MP11-13 NEW SUB-CLASSIFICATION AND TREATMENT ALGORITHM FOR CHRONIC SCROTAL CONTENT PAIN (CSCP) SYNDROME
The Journal of Urology（2024）
Abstract
You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP11)1 May 2024MP11-13 NEW SUB-CLASSIFICATION AND TREATMENT ALGORITHM FOR CHRONIC SCROTAL CONTENT PAIN (CSCP) SYNDROME Sergey Kravchick, Sijo J. Parekattil, Gennady Bratslavsky, Robert Moldwin, Daniel Shulman, and Curtis Nickel Sergey KravchickSergey Kravchick , Sijo J. ParekattilSijo J. Parekattil , Gennady BratslavskyGennady Bratslavsky , Robert MoldwinRobert Moldwin , Daniel ShulmanDaniel Shulman , and Curtis NickelCurtis Nickel View All Author Informationhttps://doi.org/10.1097/01.JU.0001008564.85995.11.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pain associated with CSCP interferes with patients' daily activity and quality of life and prompts them to seek help, leading to 2.5-4.8% of all urology outpatient visits and affects>100.000 men annually. The pain etiology is idiopathic in nearly 50% of cases and any pathology that shares nerve pathway from T10-L2 and S2- S4 may refer pain to the inguinal-scrotal area. General urologists feel ill-equipped for treating CSCP, and consequently these patients circling around with an average of 4.5 physicians and undergoing 7.2% diagnostic interventions until a solution to their illness is found. Multiple algorithms have been proposed without reaching a definitive consensus. The main goal of this study was to simplify treatment algorithms and guide General Urologists in workup and management options. METHODS: We systematically reviewed the published literature based on the PubMed, Medline, and Cochrane databases for all reports regarding CSCP diagnoses and treatments. Then we subdivided different forms of CSCP syndrome based on five distinctive types of clinical presentation: Hyperactive cremasteric reflex; Pain localized in the testicle; Pain in the testis, spermatic cord, and groin; Pain localized in the testicle, spermatic cord, groin, and Pubis; Pain in the testicle, spermatic cord/groin and in the Penis/Pelvis. The stepwise treatment was adjusted to each type and section. We included more information about the role of Pudendal neuroglia in CSCP syndrome. We also included more options of nerve blocks for CSCP. For microsurgical spermatic cord denervation (MSCD) failures we provided option for Salvage Ultrasound-guided Targeted Cryoablation, Botox injections and Posterior-Inferior Scrotal denervation. RESULTS: Classical diagnostics and stepwise treatment were adjusted to each type of chronic scrotal pain. As a result we created a new algorithm for assessment and treatment of CSCP (Figure 1). CONCLUSIONS: The subdivision of scrotal pain syndrome to 5 different types could help general urologist to concentrate assessment efforts accordinly and should simplify the stepwise treatment process. Download PPT Source of Funding: No © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e155 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sergey Kravchick More articles by this author Sijo J. Parekattil More articles by this author Gennady Bratslavsky More articles by this author Robert Moldwin More articles by this author Daniel Shulman More articles by this author Curtis Nickel More articles by this author Expand All Advertisement PDF downloadLoading ...
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