Skip to main content
Erschienen in: Current Urology Reports 6/2015

01.06.2015 | Men’s Health (R Carrion and C Yang, Section Editors)

Evaluation and Management of Chronic Scrotal Content Pain

verfasst von: Laurence A. Levine, Michael P. Hoeh

Erschienen in: Current Urology Reports | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Chronic scrotal content pain (CSCP) is a common patient complaint which virtually all urologists will encounter in practice. While our understanding of the pathophysiology and management has increased in recent years, CSCP remains a frustrating process for both the patient and physician given that there currently is no standardized protocol for treatment or evaluation. The following article is a literature review regarding the pathophysiology and current medical and surgical options for CSCP. We also provide an updated evaluation and treatment algorithm.
Literatur
2.
3.
Zurück zum Zitat Davis B, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990;143:936.PubMed Davis B, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990;143:936.PubMed
4.
5.
Zurück zum Zitat Aubin S, Serger RE, Herman JR, et al. The association between sexual function, pain, and psychological adaptation of men diagnosed with chronic pelvic pain syndrome type III. J Sex Med. 2008;5:657.CrossRefPubMed Aubin S, Serger RE, Herman JR, et al. The association between sexual function, pain, and psychological adaptation of men diagnosed with chronic pelvic pain syndrome type III. J Sex Med. 2008;5:657.CrossRefPubMed
6.
Zurück zum Zitat Costabile RA, Hahn M, McLeod DG. Chronic orchialgia in the pain prone patient: the clinical perspective. J Urol. 1991;146:1571.PubMed Costabile RA, Hahn M, McLeod DG. Chronic orchialgia in the pain prone patient: the clinical perspective. J Urol. 1991;146:1571.PubMed
7.
Zurück zum Zitat Strebel RT, Leippold T, Lugnebuehl T, Muentener M, Praz V, Hauri D. Chronic scrotal pain syndrome: management among urologists in Switzerland. Eur Urol. 2005;47:812.CrossRefPubMed Strebel RT, Leippold T, Lugnebuehl T, Muentener M, Praz V, Hauri D. Chronic scrotal pain syndrome: management among urologists in Switzerland. Eur Urol. 2005;47:812.CrossRefPubMed
8.
Zurück zum Zitat Heidenreich A, Olbert P, Engelmann UH. Management of chronic testalgia by microsurgical testicular denervation. Eur Urol. 2002;41:392–7.CrossRefPubMed Heidenreich A, Olbert P, Engelmann UH. Management of chronic testalgia by microsurgical testicular denervation. Eur Urol. 2002;41:392–7.CrossRefPubMed
9.
Zurück zum Zitat Wesselman U, Burnett AL, Heinberg LJ. The urogenital and rectal pain syndromes. Pain. 1997;73:269.CrossRef Wesselman U, Burnett AL, Heinberg LJ. The urogenital and rectal pain syndromes. Pain. 1997;73:269.CrossRef
10.
Zurück zum Zitat Ronka K, Virnone J, Kokki H, Liukkonen T, Paajanen H. Role of orchiectomy in severe testicular pain after inguinal surgery: audit of the Finnish Patient Insurance Center. Hernia 2013 Aug 9 Ronka K, Virnone J, Kokki H, Liukkonen T, Paajanen H. Role of orchiectomy in severe testicular pain after inguinal surgery: audit of the Finnish Patient Insurance Center. Hernia 2013 Aug 9
11.
Zurück zum Zitat Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990;143(5):936–9.PubMed Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990;143(5):936–9.PubMed
12.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
13.
Zurück zum Zitat Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618.CrossRefPubMed Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618.CrossRefPubMed
14.
Zurück zum Zitat Voscopoulos C, Lema M. When does acute pain become chronic? Br J Anaesth. 2010;105 suppl 1:69–85.CrossRef Voscopoulos C, Lema M. When does acute pain become chronic? Br J Anaesth. 2010;105 suppl 1:69–85.CrossRef
