Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Building Q10-1, Cleveland, OH, 44195, USA.
Department of Urology, Mayo Clinic, Rochester, MN, USA.
Curr Urol Rep. 2021 Jan 15;22(2):12. doi: 10.1007/s11934-020-01026-6.
Chronic scrotal content pain (CSCP) is a complex condition with multiple etiologies that requires a thorough understanding of its pathophysiology, workup, and treatment options. We performed a comprehensive and contemporary review to augment our current understanding of CSCP.
We discuss new advances in CSCP-specific pain questionnaires, modern studies of microscopic spermatic cord denervation and its variations, and novel techniques including electric nerve stimulation and cryoablation in addition to randomized control trials with significant negative findings. We also present literature focusing on the prevention of CSCP secondary to surgical iatrogenic causes. The constantly evolving literature of CSCP has led to the significant evolution in its diagnosis and treatment, from oral medications to salvage options after microscopic spermatic cord denervation. With each advance, we come closer to developing a more thorough, evidence-based algorithm to guide urologists in treatment of CSCP.
慢性阴囊内容物疼痛(CSCP)是一种具有多种病因的复杂疾病,需要深入了解其病理生理学、检查和治疗选择。我们进行了全面和现代的综述,以增进我们对 CSCP 的现有认识。
我们讨论了 CSCP 特定疼痛问卷的新进展、显微镜精索神经切断术及其变化的现代研究,以及除了具有显著阴性结果的随机对照试验外,还包括电神经刺激和冷冻消融等新的技术。我们还介绍了侧重于预防手术医源性原因引起的 CSCP 的文献。CSCP 的不断发展的文献导致其诊断和治疗发生了重大演变,从口服药物到显微镜精索神经切断术后的挽救选择。随着每一次进展,我们越来越接近于开发出更全面、基于证据的算法,以指导泌尿科医生治疗 CSCP。