Chronic Testicular Pain

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hronic testicular pain or chronic orchialgia is defined as constant or intermittent testicular pain, unilateral or bilateral, lasting 3 months or more, affecting the daily activities of the patient until they seek medical attention. Some authors report that in 25% of cases of orchialgia cannot identify a specific etiology.

The specific causes of chronic orchialgia include infectious processes such as urethritis and prostatitis, testicular tumors, inguinal hernias, hydrocele, spermatocele, varicocele, referred pain, traumatisms, intermittent testicular torsion, prostatodynia / non-bacterial prostatitis and neuromuscular dysfunction of the pelvic floor (chronic genital pain). The management of patients with chronic genital pain is complex. Some of these patients typically attend anxiety, they are tense and frequently worried about the possibility of being carriers of some serious pathology. Usually, they have already been treated without achieving positive results.

Medical management
When considering treatment options in patients with chronic orchialgia, it should be initiated with non-surgical options. The use of jockstrap and the modification of postural habits and the pattern of exercise. Antibiotic, anti-inflammatory, analgesic agents or a combination of these are used.

Surgical management
When medical management does not resolve the clinical condition, or if the patient has an obvious surgical pathology, doctors can consider surgical treatment for pain control. In this regard, it is important that the patient is aware that the surgery does not guarantee adequate symptomatic control and that before the surgical decision is has been offered adequate medical treatment.

Surgical options for the treatment of chronic orchialgia include corrective procedures for specific pathologies such as varicocele cure, hydrocele cure, orchidopexy, vascular anastomosis, and even removal of non-absorbable suture material in postoperative orchialgia.