15.
Zurück zum Zitat Strom KH, Levine LA. Microsurgical denervation of the spermatic cord (MDSC) for chronic orchialgia: long-term results from a single center. J Urol. 2008;180:949.CrossRefPubMed Strom KH, Levine LA. Microsurgical denervation of the spermatic cord (MDSC) for chronic orchialgia: long-term results from a single center. J Urol. 2008;180:949.CrossRefPubMed
16.
Zurück zum Zitat Gray CL, Powell CR, Amling CL. Outcomes for surgical management of orchialgia in patients with identificable intrascrotal lesions. Eur Urol. 2001;39:455.CrossRefPubMed Gray CL, Powell CR, Amling CL. Outcomes for surgical management of orchialgia in patients with identificable intrascrotal lesions. Eur Urol. 2001;39:455.CrossRefPubMed
17.
Zurück zum Zitat Yaman O, Ozdiler E, Anafarta K, Gogus O. Effect of microsurgical subinguinal varicocele ligation to treat pain. Urology. 2000;55(1):107–8.CrossRefPubMed Yaman O, Ozdiler E, Anafarta K, Gogus O. Effect of microsurgical subinguinal varicocele ligation to treat pain. Urology. 2000;55(1):107–8.CrossRefPubMed
18.
19.•
Zurück zum Zitat Kachrilas S, Popov E, Bourdoumis A, Akhter W, El Howairis M, Aghaways I, et al. Laparoscopic varicocelectomy in the management of chronic scrotal pain. JSLS. 2014;18(3):1–4. 48 patients were treated with laparoscopic varicocelectomy for dull scrotal pain attributed to varicoceles with no other identifiable etiology. 42 patients (87.5 %) noted significant improvement in the visual analog scale score, 5 patients (10.4 % noted symptom improvement, which was not statistically significant, and one patient (2.1 %) remained unchanged. They noted 5 recurrences (10.4 %) and de novo hydrocele formation in 4 patients (8.3 %). CrossRef Kachrilas S, Popov E, Bourdoumis A, Akhter W, El Howairis M, Aghaways I, et al. Laparoscopic varicocelectomy in the management of chronic scrotal pain. JSLS. 2014;18(3):1–4. 48 patients were treated with laparoscopic varicocelectomy for dull scrotal pain attributed to varicoceles with no other identifiable etiology. 42 patients (87.5 %) noted significant improvement in the visual analog scale score, 5 patients (10.4 % noted symptom improvement, which was not statistically significant, and one patient (2.1 %) remained unchanged. They noted 5 recurrences (10.4 %) and de novo hydrocele formation in 4 patients (8.3 %). CrossRef
21.
Zurück zum Zitat Lee LM, Moloney PJ, Wong HC, Magil AB, McLoughlin MG. Testicular pain: an unusual presentation of polyarteritis nodosa. J Urol. 1983;129:1243–4.PubMed Lee LM, Moloney PJ, Wong HC, Magil AB, McLoughlin MG. Testicular pain: an unusual presentation of polyarteritis nodosa. J Urol. 1983;129:1243–4.PubMed
22.
Zurück zum Zitat Van Vugt R, Valk L, van Leeuwen H, Tjan D, van der Waal C, van Zanten A. Isolated orchiodynia as the initial symptom of aneurysm of the abdominal aorta. Ne Tijdschr Geneeskd. 2007;151:310–3. Van Vugt R, Valk L, van Leeuwen H, Tjan D, van der Waal C, van Zanten A. Isolated orchiodynia as the initial symptom of aneurysm of the abdominal aorta. Ne Tijdschr Geneeskd. 2007;151:310–3.
23.
Zurück zum Zitat Christiansen CG, Sandlow JI. Testicular pain following vasectomy: a review of postvasectomy pain syndrome. J Androl. 2003;24:293–7.PubMed Christiansen CG, Sandlow JI. Testicular pain following vasectomy: a review of postvasectomy pain syndrome. J Androl. 2003;24:293–7.PubMed
24.
Zurück zum Zitat McMahon AJ, Buckley J, Taylor A, Lloyd SN, Deane RF, Kirk D. Chronic testicular pain following vasectomy. Br J Urol. 1993;69:188–91.CrossRef McMahon AJ, Buckley J, Taylor A, Lloyd SN, Deane RF, Kirk D. Chronic testicular pain following vasectomy. Br J Urol. 1993;69:188–91.CrossRef
