Chronic Scrotal Content Pain: a Review of the Literature and Management Schemes

Curr Urol Rep. 2021 Jan 15;22(2):12. doi: 10.1007/s11934-020-01026-6.


Purpose of review: Chronic scrotal content pain (CSCP) is a complex condition with multiple etiologies that requires a thorough understanding of its pathophysiology, workup, and treatment options. We performed a comprehensive and contemporary review to augment our current understanding of CSCP.

Recent findings: We discuss new advances in CSCP-specific pain questionnaires, modern studies of microscopic spermatic cord denervation and its variations, and novel techniques including electric nerve stimulation and cryoablation in addition to randomized control trials with significant negative findings. We also present literature focusing on the prevention of CSCP secondary to surgical iatrogenic causes. The constantly evolving literature of CSCP has led to the significant evolution in its diagnosis and treatment, from oral medications to salvage options after microscopic spermatic cord denervation. With each advance, we come closer to developing a more thorough, evidence-based algorithm to guide urologists in treatment of CSCP.

Keywords: Chronic orchialgia; Chronic scrotal content pain; Chronic testicular pain; Microscopic denervation; Spermatic cord block.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Chronic Pain / etiology
  • Chronic Pain / therapy*
  • Cryosurgery
  • Denervation / methods
  • Electric Stimulation Therapy
  • Genital Diseases, Male / diagnosis
  • Genital Diseases, Male / etiology
  • Genital Diseases, Male / therapy*
  • Humans
  • Iatrogenic Disease / prevention & control
  • Male
  • Microsurgery
  • Pain Measurement
  • Pelvic Pain / etiology
  • Pelvic Pain / therapy
  • Randomized Controlled Trials as Topic
  • Scrotum*
  • Skin Diseases / diagnosis
  • Skin Diseases / etiology
  • Skin Diseases / therapy
  • Spermatic Cord / innervation
  • Testicular Diseases / diagnosis
  • Testicular Diseases / therapy