Chronic testicular pain explained

Synonyms:	Chronic orchialgia
Differential:	Varicocele, spermatocele, Henoch–Schönlein purpura, post-vasectomy pain syndrome, chronic pelvic pain syndrome

Chronic testicular pain is long-term pain of the testes.^[1] It is considered chronic if it has persisted for more than three months.^[2] Chronic testicular pain may be caused by injury, infection, surgery, cancer, varicocele, or testicular torsion, and is a possible complication after vasectomy. IgG4-related disease is a more recently identified cause of chronic orchialgia.^[3]

One author describes the syndromes of chronic testicular pain thus:

Diagnosis

Testing for gonorrhea and chlamydia should be routinely performed.

Differential diagnosis

• Post-vasectomy pain syndrome

Treatment

Treatment is often with NSAIDs and antibiotics however, this is not always effective.^[4]

Notes and References

1. Masarani M, Cox R . The aetiology, pathophysiology and management of chronic orchialgia . BJU International. 91 . 5 . 435–437 . 2003 . 10.1046/j.1464-410x.2003.04094.x . 12603394. 45339688 .
2. Book: Leslie . Stephen . Chronic Testicular Pain (Orchialgia) . Chronic Testicular Pain and Orchalgia . StatPearls . 2 May 2019 . 29494088 . https://www.ncbi.nlm.nih.gov/books/NBK482481/.
3. Bobby B Najari . Brian D Robinson . Stephen A Paget . Darius A Paduch . October 2014 . Clinical, radiographic, and pathologic description of IgG4-related perivasal fibrosis: a previously undescribed etiology of chronic orchialgia . Urology . 84 . 4 . 748–750 . 10.1016/j.urology.2014.06.035 . 25260440.
4. Wampler SM, Llanes M . Common scrotal and testicular problems . Prim. Care . 37 . 3 . 613–26, x . September 2010 . 20705202 . 10.1016/j.pop.2010.04.009 .