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    How to manage testicular/groin pain: Medical and surgical ladder

    Care should be individualized and based on symptoms, response to prior therapy

    Daniel H. Williams, IV, MDDaniel H. Williams, IV, MD Christopher M. Gonzalez, MD, MBASeries Editor Christopher M. Gonzalez, MD, MBA

    Chronic orchialgia, orchidynia, epididymalgia, epididymitis, scrotalgia, scrotal content pain, scrotal pain syndrome, testicle pain, groin pain—call it what you wish. The constellation of symptoms in this heterogeneous patient population is as variable as the terms used to describe it. Regardless of the label, this condition can be very frustrating for patients to live with and equally frustrating and challenging for clinicians to manage.

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    The European Urological Association (EAU) uses the generic term “scrotal pain syndrome” to include testicular pain syndrome, post-vasectomy pain syndrome, and epididymal pain syndrome (Eur Urol 2010; 57:35-48). EAU guidelines cover the diagnosis, treatment, and follow-up of patients with these conditions. A multidisciplinary approach including physiotherapy is recommended.

    Diagnostic algorithm for scrotal content pain

    While guidelines can be useful to help direct patient care, each patient’s situation needs to be individually tailored, and care should be offered based on symptoms and response to prior therapy. This article reviews the evaluation and the medical and surgical management options for patients with what most experts refer to as chronic scrotal content pain.

     

    Next: Symptoms and impact on QoL

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