Chronic orchalgia; a vexing problem: etiology and management

ABSTRACT

Thirty-five patients with chronic intrascrotal pain were studied. The duration of pain at presentation was 3-96 months [average 22.6 months]. Diagnostic work up showed that only 14 cases [40%] had an intrascrotal pathology explaining the chronic orchalgia. On the other h and, orchalgia was the result of referred pain from the upper urinary tract in 5 cases [14.3%] and a prostatic pathology in another 5 cases. Other causes of intrascrotal pain were sensory neuralgia in 2 patients and psychosomatic troubles in another 2 cases. Four cases [11.4%] remained where no cause for orchalgia could be identified. Treatment of the cases was either surgical, medical or by spermatic cord neural block. Complete pain relief was achieved in 16 cases [45.7%]. Partial improvement was reported by another 16 cases and 3 patients [8.6%] showed no improvement