% of Group O (P = 0.04). Epididymitis was found in 1.42% of Group L and 6.5% of Group O (P = 0.03). Bruising was noted in 1.66% of Group O, with no cases in Group L (P = 0.05). Conclusion: Laparoscopic varicocelectomy resulted in fewer postoperative complications compared to open subinguinal varicocelectomy, making it the preferred surgical approach for varicocele treatment. Further studies with larger sample sizes and long-term follow-up are recommended to validate these findings.

An Uncommon Cause of Testicular Infarct: A Case Report and Review of the Literature of Testicular Infarcts From Laparoscopic Inguinal Hernia Repair

BackgroundTesticular ischemia requires timely diagnosis and definitive management to avoid serious consequences such as orchiectomy. It is almost always caused by testicular torsion; however, there are other causes to be aware of. Case ReportA 32-year-old man developed testicular ischemia following a laparoscopic robotic-assisted inguinal hernia repair with preperitoneal mesh. The ischemia progressed to a fully infarcted testicle with no evidence of torsion on subsequent surgical exploration. He ultimately did require an orchiectomy. Why should an Emergency Physician be aware of this?While extremely rare, testicular ischemia or infarct must be considered in patients presenting with testicular pain shortly after inguinal hernia repair. Emergent surgical evaluation and loosening of the hernia mesh may be required to salvage the testicle.

Chronic Orchalgia in Adolescence: A Literature-Based Evaluation of Followed Patients

Orchalgia is defined as testicular pain that occurs continuously or at variable times, may be unilateral or bilateral, restricts the daily activities of the individual, and lasts for more than 3 months. Infection or local pathology may not be present. We aimed to emphasize the treatment options in cases of chronic orchalgia according to the etiology of our 3 cases who presented to the pediatric urology outpatient clinic due to testicular pain in the adolescent age group.

Paediatric testicular torsion in low- and middle-income countries: an OxPLORE scoping study.

Literature on paediatric surgical conditions in low- and middle-income countries (LMICs) remains limited. As a common emergency, timely treatment of testicular torsion acts as a benchmark of adequate emergency service delivery in paediatric surgery. This scoping study aims to synthesise all existing literature on paediatric testicular torsion in LMICs. A database search was conducted by the OxPLORE global paediatric surgery research group to identify studies containing the terms 'testicular torsion' or 'acute scrotum' originating from LMICs. A thematic analysis was applied to the results of the search and the quality of evidence was appraised for all included articles. This review included 17 studies with 1798 patients. All studies originated from middle-income countries and the majority (76%) had sample sizes smaller than 100 patients. All studies were appraised as providing less than adequate evidence. Included studies identified long delays to treatment and highlighted ongoing debates on the value of scoring systems and Doppler ultrasonography in diagnosing torsion. Major heterogeneity in surgical approaches to treatment of testicular torsion in children was also observed. Literature on paediatric testicular torsion in LMICs is scarce and heterogeneous. Prospective, multi-centre research on the management of this common paediatric surgical emergency is urgently required.

A novel nomogram to predict testicular torsion in children with acute scrotal pain: a single-center retrospective study in western China

A novel nomogram to predict testicular torsion in children with acute scrotal pain: a single-center retrospective study in western China

Acute genital diseases

Acute genital diseases can occur at any age and are characterized by complaints of various kinds of the external genitalia. Pain, swelling, and redness of the scrotum, adjacent groin region, and immediate surroundings are the leading symptoms, the severity of which may vary. In addition, peritonitic symptoms such as nausea, vomiting, and circulatory sensations may be present and are comparable to symptoms of an acute abdomen. The term "acute scrotum" encompasses various clinical entities, where scrotal symptoms are predominant and represent aurological emergency situation. Immediate and comprehensive diagnostics are necessary to ensure timely management in case of necessary surgical intervention.

Microscopic subinguinal varicocelectomy with video telescopic operating microscope (VITOM) telescope: outcome analysis.

Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, ligation of the testicular artery, and varicocele recurrence. The advantages of the microscopic approach to varicocele repairs are detailed identification and preservation of the vascular structures. In this study, our purpose is to review the outcome of all patients that underwent microscopic subinguinal varicocelectomy with the video telescopic operating microscope (VITOM). Hence, a retrospective review of 23 varicocele patients who underwent microscopic subinguinal varicocelectomy at the center from the year 2019 until 2021 was done. They, ranging between 18 to 58 years of age, comprising one case of right varicocele, fifteen cases of left varicocele, and seven cases of bilateral varicocele, were all having symptoms (pain and swelling) and clinically palpable varicocele. Ultrasounds were done to confirm the diagnosis and measure the testicular size. The surgery was performed by a single surgeon, under spinal anesthesia. The operation was performed using the VITOM telescope system, with an average operative time of one hour. The patients were followed-up at one month postoperatively to review the wound and symptoms. Phone call evaluations of all 23 patients were done to detect any recurrence or complications. All patients were discharged one day after surgery. Post-operative, all of them have a well-formed scar at the previous subinguinal region incision wound during the clinic visits. None of the 23 patients reported with varicocele recurrence, testicular pain, hydrocele formation or sexual dysfunction. The previous testicular pain or discomfort they encountered prior to the surgery was resolved as well. In conclusion, microscopic subinguinal varicocelectomy using the VITOM telescope is feasible and could achieve good outcomes.

Evaluation of Botox treatment in patients with chronic scrotal pain: Protocol for a randomized double‐blinded control trial

AbstractBackgroundChronic scrotal pain is a common condition with a prevalence of 2.5–4.8% in male outpatients. Up to 40% of these patients report depressive symptoms and many feel isolated. Minimal invasive treatment is lacking, while spermatic cord injections of Botox® (BTX) have been proposed to offer long‐term pain relief.Study DesignThis research protocol comprises a prospective multicentre, randomized, double‐blinded clinical trial drawing patients from other urological departments in the region of Southern Denmark.End PointsThe primary end point will be reduction in pain evaluated by visual analogue score for pain at 3 months. Secondary end point will be length of effect of BTX injections along with changes in quality of life.Patients and MethodsThe study will include 50 patients for randomization to either spermatic cord block with 100 IE BTX or sterile saline. All patients will prior to randomization undergo physical examination and will be asked to fulfil multiple questionnaires regarding pain and impact in daily life, that is, (1) visual analogue score for pain, (2) quality of life (EQ‐5D‐5L), (3) Chronic Prostatitis Symptom Index (NIH‐CPSI), (4) ICD‐10 depression questionnaire (MDI), (5) Likert global assessment scale, and (6) International Index of Erectile Function questionnaire. Physical examination and fulfilment of the questionnaires will be repeated multiple times throughout the study period of 12 weeks. After this time point, patients will be unblinded, and the control arm will be given the opportunity of cross‐over.

Stripping versus ligation of vas deferens in microscopic denervation of spermatic cord in men with chronic orchialgia: A multicenter study.

Microdenervation of the spermatic cord (MSCD) is an effective treatment modality for men with intractable scrotal content pain. For patients not interested in preserving fertility, some centers advocate ligation of the vas during denervation, while others prefer stripping of the vas deferens to preserve the vasal artery, hence preserving vasculature to the testis and possibly decreasing post-operative congestion pain. To compare outcomes of patients with chronic orchialgia, who underwent MSCD by either stripping or ligating the vas deferens. A retrospective chart review of 85 patients who underwent MSCD from 2017-2023 was performed. Patients' demographics including history of prior surgical procedures were recorded. Response to surgery was evaluated as either complete resolution of pain, partial resolution of pain, or no improvement in pain. Eighty-five patients underwent MSCD with a median (interquartile range, IQR) age of 36 (25.5-46.5) years and median duration of pain of 16 (6-31) months. Thirty-seven patients underwent stripping of vas, while 48 underwent ligation of vas during MSCD. Median follow up was 12 months. Twenty-one (43.5%) patients had prior inguinal scrotal surgery in the ligation group compared to 5 (13.5%) in the stripping group, p=0.003. The etiology of pain was similar between the groups. The response to MSCD between the two groups was similar, 67.6% of patients who underwent stripping had complete resolution of pain versus 66.7% of those who had ligation (p=0.968), with similar rates of post-operative complications (p-value=0.132). In men with intractable chronic scrotal content pain with no interest in preserving fertility, ligation, or stripping of the vas deferens yields similar outcomes with regard to pain resolution. Both techniques are safe with no reports of any testicular atrophy.

