A Randomized, Double-Blind, Controlled Trial Shows that Onabotulinum Toxin A Nerve Blocks do Not Provide Improved Pain Control in Men with Chronic Scrotal Pain

Dockray, Judith; Aljumaily, Aosama; Lau, Susan; Jarvi, Keith

doi:10.1097/ju.0000000000000658

Cited by 12 publications

(15 citation statements)

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“…However, a randomised, double-blind, controlled trial by Dockray et al found no superiority of onabotulinumtoxinA plus a local anaesthetic compared to a local anaesthetic alone for the control of SCP pain. Interestingly, our open label onabotulinumtoxinA trial noted significant pain improvement, suggesting a potential placebo effect [45].…”

Section: Other Surgical Treatment Optionsmentioning

confidence: 84%

A Review of the Management of Chronic Scrotal Pain

Moubasher

Waqar

Raison

et al. 2020

Cureus

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Chronic scrotal pain (CSP) is a common and poorly understood medical condition that significantly affects individuals’ quality of life. Many patients seek evaluation and management of their symptoms from multiple physicians. Our review aims to address diagnostic modalities, clinical evaluation, and surgical and non-surgical management. We conducted a computerised detailed search of the PubMed, Medline, Embase and Cochrane databases for reports pertaining to CSP using the Medical Subject Headings keywords ‘chronic scrotal pain’, ‘testicular pain’ and ‘orchialgia’, and we included in the review those that fulfilled the inclusion (adult male with CSP presenting with the criteria of CSP ) and exclusion (extra-scrotal pain) criteria. After the direct causes of CSP were identified by reviewing the clinical evaluations (history taking and examination are mandatory) and the diagnostic evaluations (urine analysis is crucial and ultrasound can be helpful), the most-used medical and non-surgical treatments for CSP were tricyclic antidepressants (success rate of up to 66.6%) and spermatic block (success rate of more than 90%), and the most-used surgical procedure was microsurgical denervation of the spermatic cord (success rate of up to 70%). The evidence currently available remains rare and of low quality, making it difficult to strongly recommend individual treatment options. However, multimodal treatment modalities using physical therapy and psychotherapy may help patients and provide useful tools for coping with this condition. There are also useful non-surgical and surgical options for CSP that depend on the patient’s state, the severity of the complaint and what options have already been tried.

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Section: Other Surgical Treatment Optionsmentioning

confidence: 84%

A Review of the Management of Chronic Scrotal Pain

Moubasher

Waqar

Raison

et al. 2020

Cureus

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“…Onabotulinum Toxin A for Chronic Scrotal Pain Dockray et al (page 767) from Canada tested the use of onabotulinum toxin A to treat chronic scrotal pain in a randomized, prospective, double-blind trial. 8 Patients received either local anesthetic block of the spermatic cord or block plus onabotulinum toxin A. No statistically significant difference was observed for any measured outcome.…”

Section: Absent Diurnal Variation In Serum Testosterone and Testosterone Deficiencymentioning

confidence: 95%

This Month in Adult Urology

Smith¹

2020

Journal of Urology

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“…It is possible that the toxin could be used as an alternative, or that the injection itself had a placebo effect. 15 , 16 …”

Section: Non-surgical Treatment Optionsmentioning

confidence: 99%

Gold Standard Care of Chronic Scrotal Pain

Malaguti¹,

Lund²

2021

RRU

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Introduction: Chronic scrotal pain (CSP) can be a debilitating condition for patients and is often difficult to characterize. Methods: A review of literature was performed using Embase, Cochrane and Medline databases in the period 1.January 2010 to 1.January 2021. We found 132 articles, and the authors screened abstract and references. Thirty-seven articles are included after removing duplicates. Results: This review presents a variety of medical and surgical treatment options for CSP such as spermatic cord blocks (36-80% success rate), microsurgical denervation of the spermatic cord (76-100% success rates), Botox (56% success rate), targeted ilioinguinal and iliohypogastric peripheral nerve stimulation, and radical orchiectomy (55-75% success rate). Conclusion: An overview of various treatment options, both non-surgical and surgical are provided, with the aim of establishing what may be the best treatment option for CSP.

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A Randomized, Double-Blind, Controlled Trial Shows that Onabotulinum Toxin A Nerve Blocks do Not Provide Improved Pain Control in Men with Chronic Scrotal Pain

Cited by 12 publications

References 0 publications

A Review of the Management of Chronic Scrotal Pain

A Review of the Management of Chronic Scrotal Pain

This Month in Adult Urology

Gold Standard Care of Chronic Scrotal Pain

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