Urologie pro praxi 2/2018

Syndrome of chronic scrotal pain (part one)

Idiopathic scrotal pain syndrome (SPS) is defined as at least 3 months of chronic or intermittent scrotal content pain. SPS remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well – recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of SPS is not clearly delineated. Expected mechanisms include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, perineural fibrosis, etc. This article reviews the current understanding of SPS, theories behind its pathophysiology, diagnostic evaluation pathways. SPS is a "diagnosis of exclusion" and therefore differential diagnosis excluding another, especially local pathology is extremely important.

Keywords: scrotal pain syndrome, etiopathophysiology, diagnosis.