25.
Zurück zum Zitat Morris C, Mishra K, Kirkman RJ. A study to assess the prevalence of chronic testicular pain in post-vasectomy men compared to non-vasectomised men. J Fam Plann Reprod Health Care. 2002;28:142.CrossRefPubMed Morris C, Mishra K, Kirkman RJ. A study to assess the prevalence of chronic testicular pain in post-vasectomy men compared to non-vasectomised men. J Fam Plann Reprod Health Care. 2002;28:142.CrossRefPubMed
26.
Zurück zum Zitat Tandon S, Sabanegh Jr E. Chronic pain after vasectomy: a diagnostic and treatment dilemma. BJU Int. 2008;102:166.CrossRefPubMed Tandon S, Sabanegh Jr E. Chronic pain after vasectomy: a diagnostic and treatment dilemma. BJU Int. 2008;102:166.CrossRefPubMed
27.
Zurück zum Zitat Johnson AL, Howards SS. Intratubular hydrostatic pressures in testis and epididymis before and after vasectomy. Am J Physiol. 1975;228:556.PubMed Johnson AL, Howards SS. Intratubular hydrostatic pressures in testis and epididymis before and after vasectomy. Am J Physiol. 1975;228:556.PubMed
28.
Zurück zum Zitat McMahon AJ, Buckley J, Taylor A, Lloyd SN, Deane RF, Kirk D. Chronic testicular pain following vasectomy. Br J Urol. 1993;69:188–91.CrossRef McMahon AJ, Buckley J, Taylor A, Lloyd SN, Deane RF, Kirk D. Chronic testicular pain following vasectomy. Br J Urol. 1993;69:188–91.CrossRef
29.•
Zurück zum Zitat Lai Y, Yu Z, Shi B, Ni L, Liu Y, Yang S. Chronic scrotal pain caused by mild epididymitis: report of a series of 44 cases. Pak J Med Sci. 2014;30(3):638–41. Consecutive series of 44 patients with mild CSCP over 6 weeks duration noted to have mild-to-moderate epididymal tenderness without enlargement on physical exam, in addition to a negative urinalysis and Doppler ultrasound. These patients were treated for a median of 4 weeks with antibiotics (cephalosporin or quinolone and if no improvement after 1 week changed to doxycycline and azithromycin) in addition to temporary cessation of strenuous activity and all fully recovered from scrotal pain. PubMedCentralPubMed Lai Y, Yu Z, Shi B, Ni L, Liu Y, Yang S. Chronic scrotal pain caused by mild epididymitis: report of a series of 44 cases. Pak J Med Sci. 2014;30(3):638–41. Consecutive series of 44 patients with mild CSCP over 6 weeks duration noted to have mild-to-moderate epididymal tenderness without enlargement on physical exam, in addition to a negative urinalysis and Doppler ultrasound. These patients were treated for a median of 4 weeks with antibiotics (cephalosporin or quinolone and if no improvement after 1 week changed to doxycycline and azithromycin) in addition to temporary cessation of strenuous activity and all fully recovered from scrotal pain. PubMedCentralPubMed
30.
Zurück zum Zitat Schaeffer AJ, Landis JR, Knauss JS, et al. Chronic Prostatitis Collaborative Research Network Group. Demographic and clinical characteristics of men with chronic prostatitis: the National Institutes of Health Chronic Prostatitis Cohort study. J Urol. 2002;168:593.CrossRefPubMed Schaeffer AJ, Landis JR, Knauss JS, et al. Chronic Prostatitis Collaborative Research Network Group. Demographic and clinical characteristics of men with chronic prostatitis: the National Institutes of Health Chronic Prostatitis Cohort study. J Urol. 2002;168:593.CrossRefPubMed
31.
Zurück zum Zitat Nickel JC, Baranowski AP, Pontari M, Berger RE, Tripp DA. Management of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome who have failed traditional management. Rev Urol. 2007;9(2):63–72. Nickel JC, Baranowski AP, Pontari M, Berger RE, Tripp DA. Management of men diagnosed with chronic prostatitis/chronic pelvic pain syndrome who have failed traditional management. Rev Urol. 2007;9(2):63–72.
