Chronic Testicular Pain

What is Chronic Testicular Pain?

Testicular pain is a frustrating and oftentimes debilitating condition that some patients experience. There are so many causes of pain and so few effective treatment options that men will feel trapped with their pain and find very few good resources for therapy.

What are the various causes of testicular pain?

Testicle pain can be caused by a number of things, sometimes within the testicle itself or from the adjacent structure, such as the epididymis and spermatic cord.

Sometimes, what seems to be testicle pain is caused by a problem that starts in the groin, abdomen or somewhere else — for example, kidney stones and some hernias can cause testicle pain. The cause of testicle pain can’t always be identified.

Causes of testicle pain include:

  • Varicocele (enlarged veins in the scrotum)
  • Inguinal hernia
  • Spermatocele (fluid buildup in the testicle)
  • Diabetic neuropathy (nerve damage caused by diabetes)
  • Epididymitis (testicle inflammation)
  • Hydrocele (fluid buildup that causes swelling of the scrotum)
  • Idiopathic testicular pain (unknown cause)
  • Kidney stones
  • Mumps
  • Orchitis (inflamed testicle)
  • Prostatitis
  • Scrotal masses
  • Spermatocele (fluid buildup in the testicle)
  • Testicle injury or blow to the testicles
  • Testicular torsion (twisted testicle)
  • Urinary tract infection (UTI)

How is testicular pain treated?

At Tower Men’s Health, our goal is to identify the cause of a patient’s testicular pain in order to design a tailored treatment program for long lasting pain relief. These include various medications and surgical options.

Medications

  • Pain relievers: Acetaminophen/Tylenol® or non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen may help to relieve pain in cases due to injury or trauma.
  • Antibiotics: Orchitis or epididymitis that is caused by a bacterial infection should be treated with antibiotics, usually for at least 10 days. Doxycycline and quinolones are usually preferred and may be given up to four weeks.
  • Tricyclic antidepressants: Oral medications such as amitriptyline or nortriptyline may be prescribed.

Surgery

Types of surgery for testicular pain depending on the cause include:

  • Microsurgical denervation of the spermatic cord: This is a surgical procedure performed under anesthesia. The surgeon uses an operating microscope to dissect and cut nerves that pass through the spermatic cord.
  • Epididymectomy: Surgical removal of the epididymis may be required when the pain originates only in this structure.
  • Vasovasostomy: The complete or partial reversal of a vasectomy in men who develop orchialgia after having a vasectomy.
  • Orchiectomy: A small number of patients who are not helped by drugs or less invasive procedures may need to have a testicle removed. This procedure has a high failure rate.
  • Testicular de-torsion: This procedure is performed to untwist the spermatic cord and restore blood flow. It may be done in the emergency room, but usually an operation is needed to untwist the cord and prevent torsion from recurring. Stitches are sewn around the testicle to keep torsion from recurring. The opposite side, even if not involved, needs to be stitched as well to prevent future torsion.

Have a question or want to schedule an appointment?

Board-certified, fellowship-trained urologists staff Tower Men’s Health. We will pair you with one of our many experienced physicians to help address any concerns you may have and help you on your journey towards improved quality of life. Feel free to reach out to the physicians at Tower Men’s Health at 310-854-9898.