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Orchialgia

About

  • Chronic testicular pain lasting more than 3 months
  • Can come on suddenly/gradually

Potential Causes

  • Spontaneous
  • As a result of an infection (UTI/STI)
  • Trauma
  • Inflammation
  • Surgery

Symptoms

  • Pain originating from the scrotum

Diagnosis

  • Physical exam
  • STI screening (if applicable)
  • Urine sample
  • Ultrasound to rule out other pathology

Treatment

  • Heat application: Warm baths, heating pads, hot water bottles
  • Oral medications: Anti-inflammatories
  • Wearing tight-fitting underwear
  • Avoiding heavy lifting
  • Pelvic physiotherapy: If pain is due to muscle spasming
  • Temporary spermatic cord block: Local anesthetic is injected into the spermatic cord (the structure carrying the vas, nerves, blood vessels and lymphatics to the testicle)
  • Surgery: Microsurgical Cord Denervation if the temporary cord block is successful
    • The cord is exposed and the nerve containing structures are cut while the blood and lymphatic supply are maintained
    • Provides long-term pain relief in over 70% of patients who have
      • Chronic pain lasting more than 3 months
      • Failed other medical interventions and therapies
      • Received temporary relief with a cord block