32.
Zurück zum Zitat Heidelbaugh JJ, Llanes M, Weadock WJ. An algorithm for the treatment of chronic testicular pain. J Fam Pract. 2010;59(6):330–6.PubMed Heidelbaugh JJ, Llanes M, Weadock WJ. An algorithm for the treatment of chronic testicular pain. J Fam Pract. 2010;59(6):330–6.PubMed
33.
Zurück zum Zitat Sinaki M, Merritt JL, Stillwell GK. Tension myalgia of the pelvic floor. Mayo Clin Proc. 1997;52:717. Sinaki M, Merritt JL, Stillwell GK. Tension myalgia of the pelvic floor. Mayo Clin Proc. 1997;52:717.
34.
Zurück zum Zitat Williams DH. How to manage testicular/groin pain: medical and surgical ladder. Urol Times Aug 2014 Enews: urologytimes.modernmedicine.com. [Last accessed 1/6/14] Williams DH. How to manage testicular/groin pain: medical and surgical ladder. Urol Times Aug 2014 Enews: urologytimes.modernmedicine.com. [Last accessed 1/6/14]
35.
Zurück zum Zitat Levine LA. Chronic orchialgia: evaluation and discussion of treatment options. Ther Adv in Urol. 2010;2(5–6):209–14.CrossRef Levine LA. Chronic orchialgia: evaluation and discussion of treatment options. Ther Adv in Urol. 2010;2(5–6):209–14.CrossRef
36.
Zurück zum Zitat Masarani M, Cox R. The aetiology, pathophysiology, and management of chronic orchialgia. BJU Int. 2003;91:435.CrossRefPubMed Masarani M, Cox R. The aetiology, pathophysiology, and management of chronic orchialgia. BJU Int. 2003;91:435.CrossRefPubMed
37.
Zurück zum Zitat Shoskes DA, Zeitlin SI, Shahed A, et al. Quercetin in men with category III chronic prostatitis: a preliminary prospective double-blind, placebo-controlled trial. Urology. 1999;54:960.CrossRefPubMed Shoskes DA, Zeitlin SI, Shahed A, et al. Quercetin in men with category III chronic prostatitis: a preliminary prospective double-blind, placebo-controlled trial. Urology. 1999;54:960.CrossRefPubMed
38.
Zurück zum Zitat Sinclair AM, Miller B, Lee LK. Chronic orchialgia: consider gabapentin or nortriptyline before considering surgery. Int J Urol. 2007;14:622–5.CrossRefPubMed Sinclair AM, Miller B, Lee LK. Chronic orchialgia: consider gabapentin or nortriptyline before considering surgery. Int J Urol. 2007;14:622–5.CrossRefPubMed
39.
Zurück zum Zitat Chen R, Nickel JC. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003;61:1156.CrossRefPubMed Chen R, Nickel JC. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003;61:1156.CrossRefPubMed
40.
Zurück zum Zitat Issa M, Hsiao K, Bassel Y, et al. Spermatic cord anesthesia block for scrotal procedures in the outpatient clinic setting. J Urol. 2004;172:2358.CrossRefPubMed Issa M, Hsiao K, Bassel Y, et al. Spermatic cord anesthesia block for scrotal procedures in the outpatient clinic setting. J Urol. 2004;172:2358.CrossRefPubMed
41.•
Zurück zum Zitat Khambati A, Lau S, Gordo A, Jarvi KA. OnabotulinumtoxinA (botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: a pilot open-label trial. J Sex Med. 2014;11(12):3072–7. 18 patients with CSCP had 100 units botox injected as a cord block. 13 of 18 patients (72 %) noted pain reduction at 1-month follow up, 10 of 18 (52 %) at 3 months, and most men had a return to baseline levels of pain and tenderness at 6 months. CrossRefPubMed Khambati A, Lau S, Gordo A, Jarvi KA. OnabotulinumtoxinA (botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: a pilot open-label trial. J Sex Med. 2014;11(12):3072–7. 18 patients with CSCP had 100 units botox injected as a cord block. 13 of 18 patients (72 %) noted pain reduction at 1-month follow up, 10 of 18 (52 %) at 3 months, and most men had a return to baseline levels of pain and tenderness at 6 months. CrossRefPubMed
43.
