Abstract: PD05-02
Sources of Funding: none

Introduction

Chronic pain is an important public health issue across the world. Men with chronic unexplained orchialgia (CUO) are an understudied population, for whom there are significant knowledge gaps related to prevalence, demographics, etiology, and reliable treatment. This research begins to address these knowledge gaps.

Methods

This was a one-year feasibility study consisting of a convenience sample of men with chronic genital pain (non-pelvic pain) seen in an adult urology specialty clinic focused on men with CUO, and staffed by a nurse practitioner.

Results

A total of 228 men were evaluated in this half-day clinic (Figure 1): 107 were new referrals; 15 were scheduled for a second opinion; and 106 were previously evaluated for pain issues. In 125 men a diagnosis other than pain or pain at non-scrotal/testicular sites was identified, meaning that in 84% of men referred for “unexplained� orchialgia an actual cause was established. The algorithm for evaluation is shown in Figure 2. This is the first project to report the range of diagnoses associated with CUO in a given timeframe. After identifying etiologies, 20 men had true unexplained pain. This busy academic department sees over 38,000 visits a year, suggesting a prevalence for true CUO at < 1%.

Conclusions

Far fewer men than anticipated had truly unexplained chronic orchialgia. Offering a dedicated clinic for men with chronic genital pain provided rapid access to specialized expertise and accelerated diagnosis of etiologies for chronic genital pain. Conservative symptom management was the first course of treatment pursued during the timeframe of data collection. This specialized clinic decreases costs to the healthcare system, utilizing a staged screening strategy that maximized the value of tests and treatments offered, and by scheduling men with a specialized, but non-surgical, clinician. Future research will include ongoing data collection to achieve a larger sample size.

Funding

none