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Minerva Urology and Nephrology 2022 October;74(5):551-8

DOI: 10.23736/S2724-6051.21.04529-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Surgical management of chronic scrotal pain: a review of the current literature

William R. VISSER 1, Luriel SMITH-HARRISON 1, Brayden PAYNE 2, Ryan P. SMITH 3, Sarah C. KRZASTEK 1, 3, 4

1 Division of Urology, Virginia Commonwealth University, Richmond, VA, USA; 2 School of Medicine, Virginia Commonwealth University, Richmond, VA, USA; 3 Department of Urology, University of Virginia, Charlottesville, VA, USA; 4 Division of Urology, Richmond VA Medical Center, Richmond, VA, USA



Chronic scrotal pain (CSP) may be due to an identifiable cause, may be multifactorial, or may be idiopathic. Successful treatment often requires multimodal therapy with a multidisciplinary approach. Conservative options may be offered initially, but if symptoms fail to improve with conservative interventions, more invasive therapies may be required. A nerve block may be attempted and patients who experience improvement in pain following nerve blocks may be good candidates for surgical denervation of the spermatic cord. Alternative surgical treatment options including proximal nerve blocks, neuromodulation, cryoablation, vasectomy reversal, varicocelectomy, and even orchiectomy have been described. The aim of this review is to discuss the treatment options for CSP with a focus on surgical treatment options.


KEY WORDS: Spermatic cord; Denervation; Pelvic pain

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