Frequency and severity of chronic scrotal pain in Canadian men presenting to urologists for infertility investigations

Background: Chronic scrotal pain (CSP) may be debilitating in men presenting for treatment for CSP, but we have little information on the frequency and severity of CSP in the men who do not seek care for the CSP. Our objective was to identify the frequency and characteristics of CSP in a population of men presenting for reasons other than CSP to a urology clinic. Methods: Men presenting to a urology clinic for investigation of male infertility (INF) completed a standardized CSP questionnaires if they self-reported having CSP. This prospectively collected database was then retrospectively analyzed. Results: Forty-five of 1,203 (3.7%) of INF patients (mean age 35: range, 24-59), reported having CSP (INF/CSP). Our comparison group was 131 men presenting for investigation of CSP [mean age 43 +/- 12 (SD) years with a mean duration of CSP of 4.7 +/- 5.95 years]. On average, men with INF/CSP had less severe and frequent pain than those with CSP, with significantly less pain during "bad" pain episodes (5.2 +/- 2.2 vs. 7.4 +/- 2.1, VAS score 0-10, P<0.0001 Student's t-test), less frequent "bad" pain episodes (23%+/- 21% vs. 42%+/- 30% of the time, P<0.0001 Student's t-test) and lower proportion of men who reported having severe pain (VAS score 7-10/10) (4/45 vs. 46/131, P<0.001, chi-squared test). Both groups reported a negative impact of the pain on quality of life (QOL), with 60% and 86% of men with INF/CSP and CSP alone reporting that they would feel 'mostly dissatisfied', 'unhappy', or 'terrible' if they had to continue life with their present scrotal pain symptoms. Conclusions: Clinicians should be aware that CSP is common among men presenting for conditions other than CSP and that even if the pain levels are not "severe", the chronic pain often has a significant negative impact on QOL.