Zurück zum Zitat De Maddalena C, Bellini M, Berra M, Meriggiola MC, Aloisi AM. Opioid-induced hypogonadism: why and how to treat it. Pain Physician. 2012;15(3 suppl):ES111–8.PubMed De Maddalena C, Bellini M, Berra M, Meriggiola MC, Aloisi AM. Opioid-induced hypogonadism: why and how to treat it. Pain Physician. 2012;15(3 suppl):ES111–8.PubMed
44.
Zurück zum Zitat Misra S, Ward S, Coker C. Pulsed radiofrequency for chronic testicular pain—a preliminary report. Pain Med. 2009;10:673.CrossRefPubMed Misra S, Ward S, Coker C. Pulsed radiofrequency for chronic testicular pain—a preliminary report. Pain Med. 2009;10:673.CrossRefPubMed
45.
Zurück zum Zitat Terkawi AS, Romdhane K. Ultrasound-guided pulsed radiofrequency ablation of the genital branch of the genitofemoral nerve for treatment of intractable orchalgia. Saudi J Anaesth. 2014;8(2):294–8.CrossRefPubMedCentralPubMed Terkawi AS, Romdhane K. Ultrasound-guided pulsed radiofrequency ablation of the genital branch of the genitofemoral nerve for treatment of intractable orchalgia. Saudi J Anaesth. 2014;8(2):294–8.CrossRefPubMedCentralPubMed
46.
Zurück zum Zitat Hori S, Sengupta A, Shukla CJ, Ingall E, McLoughlin J. Long-term outcome of epididymectomy for the management of chronic epididymal pain. J Urol. 2009;182:1407–12.CrossRefPubMed Hori S, Sengupta A, Shukla CJ, Ingall E, McLoughlin J. Long-term outcome of epididymectomy for the management of chronic epididymal pain. J Urol. 2009;182:1407–12.CrossRefPubMed
47.
Zurück zum Zitat West AF, Leung HY, Powell PH. Epididymectomy is an effective treatment for scrotal pain after vasectomy. BJU Int. 2000;85:1097–9.CrossRefPubMed West AF, Leung HY, Powell PH. Epididymectomy is an effective treatment for scrotal pain after vasectomy. BJU Int. 2000;85:1097–9.CrossRefPubMed
48.
Zurück zum Zitat Calleary JG, Masood J, Hill JT. Chronic epididymitis: is epididymectomy a valid surgical treatment? In J Androl. 2009;32:468. Calleary JG, Masood J, Hill JT. Chronic epididymitis: is epididymectomy a valid surgical treatment? In J Androl. 2009;32:468.
49.
Zurück zum Zitat Padmore DE, Norman RW, Millard OH. Analyses of indications for and outcomes of epididymectomy. J Urol. 1996;156:95.CrossRefPubMed Padmore DE, Norman RW, Millard OH. Analyses of indications for and outcomes of epididymectomy. J Urol. 1996;156:95.CrossRefPubMed
50.
Zurück zum Zitat Siu W, Ohl DA, Schuster TG. Long-term follow-up after epididymectomy for chronic epididymal pain. Urology. 2007;70:333–5.CrossRefPubMed Siu W, Ohl DA, Schuster TG. Long-term follow-up after epididymectomy for chronic epididymal pain. Urology. 2007;70:333–5.CrossRefPubMed
51.
Zurück zum Zitat Myers SA, Mershon CE, Fuchs EF. Vasectomy reversal for the treatment of the post-vasectomy pain syndrome. J Urol. 1997;157:518.CrossRefPubMed Myers SA, Mershon CE, Fuchs EF. Vasectomy reversal for the treatment of the post-vasectomy pain syndrome. J Urol. 1997;157:518.CrossRefPubMed
52.
Zurück zum Zitat Nangia AK, Myles JL, Thomas Jr AT. Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation. J Urol. 2000;164:1939–42.CrossRefPubMed Nangia AK, Myles JL, Thomas Jr AT. Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation. J Urol. 2000;164:1939–42.CrossRefPubMed
53.
Zurück zum Zitat Shapiro EI, Silber SJ. Open-ended vasectomy: sperm granuloma, and postvasectomy orchialgia. Fertil Steril. 1979;32:546.PubMed Shapiro EI, Silber SJ. Open-ended vasectomy: sperm granuloma, and postvasectomy orchialgia. Fertil Steril. 1979;32:546.PubMed
54.
Zurück zum Zitat Werthman P. Vasectomy reversal for post-vasectomy pain syndrome: a ten-year experience. J Urol. 2010;183(suppl):e752.CrossRef Werthman P. Vasectomy reversal for post-vasectomy pain syndrome: a ten-year experience. J Urol. 2010;183(suppl):e752.CrossRef
