Chronic testicular pain

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Chronic testicular pain
Synonyms	Orchialgia, chronic orchialgia, testicular pain syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Persistent pain in one or both testes
Complications	Infertility, depression, anxiety
Onset	Can occur at any age, often in young and middle-aged men
Duration	Pain lasting more than 3 months
Types	N/A
Causes	Infection, trauma, surgery, varicocele, epididymitis, nerve damage
Risks	Previous testicular torsion, vasectomy, inguinal hernia repair
Diagnosis	Physical examination, ultrasound, urinalysis, semen analysis
Differential diagnosis	Testicular cancer, epididymitis, inguinal hernia, hydrocele, varicocele
Prevention	N/A
Treatment	Pain management, antibiotics, surgery, nerve block, counseling
Medication	Analgesics, antidepressants, anticonvulsants
Prognosis	N/A
Frequency	Affects approximately 100,000 men annually in the United States
Deaths	Rarely life-threatening, but can significantly impact quality of life

An overview of chronic testicular pain

Chronic Testicular Pain

Diagram of the testis surface

Chronic testicular pain (CTP), also known as chronic orchialgia, is a condition characterized by persistent pain in one or both testes lasting for more than three months. It is a complex condition that can significantly affect a patient's quality of life.

Causes

Chronic testicular pain can arise from a variety of causes, including:

• Epididymitis: Inflammation of the epididymis, often due to infection.
• Orchitis: Inflammation of the testis, which can be caused by infections such as mumps.
• Varicocele: Enlargement of the veins within the scrotum, which can lead to discomfort.
• Hydrocele: Accumulation of fluid around the testicle, causing swelling and pain.
• Inguinal hernia: A condition where tissue protrudes through a weak spot in the abdominal muscles, potentially causing testicular pain.
• Nerve damage: Injury or irritation of the nerves supplying the scrotum and testicles.

Symptoms

The primary symptom of chronic testicular pain is a persistent ache or discomfort in the testicles. The pain may be constant or intermittent and can vary in intensity. Some patients may also experience:

• Swelling or tenderness in the scrotum
• Pain radiating to the groin or abdomen
• Nausea or vomiting in severe cases

Diagnosis

Diagnosing chronic testicular pain involves a thorough medical history and physical examination. Additional tests may include:

• Ultrasound: To visualize the testicles and surrounding structures.
• Urinalysis: To check for signs of infection.
• Blood tests: To identify any underlying conditions.

Treatment

Treatment for chronic testicular pain depends on the underlying cause. Options may include:

• Antibiotics: For infections such as epididymitis or orchitis.
• Pain management: Including NSAIDs or other analgesics.
• Surgery: In cases of varicocele, hydrocele, or hernia.
• Nerve blocks: To alleviate pain by interrupting nerve signals.

Prognosis

The prognosis for chronic testicular pain varies depending on the cause and the effectiveness of treatment. Some patients may experience complete relief, while others may have persistent symptoms despite treatment.

See also

• Testicular torsion
• Testicular cancer
• Scrotal ultrasound