Pediatric chronic orchialgia: patient population and patterns of care.

Ching CB, Hays SR, Kaffenberger SD, Stephany HA, Luckett TR, Clayton DB, Tanaka ST, Thomas JC, Adams MC, Brock JW, Pope JC
J Pediatr Urol. 2014 10 (5): 799-803

PMID: 24768521 · DOI:10.1016/j.jpurol.2014.01.008

OBJECTIVE - A major hurdle in management of any chronic pain syndrome is understanding the population in which it occurs. We describe our pediatric population of patients with peripubertal and postpubertal chronic orchialgia.

PATIENTS AND METHODS - Pediatric patients ≥ 10 years of age seen between 2002 and 2012 were identified by ICD code 608.9, Male Genital Disorder NOS. Patients were included if they had orchialgia without identifiable cause lasting >3 months. Patient history, diagnostic evaluations, treatments, and outcomes were assessed.

RESULTS - Seventy-nine pediatric patients were identified. The mean age was 13.3 years (range 10-18); mean duration of orchialgia was 16.3 months (range 3-85). Thirty-three of 79 (42%) had concomitant medical conditions and/or psychiatric-behavioral issues. The mean follow-up was 7.1 months (range 0-70.4) with 41/79 (52%) having more than one office visit follow-up. Eleven patients were referred to a pediatric pain clinic; 10 out of 11 (91%) were evaluated there. Overall, 16 out of 41 (39%) had resolution of pain: nine out of 41 (22%) responding to conservative management vs seven of 10 (70%) responding to pain clinic management (3 to anti-neuropathic medications, 4 to nerve block).

CONCLUSION - Many pediatric patients with chronic orchialgia have co-morbidities amenable to multidisciplinary collaborative coordination of care. Referral to pediatric pain clinic can be of significant benefit.

Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

MeSH Terms (17)

Adolescent Age Factors Analgesics Child Chronic Pain Diagnostic Imaging Emergency Service, Hospital Groin Humans Male Nerve Block Pain Clinics Pain Management Puberty Referral and Consultation Testicular Diseases Treatment Outcome

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