Acute Neuropathic Orchalgia and Scrotalgia After Percutaneous Spinal Cord Stimulator Lead Placement: Two Cases with an Unusual Complication

Abstract

Spinal cord stimulation is an effective adjunct to the treatment of a variety of chronic pain syndromes. Complications are relatively low in morbidity and are most often secondary to hardware malfunction/malposition. Infection and undesired dysesthesias represent only a minority of complications. Neuropathic orchalgia and scrotalgia after placement of epidural spinal cord stimulator is a previously unreported morbidity. While alarming, this condition is physiologically benign, causing no neurological or urological dysfunction. The two cases we encountered both occurred during uncomplicated percutaneous trial stimulator placement. Corticosteroid treatment and stimulator activation facilitated resolution of the dysesthesia and allowed completion of the trial in one case, while the other case was refractory and resulted in termination of the trial.