Chronic orchialgia: consider gabapentin or nortriptyline before considering surgery.
OBJECTIVE
To establish if there is a role for gabapentin or nortriptyline in the treatment of chronic orchialgia.


METHODS
Twenty-six consecutive patients with chronic orchialgia were seen in the chronic pain clinic by a multidisciplinary team. A pain questionnaire was completed prior to commencing either gabapentin or nortriptyline. They were reviewed at 3 months and a repeat questionnaire completed. A 50% improvement in pain was considered successful.


RESULTS
Complete data was available for 19 patients. Overall, 61.5% of patients commenced on gabapentin and 66.6% of patients commenced on nortriptyline had a greater than 50% improvement in pain. Patients with post-vasectomy testicular pain were considered as a subgroup. None of these patients had a greater than 50% improvement in pain. However, 80% of patients in the subgroup with idiopathic chronic orchialgia had a greater than 50% improvement in pain.


CONCLUSIONS
Although this is a small study, it appears that gabapentin and nortriptyline are effective in the treatment of idiopathic chronic orchialgia but not post-vasectomy pain.
Sinclair
Andrew M
AM
Department of Urological Surgery, Royal Bolton Hospital, Minerva Road, Farnworth, Bolton, UK.
Miller
Barry
B
Lee
Ling K
LK
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000588:Amines / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002908:Chronic Disease; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D013733:Testicular Diseases / Q000188:drug therapy*; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
D018759:Adrenergic Uptake Inhibitors; D000588:Amines; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D009661:Nortriptyline