A simplified treatment algorithm for chronic scrotal content pain syndrome  

作　　者：Sergey Kravchick Sijo J.Parekattil Gennady Bratslavsky Matthew R.Beamer Robert Moldwin Daniel Shulman J.Curtis Nickel 

机构地区：[1]Arthur Smith Institute for Urology of the Northwell Health System,Riverhead,NY,USA [2]Avant Concierge Urology,Winter Garden,FL,USA [3]Department of Urology,SUNY Upstate Medical University,Syracuse,NY,USA [4]Arthur Smith Institute for Urology of the Northwell Health System,Lake Success,NY,USA [5]Binghamton University,Binghamton,NY,USA [6]Department of Urology,Queen's University,Kingston,Ontario,Canada

出　　处：《Current Urology》2024年第4期251-256,共6页当代泌尿学（英文）

摘　　要：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.

关 键 词：Chronic scrotal content pain Testicular pain ORCHIALGIA Testicular pain syndrome Microdenervation of the spermatic cord Postvasectomy pain syndrome Postinguinal hernia repair pain Testialgia Pudendal neuralgia 

分 类 号：R697.21[医药卫生—泌尿科学]