Background: Chronic scrotal pain syndrome (CSPS) – is a common clinical condition of HIV + male patients evaluated by infectious disease physicians in Lviv Regional AIDS Center (LRAC) . The purpose of this study was to define the most frequent causes of CSPS in HIV + male patients.
Methods: Patients recruited to the study were males from Lviv region of Ukraine with CSPS according to chronic pelvic pain classification by European Association of Urology. Ultrasound examination of the scrotum, semen analysis, and semen and urine PCR (polymerase chain reaction) for Chlamydia trachomatis(CT), Trichomonas vaginalis (TV), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), Mycoplasma hominis(MH) and Neisseria gonorrhoeae( NG) were performed for the study group. Physical examination and detailed patient history were taken into consideration as well.
Results: During September 2011 - October 2013 52 eligible men (age range 19- 46 years; mean 33 years) with CSPS were enrolled in the study. Ultrasound examinations of the scrotum revealed the following: varicocele ( 4,2%), hydrocele (2,1%), small epididymal cyst ( 2,1%), testicular tumour ( 2,1%), and normal ultrasound examination (89,6%). The semen analysis revealed that 18,6% patients had < 1,000,000/ml white blood cell count while 81,3% patients had 1,000,000- 8,000,000/ml . PCR testing for infectious diseases demonstrated that MH, MG, UU or combination was identified in 59 ,8 % while CT and NG were found in 12,4% of patients. In 27.8% of patients PCR testing was negative. Pain was reported in 81,3% as a primary complaint and a history of multiple, unsuccessful treatments had low correspondence between symptoms and medical findings.
Conclusions: This study suggests that Mycoplasma is common in HIV + male patients with CSPS. However, this finding needs to be confirmed in a larger sample population and calls for further research to explore the potential role of these microorganisms in the pathogenesis of CSPS.