Male Chronic Pelvic Pain: AUA Guideline: Part III Treatment of Chronic Scrotal Content Pain

Abstract

Purpose: This Guideline covers the evaluation and treatment of men who present to a clinician with a complaint of chronic pelvic pain. This is Part III of a three-part series focusing on treatment of chronic scrotal content pain (CSCP). CSCP patients typically present with pain described in the testes with tenderness in the epididymis and/or spermatic cord. Patient education of the underlying etiology may promote discussion of treatment options, which often require a multidisciplinary approach that includes management of expectations through supportive counseling during treatment. For discussion of patient evaluation and treatment of chronic prostatitis/chronic pelvic pain syndrome, refer to Parts I and II of this series.

Materials and methods: The systematic review that informs the Guideline statements was based on searches in Ovid MEDLINE (1946 to June 6, 2023), the Cochrane Central Register of Controlled Trials (through May 2023), and the Cochrane Database of Systematic Reviews (through May 2023). An updated search was conducted in June 2024.

Results: The Chronic Pelvic Pain Panel developed evidence- and consensus-based statements to provide guidance for treatment of patients with CSCP, which may include lifestyle modification, pharmacologic management, and procedural intervention.

Conclusions: Specific data on CSCP are lacking with most management options described as off-label use. While there are multiple evolving treatments for CSCP that have shown promising results, most currently lack sufficient data to recommend as treatment and require further investigation to establish a role in patient care.