A new approach to the treatment of non‐specific male genital pain

Abstract

OBJECTIVES • To review the literature and the generally accepted unsatisfactory management of chronic genital pain in men. • To refer such patients for Journey psychotherapy and record the outcomes of such treatment. PATIENTS AND METHODS • We describe an alternative psychotherapeutic approach in the treatment of such men, whereby deep‐seated emotions are considered an underlying cause in the expression of chronic genital pain. • Eleven men with refractory chronic genital pain were counselled, and given one Journey process, lasting 2–3 h. • They were followed up for up to 4 years in some cases, and their outcomes recorded. • No further treatment was undertaken in this time. RESULTS • Of the 11 cases, four had significant pain relief, four had partial relief of their symptoms, and three did not (or may have had some relief but were lost to follow‐up). CONCLUSION • Chronic genital pain syndromes are common and often debilitating. Patients are subject to an array of investigations that usually identify non‐specific abnormalities at best. Treatment is usually aimed at symptomatic control as underlying organic pathology is rarely identified. Patients have been given multiple courses of antibiotics even in the absence of identifiable organisms, anti‐inflammatory drugs in the absence of proven inflammation, and narcotic analgesics in an attempt to control chronic pain. Occasionally surgery, such as orchidectomy, has been performed to remove the painful organ, without satisfactory results. We therefore looked for an alternative approach that had the promise of a more satisfactory outcome. • Given the usual psychotherapeutic requirement of lengthy periods of therapy, and given that each patient only had one session, we find the above results remarkable and very encouraging. • With this experience, we now offer this approach early to avoid wasting time and money, and would persist with further therapy sessions especially in those with partial relief of their pain.

Dysaesthetic penoscrotodynia may be a somatoform disorder: results from a two-centre retrospective case series

“…Although the large majority of our patients were treated with oral psychiatric medications, there is an equally valid case for instituting psychological treatment. A recent report illustrates the potential benefit of so‐called ‘journey psychotherapy’ in a series of men with refractory genital pain …”

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