Scrotal pain syndrome: The annoying testicular discomfort symptom

Scrotal pain syndrome New
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

Several patients are being at my office complaining about simply scrotal pain or discomforts. The symptom is not too severe but it was kept frustrated them. Sometimes, it makes them to digging out a medical advice in order to perform a vary procedure of the investigation. Surprisingly, every type of testicular-related tests will always showed a negative finding and most physicians didn’t offer them such a good explanation or details, rather to make them more stressful and shot many bullets of questions into their minds like; can it possibly become a tumor? Will I need to tolerate or suffering like this in my entire life? Well! This is the points that I’m going to shed the light – it so called “Scrotal pain syndrome” disease.

Scrotum pain syndrome is defined by at least 3 months of unusual discomfort at scrotal area which interfere daily activities. The syndrome has been referred to by many names, including scrotal pain syndrome,  chronic orchialgia, testialgia, testicular pain syndrome, post-vasectomy pain syndrome, post-vasectomy orchalgia, chronic testicular pain, chronic scrotal content pain.

Approximately 2.5% of patients at Urology office suffered from a scrotal pain syndrome. It is described by any kind of stimulation that irritates the nerves in the scrotum. The stimulus can be something such as trauma, infection, irritation stimulus or even nothing (Idiopathic). The nerves at the scrotum share the same branches with the nerve at the groin and the flank area, that mean the unusual discomfort can radiated to the groin and the flank area.

Scrotal pain syndrome can express symptoms as following;

  1. Testicular pain
  2. Epididymal pain
  3. Vas deferens pain
  4. Pain during ejaculation
  5. Premature ejaculation
  6. Pain during straining the urine
  7. Pain after sitting for a long time
Scrotal pain syndrome: The annoying testicular discomfort symptom
The unexplained perineal pain after long sitting can be Scrotal pain syndrome

The principles of investigations are trying to exclude any conditions which can grossly explain the pain, sound funny right? Because of the scrotal pain syndrome is all-about the nerve thing so every kind of tests must result as NEGATIVE. The treatments options will be step by step begins from the less invasive to more invasive depend on the clinical outcome. Here are the treatment options.

Acupuncture
Acupuncture is a good alternative choice in Scrotal pain syndrome management
  • Psychological evaluation
  • Pelvic floor exercise
  • Acupuncture
  • Antibiotics (Presence of infection)
  • Non-steroidal anti-inflammatory drugs
  • Antidepressant drugs
  • Anticonvulsant drugs
  • Radio-frequency therapy
  • Spermatic cord nerve block
  • Surgical intervention
Oral medication may be a good trial
The oral medication is the first good trial in Scrotal pain syndrome
Surgical intervention will be the last resort
The surgical intervention is preserved as the last choice

You can see that there are a lot of treatment options. By the way, the most important thing is a doctor’s role and responsibility. We must provide transparent information to the patient; let them know what is going on and what is the whole picture of this kind of annoying condition. Binding a good relation between patient and doctor. Relationship is very essential for getting through the disease that so called a “Scrotal pain syndrome”

Any questions, you can feel free to discuss with me.

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