A simplified treatment algorithm for chronic scrotal content pain syndrome

Abstract Background Chronic scrotal content pain (CSCP) is a devastating condition characterized by localized scrotal pain that persists for ≥ 3 months and interferes with daily activities. Approximately 2.5% of all urology outpatient visits are associated with CSCP. General urologists may have difficulty treating these patients because of uncertainties regarding the etiology and pathophysiology of CSCP. Therefore, we aimed to provide a simplified diagnostic and treatment approach for CSCP by subdividing it into distinct categories. Materials and methods We systematically reviewed the published literature in the PubMed, MEDLINE, and Cochrane databases for all reports on CSCP diagnosis and treatment using the keywords “chronic scrotal content pain,” “testicular pain,” “orchialgia,” “testicular pain syndrome,” “microdenervation of the spermatic cord,” “post-vasectomy pain syndrome,” “post-inguinal hernia repair pain,” “testialgia,” and “pudendal neuralgia.” This review included only CSCP-related articles published in English language. Results We subdivided CSCP syndrome into 5 clinical presentation types, including hyperactive cremasteric reflex, pain localized in the testicles, pain in the testis, spermatic cord, and groin, pain localized in the testicles, spermatic cord, groin, and pubis, and pain in the testicles, spermatic cord/groin, and penis/pelvis. Treatments were adjusted stepwise for each type and section. We included more information regarding the role of pudendal neuroglia in CSCP syndrome and discussed more options for nerve blocks for CSCP. For microsurgical spermatic cord denervation failure, we included treatment options for salvage ultrasound-guided targeted cryoablation, Botox injections, and posterior-inferior scrotal denervation. Conclusions Different CSCP subtypes could help general urologists assess the appropriate diagnostic and treatment approaches for scrotal pain management in daily practice.

Turkish validation of the chronic orchialgia symptom index and its association with the visual analog scale.

To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language. The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method. The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r = 0.80 (p < 0.001). The Cronbach alpha values for the subscores were 0.80 for P, 0.71 for SS, and 0.80 for QoL. There was determined to be a statistically significant positive correlation between the VAS score and the COSI P, SS, QoL, and total scores (r: 0.63, p < 0.001; r = 0.32, p < 0.001; r = 0.56, p < 0.001; r = 0.59, p < 0.001, respectively). The optimal cutoff point of the COSI total score was determined to be 16.5 points (AUC:0.77, p < 0.001) for the determination of patients experiencing severe pain (⩾ 7.5) according to the VAS score. The Turkish version of the COSI questionnaire is a valid, reliable, and repeatable questionnaire that can be used to evaluate the effects of symptom severity in patients with CSCP.

Symptomatic Intraparenchymal Epididymal Cysts: Description of 11 cases.

Epididymal cysts are benign cystic formations of the epididymis that usually appear in adolescence or early adulthood. Their frequency doubles after the age of 14-15. Obstruction in the epididymal efferent ductules with subsequent prostenotic dilatation of them, as well as dysgenesis due to hormonal disorders during fetal or postnatal life, are possible. At the 1st Department of Pediatric Surgery of A.U.Th. we treated 11 cases of boys at the age of 11-16 who presented with acute scrotum because of an epididymal cyst. The diagnosis was confirmed by ultrasound scanning . Due to persistent symptomatology, patients underwent surgical exploration and removal of the cyst. The postoperative care of the patients was uncomplicated with immediate remission of symptoms. In one case, ipsilateral acute epididymitis occurred after 10 days, which was successfully treated with antibiotic therapy. It is reported that approximately 50% of epididymal cysts involute within an average of 17 months. In conclusion, using the data obtained from the review, of the small in number of international bibliography studies, it is proposed conservative treatment of asymptomatic cysts with diameter smaller than 1 cm and surgical excision [1] of large asymptomatic cysts with diameter greater than 1 cm, which do not regress after a follow-up of 24-48 months, cysts, regardless of their diameter, responsible for persistent symptoms and in the manifestation of acute scrotal symptoms due to inflammation, intravesical bleeding or secondarily torsion of the epididymis.

