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Male Sexual Dysfunction

Chronic Scrotal Pain

Chronic scrotal pain is persistent or recurrent pain in the scrotal contents lasting more than 3 months. It can originate from the testicle, epididymis, spermatic cord, or referred from other areas.

60%
Success Rate
Chronic condition; treatment response over 3-6 months
Duration
Multiple
Treatment Options
3+ Groups
May Affect

What is Chronic Scrotal Pain?

Chronic scrotal pain is persistent or recurrent pain in the scrotal contents lasting more than 3 months. It can originate from the testicle, epididymis, spermatic cord, or referred from other areas.

Prevalence: Affects 2-5% of men; most common after vasectomy

Symptoms and Signs

  • Continuous or intermittent scrotal pain
  • Dull ache or sharp sensation
  • Pain radiating to the groin or inner thigh
  • Tenderness of the testicle or epididymis
  • Pain worsened by prolonged standing or activity
  • Sexual dysfunction or discomfort

Causes and Risk Factors

Common Causes

  • Post-vasectomy pain syndrome
  • Varicocele or hydrocele
  • Chronic epididymal inflammation
  • Spermatic cord nerve entrapment
  • Referred pain from ureter or spine
  • Testicular tumor (rare)
  • Idiopathic (no identifiable cause)

Risk Factors

  • ⚠️Vasectomy
  • ⚠️Varicocele
  • ⚠️History of scrotal trauma
  • ⚠️Inguinal hernia repair
  • ⚠️Prolonged standing occupations

Treatment Options

Expected Outcomes: Variable; 60-70% improve with conservative measures; surgery reserved for refractory cases

Available Treatments:

  • Scrotal support and elevation
  • Anti-inflammatory medications
  • Nerve blocks (spermatic cord block)
  • Nerve decompression or neurectomy
  • Epididymectomy (removal of epididymis)
  • Orchiectomy (last resort for severe cases)
  • Pelvic floor physical therapy
  • Anticonvulsant medications (gabapentin)

Prevention Tips

  • Protect scrotum during physical activity
  • Consider vasectomy alternatives (discuss risks)
  • Treat injuries promptly

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