Orchialgia refers to testicular pain, which can be caused by a number of medical issues. It can be acute in nature, with a rapid onset and severe pain, or it may be chronic, characterized by at least three months of intermittent to constant pain. Evaluation and treatment can be challenging, as this symptom is notoriously difficult to track to a cause in some cases, and some of the treatment options come with an increased risk of causing further orchialgia. Patients may find it helpful to see a urologist with experience in this area to get the best care.
Acute pain can be caused be an infection or injury, with testicular torsion being a common culprit. This condition occurs when the spermatic cord twists, creating a situation similar to a kink in a hose. Without adequate blood supply, tissues below the twist start to develop ischemia, a lack of oxygen, which can cause acute pain. If the patient doesn’t receive treatment, there is a risk parts of the testes could die, which puts the patient at risk of serious infection.
Cases of chronic orchialgia may be associated with cysts, cancerous growths, and a history of surgery. Cysts may present early on with pain and some swelling, and can take time to accurately diagnose, as can cancers, especially if the patient doesn’t appear to be at high risk. A doctor might not consider testicular cancer in a very young man, for instance, when the patient reports chronic orchialgia. Surgeries like vasectomies can sometimes cause chronic lingering pain as a result of nerve damage or scarring.
One immediate option for managing orchialgia is pain care to help the patient feel more comfortable. The next step is a thorough evaluation to find out what is causing the problem. This may require palpation, medical imaging, and a patient interview to look for risk factors that might be involved. Some conditions need to be treated surgically to relieve pain and discomfort, while options like electrical stimulation might be considered for patients with what appears to be nerve pain that isn’t associated with any specific disorder in the testes.
It can take weeks or months to pin down the case of orchialgia and provide adequate treatment, especially when there is no apparent physical cause. During this period, patients may be very uncomfortable. Some patients find it helpful to use treatments like physical therapy, stretching, and acupuncture to complement their care.