Inclusion Criteria:  Age of 18 - 70 years Unilateral or bilateral scrotal pain > 3 months No other identifiable cause of pain Insufficient effect of conservative treatment A positive effect of local anesthesia spermatic cord block  Exclusion Criteria:  Inability to provide informed consent Interest in trying to conceive with partner in the following 6 months Local infection near the proposed injection site History with an allergic reaction to BTX and / or human serum albumin History of motor neuron disease or hemostatic disorder Active urogenital cancer Current use of botox injections which would result in a total dose of botox higher than 300 IE in the span of 3 months