Frequency and severity of chronic scrotal pain in Canadian men presenting to urologists for infertility investigations
Aosama Aljumaily, Ellen Forbes, Hind Abdul Jaleel Al-Khazraji, Allan Gordon, Susan Lau, Keith Allen Jarvi, Aosama Aljumaily, Ellen Forbes, Hind Abdul Jaleel Al-Khazraji, Allan Gordon, Susan Lau, Keith Allen Jarvi
Abstract
Background: Chronic scrotal pain (CSP) may be debilitating in men presenting for treatment for CSP, but we have little information on the frequency and severity of CSP in the men who do not seek care for the CSP. Our objective was to identify the frequency and characteristics of CSP in a population of men presenting for reasons other than CSP to a urology clinic.
Methods: Men presenting to a urology clinic for investigation of male infertility (INF) completed a standardized CSP questionnaires if they self-reported having CSP. This prospectively collected database was then retrospectively analyzed.
Results: Forty-five of 1,203 (3.7%) of INF patients (mean age 35: range, 24-59), reported having CSP (INF/CSP). Our comparison group was 131 men presenting for investigation of CSP [mean age 43¡À12 (SD) years with a mean duration of CSP of 4.7¡À5.95 years]. On average, men with INF/CSP had less severe and frequent pain than those with CSP, with significantly less pain during "bad" pain episodes (5.2¡À2.2 vs. 7.4¡À2.1, VAS score 0-10, P<0.0001 Student's t-test), less frequent "bad" pain episodes (23%¡À21% vs. 42%¡À30% of the time, P<0.0001 Student's t-test) and lower proportion of men who reported having severe pain (VAS score 7-10/10) (4/45 vs. 46/131, P<0.001, chi-squared test). Both groups reported a negative impact of the pain on quality of life (QOL), with 60% and 86% of men with INF/CSP and CSP alone reporting that they would feel 'mostly dissatisfied', 'unhappy', or 'terrible' if they had to continue life with their present scrotal pain symptoms.
Conclusions: Clinicians should be aware that CSP is common among men presenting for conditions other than CSP and that even if the pain levels are not "severe", the chronic pain often has a significant negative impact on QOL.
Keywords: Chronic scrotal pain (CSP); infertility (INF); questionnaires; sexuality; varicocele.
Conflict of interest statement
Conflicts of Interest: The authors have no conflicts of interest to declare.
References
- Davis BE, Noble MJ, Weigel JW, et al. Analysis and management of chronic testicular pain. J Urol 1990;143:936-9. 10.1016/S0022-5347(17)40143-1
- Ciftci H, Savas M, Yeni E, et al. Chronic orchialgia and associated diseases. Current Urology 2010;4:67-70. 10.1159/000253415
- Strebel RT, Leippold T, Luginbuehl T, et al. Chronic scrotal pain syndrome: management among urologists in Switzerland. Eur Urol 2005;47:812-6. 10.1016/j.eururo.2005.01.003
- Aljumaily A, Al-Khazraji H, Gordon A, et al. Characteristics and etiologies of chronic scrotal pain: a common but poorly understood condition. Pain Res Manag 2017;2017:3829168.
- Nickel JC, Siemens DR, Nickel KR, et al. The patient with chronic epididymitis: characterization of an enigmatic syndrome. J Urol 2002;167:1701-4. 10.1016/S0022-5347(05)65181-6
- Khambati A, Lau S, Gordon A, et al. OnabotulinumtoxinA (Botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: a pilot open-label trial. J Sex Med 2014;11:3072-7. 10.1111/jsm.12707
- Hawker GA, Mian S, Kendzerska T, et al. Measures of adult pain: visual analog scale for pain (VAS Pain), numeric rating scale for pain (NRS Pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63:S240-52. 10.1002/acr.20543
- Whooley MA, Avins AL, Miranda J, et al. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997;12:439-45. 10.1046/j.1525-1497.1997.00076.x
- Morley JE, Charlton E, Patrick P, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism 2000;49:1239-42. 10.1053/meta.2000.8625
Source: PubMed