Follow‐up results regarding fixation of contralateral testis after testicular torsion in children

AbstractThe aim is to investigate the possible advantages and disadvantages of contralateral testicular fixation (CTF) for boys with testicular torsion (TT) by long‐term clinical follow‐up results. A retrospective cohort study was conducted on TT boys at Children’s Hospital of Chongqing Medical University from September 2005 to December 2020. The baseline characteristics, intraoperative findings, and clinical follow‐up results were compared between TT patients underwent orchiopexy with or without CTF, and orchiectomy with or without CTF, respectively. The χ2 test and the Fisher’s Exact test were used to compare dichotomous outcomes, and the Mann‐Whitney U test was used to compare continuous outcomes without normal distribution. A total of 140 cases were included in this study. The bell clapper deformity was found in 30.4% of all torsed testes underwent orchiopexy, 16.4% during contralateral testicular exploration, and only 10.9% in bilateral sides. Contralateral testicular volume, adverse events, and paternity rates were comparable between patients underwent orchiopexy with or without CTF, and no subsequent contralateral TT observed during follow‐up. However, those patients underwent orchiectomy without CTF had more incidence of scrotal discomfort than those had orchiectomy with CTF (P = 0.027). In addition, one boy suffered subsequent contralateral TT after orchiectomy without CTF. The incidence of bell clapper deformity was lower in this research than that of literature reports. CTF would not induce testicular volume loss, atrophy or scrotal pain. Contralateral testicular discomfort and even subsequent TT could be more easily observed during follow‐up in patients without CTF. We still recommend routine surgical fixation of contralateral testicle during surgery.

Combination of pregabalin and Amitriptyline in management of chronic idiopathic pain following penile prosthesis implantation: a pilot study

BackgroundChronic post-penile prosthesis pain is de novo pain persisting > 2 months post-operatively. This pain is inadequately reported, poorly understood and undermanaged. The purpose of this current pilot study was to improvise a medical approach to alleviate the condition and assess the combination of Pregabalin and Amitriptyline in its management.ResultsThe study enrolled 9 patients complaining of idiopathic penile, pelvic, or scrotal pain persisting > 2 months after penile prosthesis implantation. Patients were prescribed pregabalin 75mg/12h (escalated after 1 week to 150mg/12h upon demand) and Amitriptyline 25mg once daily for 3 months. The pain was reassessed after 10, 30 and 100 days. The dose of pregabalin required and the side effects of the medication were noted. Findings revealed a significant decrease in pain duration (p = 0.007), frequency (p < 0.001), and intensity (p < 0.001); in glanular (p = 0.008), shaft pain (p = 0.046) but not scrotal (p = 0.112). Moreover, a significant decrease was found in sharp pain (p = 0.003) and pain aggravated by touch (p = 0.008) but not aching pain (p = 0.277). Additionally, significant improvement was reported in QoL (p < 0.001) and dose escalation of pregabalin to 150mg/12h was required in only 1 case (11%).ConclusionThe combination of pregabalin and amitriptyline is very effective in the management of chronic idiopathic pain following penile prosthesis implantation. However, due to the ambiguity and lack of reporting of the condition, we recommend a multicentric contribution to acknowledge the condition, and weigh its prevalence accurately, whilst evaluating the efficacy of our approach.This study received ethical approval from Ain Shams University Research Ethics Committee (REC) FWA 000017585, on 04/13/2023 (REC-FMASU@med.asu.edu.eg). Trial registrationno FMASU R98/2023.