Chronic Testicular Pain

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What to expect for evaluation of Chronic Testicular Pain...

  1. A detailed history and physical examination. This is the most important part of your visit, providing an insight into other tests that might be needed; and, most importantly, what therapies will likely be helpful. Patients have often been evaluated by multiple clinicians in the past. Records from these encounters should be obtained and brought with you on your first visit to our Center. These records may include information that will greatly facilitate your care. Typical records may include: office notes, operative reports, pathology reports, urinalysis reports, semen analysis reports, urine and/or prostate fluid culture reports, urine cytology reports, CAT scans, MRIs, etc.
  2. Laboratory exams may include a urinalysis, a urine culture, and blood tests (including PSA -prostate specific antigen). A "prostate massage" may be performed during the physical examination. This procedure is rather uncomfortable as it entails squeezing the prostate during a digital rectal examination. Seminal fluid obtained during this exam or in the urine obtained after the exam may give clues to your diagnosis. Semen analysis and semen culture may also be obtained.
  3. Other testing. Further testing depends upon the information obtained through your history, physical examination and initial laboratory testing. Other recommended tests may include:
    1. Testing for sexually transmitted diseases
    2. Ultrasound exams. May include ultrasound of the testicles and spermatic cord, and/or prostate
    3. Ultrasound, CAT scans or MRI of abdomen and/or pelvis

Treatment Options Available...

Treatment of CTP is individualized for each patient and is primarily based upon the likely cause of symptoms. Treatments are, therefore, quite varied. They may include:

  • Behavior modification
  • Herbal Therapies
  • Acupuncture
  • Antibiotic therapy
  • Anti-inflammatory agents
  • Skeletal muscle relaxants
  • Antihistamines
  • Antiseizure agents (many agents in this group are indicated for "neuropathic pain")
  • Antidepressant therapy (many agents in this group are indicated for "neuropathic pain")
  • "Atypical opioids"
  • Narcotic Therapy (generally dispensed by Pain Management Centers)
  • Physical Therapy
  • Trigger point injection to affected muscle group(s)
  • Nerve blocks (nerve blocks may also give clues to the origin of pain)
  • Surgical therapy