TREATMENT OF IDIOPATHIC CHRONIC ORCHIALGIA WITH TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS): A PRELIMINARY RESULT

Purpose: Unilateral or bilateral testicular pain lasting more than three months is called as chronic orchialgia. Approximately 25-50% of chronic orchialgia is the idiopathic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy due to Idiopathic Chronic Orchialgia (ICO). Methods: Five patients were included in this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal Doppler ultrasound. Medical history revealed that multiple conservative therapy attempts failed to alleviate the pain. Two of the patients had right sided ICO. Traditional TENS device is placed to the most painful points. TENS applied three times in a week with duration 30 minutes for four weeks. Before and after TENS application, patients were evaluated by using Visual Analog Scale (VAS) at first and third months. Results: Median age of patients was 26.20±2.38 (22-30). Mean VAS value was 6.52 ± 0.89 before the procedure. After 1 month VAS value was 3.82 ± 0.83 (p<0.05). VAS value was 5.67±0.44 at the end of the third month (p>0.05). None of the patients needed any analgesics after during the one month. No complications, hyperemia or hypoesthesia of the scrotal or penile skin, occurred after the procedure. Conclusion: TENS reduces pain by increasing endorphin release in the spinal cord dorsal horn. TENS is very effective method for first one month in patients with ICO, but its effect reduces the time. There is no standard therapeutic protocol for idiopathic chronic orchialgia. Therefore, TENS may be an alternative for patients who do not benefit from medical therapy and do not want invasive procedures. Short-term use of TENS and a low number of the patients are the limitations of this study. Randomized, placebo-controlled, and longer follow-up period studies are needed to assess better the efficacy of TENS for ICO.