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- Chronic scrotal pain of at least 3 months duration arising from any intrascrotal structure and negatively affecting quality of life
- Pain may be intermittent or constant, unilateral or bilateral, direct (infection, obstruction, tumor, or trauma) or referred. In many cases, pain is idiopathic.
- Majority of patients present in mid- to late 30s.
- Affects up to 6% of postvasectomy patients (1)
Up to 0.4% of men, overall (1)
Etiology and Pathophysiology
- Urinary tract infection
- Other abdominal, scrotal, or testicular surgery
- Nerve entrapment
- Torsion or posttorsion
- Urethral stricture
- Testicular tumor
- Radicular pain
- Ureteric calculi
- Indirect inguinal hernia
- Aortic or common iliac artery aneurysm
- Retroperitoneal tumor
- Sexual abuse
- Vitamin B12 and/or testosterone deficiency
- A small 2016 study showed that 76% of men with chronic testicular pain were deficient in either vitamin B12 or in testosterone (2).
- Poorly understood
- Afferent innervation via somatic nerves in the genital branch of the genitofemoral and ilioinguinal nerves implicated in chronic pain
- Referred pain may be due to entrapment neuropathies involving the pudendal nerve, aneurysms, obstruction of the pelviureteric junction, or other disorders.
- Other scrotal or abdominal surgery
- Bicycle riding
- Horseback riding
- Long periods without postural changes
- Heavy lifting
Commonly Associated Conditions
- Low back pain
- Clinical depression