Quality of life in men with chronic scrotal pain

Abstract

Background: Chronic scrotal pain (CSP) is a common and often debilitating condition found in up to 4.75% of men. There is little written on the impact of CSP on men's lives. Aim: The aim of this study was to understand the impact of CSP on men's lives. Methods: Patients with CSP were prospectively asked to complete a comprehensive questionnaire, including questions on quality of life (QoL), activities, and mood. Results: The mean age of the 131 patients was 43 years. Pain was intermittent, with severe pain episodes (mean pain scores 7.2 ± 2 out of 10) affecting men on average 40% ± 30% of the time. Overall, 88/131 (67.17%) of patients responded that they felt "unhappy" or "terrible" with their present situation. More than 40% of patients complained of depressive symptoms more than half the days of the month. Normal activities were adversely affected, with 68/131 (51.90%) reporting limited ability to work, 93/131 (70.99%) patients reporting decreased physical activity, and 81/131 (61.83%) reporting decreased sexual activity. Comparing men with pain levels ≥ 7/10 vs. those with pain levels < 7/10, 47% (41/88) vs. 8.1% (3/37) reported that they felt "terrible," 40% (35/88) vs. 13% (5/38) had depressive feelings more than half the time, and 35% (28/80) vs. 16% (6/38) felt little pleasure doing things (P < 0.01 for all). Conclusion: Our study suggests that QoL, mood, and the ability to perform normal activities are profoundly disturbed in CSP patients and that the pain severity is directly related to QoL. RÉSUMÉContexte: La douleur scrotale chronique est une affection commune et souvent débilitante dont souffrent près de 4,75 % des hommes. Il y a peu d'écrits sur l'impact de la douleur scrotale chronique sur la vie des hommes. But: Comprendre l'impact de la douleur scrotale chronique sur la vie des hommes. Méthodes: On a demandé de manière prospective à des patients souffrant de douleur scrotale chronique de remplir un questionnaire détaillé comprenant des questions sur leur qualité de vie, leurs activités et leur humeur. Résultats: L'âge moyen des 131 patients était de 43 ans. La douleur était intermittente, comportait des épisodes de douleur intense (scores de la douleur moyens 7,2 +/-2 sur 10) et affectait les hommes 40 % +/-30 % du temps. Globalement, 88/131 (67,17 %) des patients ont répondu qu'ils se sentaient malheureux ou « horriblement mal » en raison de leur situation actuelle. Plus de 40 % des patients se sont plaints de symptômes de dépression plus de la moitié des jours du mois. Leurs activités habituelles étaient affectées négativement, alors que 68/131 (51,90 %) disaient avoir une capacité de travail limitée, que 93/131 (70,99 %) des patients signalaient une diminution de leur activité physique et que 81/131 (61,83 %) d'entre eux faisaient état d'une diminution de leur activité sexuelle. La comparaison des hommes qui avaient un niveau de douleur ≥ 7/10 à ceux qui avaient un niveau de douleur < 7/10 a révélé que 47 % d'entre eux (41/88) se sentaient « horriblement pas bien » contre 8,1 % (3/37), que 40 %...

A Review of the Management of Chronic Scrotal Pain

“…The content of a detailed social history also informs diagnosis and treatment. For instance, a history of sexual abuse has been associated with increased rates of chronic pelvic pain in adulthood and may affect subsequent approaches to physical examination and adjunctive testing [ 16 ]. Up to 40% of patients who have CSP complain of depressive symptoms, and many feel socially isolated [ 17 , 18 ].…”

“…Other non-surgical techniques include pulsed radiofrequency of the spermatic cord and the genital branch of the genitofemoral nerve for PVPS if the patient receives temporary relief from an SCB. Acupuncture is rarely mentioned, being reported only in some small non-randomised trials [ 2 , 16 ]. Finally, the least mentioned non-surgical techniques are transcutaneous electrical stimulation (TENS) and vibratory stimulation [ 16 ].…”

“…Acupuncture is rarely mentioned, being reported only in some small non-randomised trials [ 2 , 16 ]. Finally, the least mentioned non-surgical techniques are transcutaneous electrical stimulation (TENS) and vibratory stimulation [ 16 ]. Tables 1 - 4 analyse medical, psychotherapy, physical, SCB, radiofrequency and other non-surgical options of treatment in the last five years.…”

“…Other, rarely mentioned, surgical treatments for CSP that need more research include laparoscopic denervation [ 1 , 2 ], robotic denervation [ 46 ], resection of the genitofemoral nerve [ 2 ], sperm granuloma resection [ 16 ], AmnioFix® injection [ 36 , 37 ], spinal cord stimulation [ 36 ], scrotoscopy using the novel autoclave [ 47 ] and microsurgical sub-inguinal cremaster muscle release (MSCMR), which has been shown to be an effective option that has a relatively low rate of complications in cases of chronic orchialgia that has been clearly identified as secondary to testicular retraction due to a hyperactive cremaster muscle reflex and in which all other aetiologies of orchialgia have been ruled out [ 48 ]. Table 6 analyses vasectomy reversal, epididymectomy and orchidectomy in the last five years’ publications.…”

Spermatic Cord Block Series as a Minimally Invasive Therapy for Chronic Scrotal Content Pain

“…2,3 Treatment of CSCP is often a prolonged, frustrating process for both patients and physicians. 4 Evaluation begins with a detailed history and physical examination to characterize symptoms with the goal of identifying medically important or potentially reversible etiologies. 5 Therapy is generally guided by the presumed etiology of pain, which can be highly variable, including infection, trauma, surgery, chronic pelvic pain syndrome, scrotal mass (eg varicocele, hydrocele, tumor), and sources of referred pain from extrascrotal structures with shared innervation.…”