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Author: Dr David Lim, Dermatology Registrar, Greenlane Clinical Centre, Auckland, New Zealand, 2011.
Scrotodynia is a chronic pain syndrome of the scrotal skin. The name scrotodynia is only used when the cause of the discomfort is unknown. It is a recently described condition and our understanding of it is still evolving. It is thought to be similar to vulvodynia which affects women.
Scrotodynia may be confused with other chronic pain syndromes of adjacent structures. These include testicular pain syndrome, post-vasectomy pain syndrome and epididymal pain syndrome. Scrotodynia has also been referred to as ‘the male genital skin burning syndrome’.
Men have described pain, burning or abnormally sensitive scrotal skin over a prolonged period of time. There are no abnormalities visible when the scrotal skin is examined. However, similar symptoms may arise in patients with visible and named skin disorders.
Please refer to DermNet’s page on genital skin problems for other conditions that may cause scrotal burning, stinging, irritation and rawness.
The cause of scrotodynia is currently unknown. Like other chronic pain syndromes it may involve a complex interplay between components of the nervous system. This may involve the nerves, spinal cord, brain and neurotransmitters.
There are limited reports of scrotodynia in the medical literature, so information is scarce. Previous reports have included men aged from their mid-30’s to mid-50’s.
Scrotodynia can have a dramatic effect on quality of life and may lead to difficulties with relationships. In some cases it can lead on to depression.
Treatment of scrotodynia can be difficult and a satisfying outcome may not be achieved. However, there have been reports of success with amitriptyline, paroxetine and fluoxetine. While these medications have traditionally been used for depression, they are also commonly used for a range of chronic pain syndromes. The symptoms of scrotodynia may recur with the cessation of medication.
NZ DermNet also has a topic entitled male genital dysaesthesia, which is a broader term than scrotodynia.
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