How to Treat Chronic Idiopathic Testicular Pain? Scrotoscopy with a Novel Percutaneous Endoscopy Equipment

Background. Management of chronic idiopathic testicular pain may be difficult because of problems identifying the causes. We evaluated "AUTOKLAV", a novel endourological nephrolithotomy device to diagnose and treat chronic idiopathic testicular pain. Methods. We divided 103 patients to either scrotoscopy group (SG, n = 64) or open exploration group (OEG, n = 39) between September 2014 and March 2017 at Zhongnan Hospital. Perioperative information, like operating time, length of incision, and wound infections, was carefully recorded during in hospital. Follow-up data, like pain scores improvement, satisfaction with penis appearance, and adverse event, were collected at one month postoperatively. Results. Finally, both the operating time and length of incision showed better performance for SG (43.6 +/- 4.7 versus 51.5 +/- 9.0 min; 0.7 +/- 0.2 versus 4.1 +/- 0.8 cm; both P <0.01). Though the pain improvement had no significant differences between the two groups (2.92 +/- 0.99 and 2.14 +/- 1.02, p>0.05), SG showed obvious advantages in incidence of wound infections and satisfaction with wound/scrotum appearance (0% versus 2.9%; 96.4% versus 85.3%, both P<0.05). Conclusions. In conclusion, scrotoscopy using the novel AUTOKLAV device is feasible, has an acceptable complication rate, and can be effective and safe in men with idiopathic chronic testicular pain. Etiologically, secondary inflammatory changes caused by the complete or incomplete torsion of testicular or epididymis appendices or by the existence of stones in the tunica sac might be responsible for the pain.