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Urology (Expert Forum)
Chronic Testicular Pain
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Chronic Testicular Pain
by ennio, Mar 11, 2006 12:00AM
I’ve had chronic testicle pain in my left testicle for about 10 years, since I was 23, with varying degrees of serverity.
Lately the problem has become worse due to some sexual activity which did not include penetration.
I’ve had tests over the years that were all negative: urinalysis, ultrasound, retrograde urethrogram(to see if hypospadius surgery scar-tissue stricture was related), prostate exam. I have been to 4 urologists on the issue, each has said there’s nothing they can do. My final diagnosis was “chronic idiopathic orchialgia.”
I had a nerve block at a pain center once, and that proved ineffective. I’ve been prescribed anti-imflammatories(Naproxen, Ibuprofen) which have been useless. I tried Percocet, and that seemed to improve it slightly, but only for a few brief hours. I asked one doctor to give me a Percocet prescription, just 10 pills a month, and he wouldn’t do it which to me is preposterous. Ten pills in one month, what amounts to about 2 per week, to my mind, is not approaching addiction concern.
I was told that the only thing that could be done was to remove the testicle. For obvious reasons, I don’t want to have to go to that measure, but at this point, the pain is aggravated so easily, often by just sitting down or lying down on the wrong side, that I am wondering if that extreme solution isn’t worth considering. My mood is miserable because the pain is inescapable all day and is restricting in so many ways. I’ve lost a relationship recently because of this problem (as of now I can’t have sex because of it), and have become more depressed and hopeless.
Any suggestions would be greatly appreciated..
Lately the problem has become worse due to some sexual activity which did not include penetration.
I’ve had tests over the years that were all negative: urinalysis, ultrasound, retrograde urethrogram(to see if hypospadius surgery scar-tissue stricture was related), prostate exam. I have been to 4 urologists on the issue, each has said there’s nothing they can do. My final diagnosis was “chronic idiopathic orchialgia.”
I had a nerve block at a pain center once, and that proved ineffective. I’ve been prescribed anti-imflammatories(Naproxen, Ibuprofen) which have been useless. I tried Percocet, and that seemed to improve it slightly, but only for a few brief hours. I asked one doctor to give me a Percocet prescription, just 10 pills a month, and he wouldn’t do it which to me is preposterous. Ten pills in one month, what amounts to about 2 per week, to my mind, is not approaching addiction concern.
I was told that the only thing that could be done was to remove the testicle. For obvious reasons, I don’t want to have to go to that measure, but at this point, the pain is aggravated so easily, often by just sitting down or lying down on the wrong side, that I am wondering if that extreme solution isn’t worth considering. My mood is miserable because the pain is inescapable all day and is restricting in so many ways. I’ve lost a relationship recently because of this problem (as of now I can’t have sex because of it), and have become more depressed and hopeless.
Any suggestions would be greatly appreciated..
Doctor's Answer
by Kevin Pho, MD, Mar 13, 2006 12:00AM
, Mar 13, 2006 12:00AM
This sounds like a difficult situation. You clearly have been through a comprehensive evaluation with multiple urologists as well as a pain clinic.
I cannot think of further testing that can help. Reasonable oral pain therapy is reasonable - I would consider another referral to a pain clinic to discuss this option.
If surgery is considered, keep in mind that there are prostheses available that can maintain testicular appearance.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
I cannot think of further testing that can help. Reasonable oral pain therapy is reasonable - I would consider another referral to a pain clinic to discuss this option.
If surgery is considered, keep in mind that there are prostheses available that can maintain testicular appearance.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Member Comments (3)
by sarajevo, Mar 12, 2006 12:00AM
To: Urology - General
0
by Michael MRM, Mar 14, 2006 12:00AM
To: Urology - General
0
by stoddy13, Apr 10, 2006 12:00AM
To: Urology - General
0
by jimmy1959, Feb 29, 2008 01:25PM
A related discussion, chronic testicular pain was started.
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