Chronic Testicular Pain in Adult Men

Abstract

Past investigations of chronic testicular pain provide a sparse representation of the men with this condition and lack key details to aid our understanding of this important men's health condition. As a chronic pain syndrome, more research is necessary to understand the phenomenon of chronic testicular pain and the pain experience of these men. This integrative literature review provides a summary of the current state of the science of chronic testicular pain in men, identifies the gaps in our knowledge, and provides recommendations to address this knowledge gap.

Extirpative surgery for chronic orchialgia: is there a role?

“…Orchialgia is associated with significant psychological burden. A precipitating event prior to development of pain has been suggested by several authors (9,13). This event may have been prior sexual abuse, trauma, or emotional disturbance.…”

“…These psychological aspects may need treated for successful resolution of the pain, often involving a multidisciplinary team. Quallich and Arslanian-Engoren (13) found that few studies in the literature utilized psychologic or psychiatric evaluation in the treatment algorithm potentially limiting pain resolution success in cases of somatization. There is inadequate literature to document the impact of chronic orchialgia on quality of life, emotional suffering, avoidance behaviors, or lost productivity.…”

“…In general, men with chronic orchialgia do exhibit characteristics of other chronic pain syndromes. These specific characteristics include pain as a chief complaint, history of unsuccessful treatments, and lack of correspondence between symptoms and objective medical findings (13). An Institute of Medicine report documenting the annual cost of a chronic pain patient compared with a patient without pain showed an increased cost of $4,500 for moderate pain and $7,700 for severe pain.…”

“…Unfortunately, there is a lack of research regarding psychologic changes related to loss of a testicle for benign disease. Additionally, patients may be reluctant to consider a psychological component to their chronic pain prior to considering surgery (13). Following surgery, a loss of testosterone may lead to moodiness and increase risk of depression.…”

“…An estimated 18.6% of men with chronic scrotal pain never receive a satisfactory explanation for their pain even after visiting an average of 4.5 urologists and undergoing an average of 4.7 to 7.2 procedures (13). The exact etiology of chronic scrotal pain is often not identified and the pathophysiology not fully understood (1,2,4,11,14).…”