55.
Zurück zum Zitat Holland JM, Feldman JL, Gilbert HC. Phantom orchialgia. J Urol. 1994;152:2291.PubMed Holland JM, Feldman JL, Gilbert HC. Phantom orchialgia. J Urol. 1994;152:2291.PubMed
56.
Zurück zum Zitat Levine LA, Matkov TG. Microsurgical denervation of the spermatic cord as primary surgical therapy for the treatment of chronic orchialgia. J Urol. 2001;165:1927.CrossRefPubMed Levine LA, Matkov TG. Microsurgical denervation of the spermatic cord as primary surgical therapy for the treatment of chronic orchialgia. J Urol. 2001;165:1927.CrossRefPubMed
57.
Zurück zum Zitat Levine LA, Matkov TG, Lubenow TR. Microsurgical denervation of the spermatic cord: a surgical alterative in the treatment of chronic orchialgia. J Urol. 1996;155:1005.CrossRefPubMed Levine LA, Matkov TG, Lubenow TR. Microsurgical denervation of the spermatic cord: a surgical alterative in the treatment of chronic orchialgia. J Urol. 1996;155:1005.CrossRefPubMed
58.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
59.
Zurück zum Zitat Devine Jr CJ, Schellhammer PF. The use of microsurgical denervation of the spermatic cord for orchialgia. Trans Am Assoc Genitourin Surg. 1978;70:149.PubMed Devine Jr CJ, Schellhammer PF. The use of microsurgical denervation of the spermatic cord for orchialgia. Trans Am Assoc Genitourin Surg. 1978;70:149.PubMed
60.
Zurück zum Zitat Heidenreich A, Olbert P, Engelmann UH. Management of chronic testalgia by microsurgical testicular denervation. Eur Urol. 2002;41:392–7.CrossRefPubMed Heidenreich A, Olbert P, Engelmann UH. Management of chronic testalgia by microsurgical testicular denervation. Eur Urol. 2002;41:392–7.CrossRefPubMed
61.
Zurück zum Zitat Kavoussi PK, Costabile RA. Orchialgia and the chronic pelvic pain syndrome. World J Urol. 2013;31:773–8.CrossRefPubMed Kavoussi PK, Costabile RA. Orchialgia and the chronic pelvic pain syndrome. World J Urol. 2013;31:773–8.CrossRefPubMed
62.
63.
Zurück zum Zitat Parekattil SJ, Brahmbhatt JV. Robotic approaches for male infertility and chronic orchialgia microsurgery. Curr Opin Urol. 2011;21(6):493–9.CrossRefPubMed Parekattil SJ, Brahmbhatt JV. Robotic approaches for male infertility and chronic orchialgia microsurgery. Curr Opin Urol. 2011;21(6):493–9.CrossRefPubMed
64.
Zurück zum Zitat Larsen SM, Benson JS, Levine LA. Microdenervation of the spermatic cord for chronic scrotal content pain: single institution review analyzing success rate after prior attempts at surgical correction. J Urol. 2013;189(2):554–8.CrossRefPubMed Larsen SM, Benson JS, Levine LA. Microdenervation of the spermatic cord for chronic scrotal content pain: single institution review analyzing success rate after prior attempts at surgical correction. J Urol. 2013;189(2):554–8.CrossRefPubMed
Metadaten
Titel
Evaluation and Management of Chronic Scrotal Content Pain
verfasst von
Laurence A. Levine
Michael P. Hoeh
Publikationsdatum
01.06.2015
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 6/2015
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-015-0510-1

Weitere Artikel der Ausgabe 6/2015

Current Urology Reports 6/2015 Zur Ausgabe

New Imaging Techniques (A Rastinehad and S Rais-Bahrami, Section Editors)

The Role of MRI in Active Surveillance for Prostate Cancer

Prostate Cancer (A Kibel, Section Editor)

Immunotherapy in Prostate Cancer

Urothelial Cancer (A Sagalowsky, Section Editor)

Practical Tips for Safe and Efficient Robotic Cystectomy

Men’s Health (R Carrion and C Yang, Section Editors)

Evaluation and Treatment of Penile Thrombophlebitis (Mondor’s Disease)

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.