Editing CUA: Chronic Scrotal Pain (2018) (section)

==== Mandatory ====

===== History and Physical Exam =====
* '''<span style="color:#ff0000">History'''
** Characterize pain (onset, location, quality, severity, referral, psychosocial impact, aggravating/alleviating factors)
** Urinary, bowel, and sexual function
** Potential risk factors for infectious causes of scrotal pain, such as epididymo-orchitis
** Potential reversible causes for scrotal pain
** PMHx and PSHx, including any previous scrotal, inguinal, abdominal, or pelvic surgeries
** Prior evaluations/interventions for the presenting pain, as well as whether any prior treatment has brought relief
** History of psychological, physical, or sexual abuse
*** Males with a history of abuse are at increased risk of CP/CPPS
* '''<span style="color:#ff0000">Physical exam (4)'''
*# '''<span style="color:#ff0000">Scrotum'''
*#*'''Patient should be examined in both standing and supine position'''
*#*Examination should begin on the non-painful or less painful side
*#* Testis, epididymis, vas should be carefully palpated for any anatomic abnormalities and to localize the source of the scrotal pain
*# '''<span style="color:#ff0000">Inguinal area''' 
*#*should be carefully inspected for surgical scars, hernias, or areas of tenderness. Care should also be taken to identify '''tenderness in the region of the adductor insertion''', which is often found in men presenting for investigation of CSP.
*# '''<span style="color:#ff0000">Digital Rectal Exam'''
*#*'''<span style="color:#ff0000">Essential</span>''' to assess for any abnormalities of the prostate, as well as hypertonicity or point tenderness of the pelvic floor structures.
*# '''<span style="color:#ff0000">Screening neurological examination of the lower limbs and genitals''' 
*#*Often required to assess for sensory deficits and radicular syndromes.