Genitofemoral Neuromodulation as a Novel Pain Management Solution for Patients with Chronic Testicular Pain: A Proof-of-Concept Study.

Introduction: Severe chronic testicular pain that has failed medical therapy and physiotherapy poses a treatment dilemma. This study presents a proof of concept for the use of genitofemoral neuromodulation (GFM) as a potential pain management solution for patients with persistent testicular pain unresponsive to conservative and surgical management. Methods: Patients with chronic testicular pain refractory to conventional treatments were selected for GFM. A total of three patients were included in this proof-of-concept study. Demographic information, prior medical and surgical interventions, and pre- and post-operative pain scores using the Numerical Rating Pain Scale were collected. All patients must have had temporary relief from pain with a spermatic cord block. Results: Patient 1 (75 years old) had a history of opioid medication use, physiotherapy, radiofrequency ablation, and nerve block. His pain score reduced from 10/10 to 4/10 six months post-operatively. Patient 2 (59 years old) had a history of opioid, nortriptyline, baclofen medication use, and physiotherapy. His pain score reduced from 9/10 to 2/10 six months post-operatively. Patient 3 (36 years old) had a history of opioid medication use and physiotherapy, and bilateral orchidectomy for pain relief. His pain score reduced from 8/10 to 6/10 six months post-operatively. Conclusion: This study suggests that GFM is effective in reduce pain scores and could be a viable option for patients with chronic testicular pain refractory to traditional interventions. Further research is essential to establish the long-term efficacy and safety of GFM in this cohort.