OnabotulinumtoxinA (Botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: a pilot open-label trial.

Abstract Introduction Chronic scrotal pain (CSP) is a common, often debilitating, condition affecting approximately 4.75% of men. While nerve blocks using local anesthetics usually provide temporary pain relief, there are no publications on the use of longer acting nerve blocks to provide more durable pain relief for men with CSP. Aim The aim of this study was to determine if onabotulinumtoxinA (Botox) cord blocks provide durable pain relief for men with CSP. Methods In this pilot open‐label study, men with CSP who had failed medical management but experienced temporary pain relief from a standard cord block underwent a cord block with 100U Botox. Main Outcome Measures The outcomes measured were changes 1, 3, and 6 months post‐Botox injection in (i) a 10‐point visual analog scale (VAS) pain score; (ii) scrotal tenderness on a three‐point scale as rated by physical examination; and (iii) the Chronic Epididymitis Symptom Index (CESI) to measure the severity and impact of scrotal pain on men. Paired t ‐tests were used to compare groups. Results Eighteen patients with CSP seen between April and September 2013 had Botox injected as a cord block. At the 1‐month follow‐up, pain reduction was reported by 72% of patients (mean VAS score: 7.36 vs. 5.61, P P P Conclusions Our pilot study found that Botox cord blocks provide pain reduction for 3 months or more for most men with CSP. Khambati A, Lau S, Gordon A, and Jarvi KA. OnabotulinumtoxinA (Botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: A pilot open‐label trial. J Sex Med 2014;11:3072–3077.