Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 May;6(Suppl 1):S37-S43.
doi: 10.21037/tau.2017.05.23.

Chronic orchialgia: epidemiology, diagnosis and evaluation

John T Sigalos  1 , Alexander W Pastuszak  2   3
Affiliations
Review

Chronic orchialgia: epidemiology, diagnosis and evaluation

John T Sigalos et al. Transl Androl Urol. 2017 May.

Abstract

Chronic orchialgia is a vexing condition defined as chronic or intermittent scrotal pain lasting at least three months that significantly interferes with daily activities. There are currently no guidelines regarding the diagnosis and management of this condition despite it being the cause of 2.5-4.8% of urologic clinic visits. Men often present with chronic orchialgia in their mid to late 30s, although the condition can present at any age. A broad differential diagnosis of chronic orchialgia includes epididymitis, testicular torsion, tumors, obstruction, varicocele, epididymal cysts, hydrocele, iatrogenic injury following vasectomy or hernia repair, and referred pain from a variety of sources including mid-ureteral stone, indirect inguinal hernia, aortic or common iliac artery aneurysms, lower back disorders, interstitial cystitis, and nerve entrapment due to perineural fibrosis; approximately 25-50% of chronic orchialgia is idiopathic in nature. In such cases, it is reasonable to consider psychological and psychosocial factors that may be contributing to chronic pain. Invasive testing is not recommended in the work-up of chronic orchialgia.

Keywords: Chronic orchialgia; scrotal pain; testicular pain.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Dr. Pastuszak reports the following potential conflicts: Endo Pharmaceuticals—speaker and advisor and Boston Scientific/AMS—research support. The other author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Diagnosis and work-up algorithm.
See this image and copyright information in PMC

References

    1. Hakenberg OW, Wirth MP. Chronic pelvic pain in men. Urol Int 2002;68:138-43. 10.1159/000048438 - DOI - PubMed
    1. Mathias SD, Kuppermann M, Liberman RF, et al. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996;87:321-7. 10.1016/0029-7844(95)00458-0 - DOI - PubMed
    1. Hedelin H, Johannisson H, Welin L. Prevalence of the chronic prostatitis/chronic pelvic pain syndrome among 40-69-year-old men residing in a temperate climate. Scand J Urol 2013;47:390-2. 10.3109/00365599.2012.756930 - DOI - PubMed
    1. Zermann DH, Ishigooka M, Doggweiler R, et al. Neurourological insights into the etiology of genitourinary pain in men. J Urol 1999;161:903-8. 10.1016/S0022-5347(01)61802-0 - DOI - PubMed
    1. Strebel RT, Leippold T, Luginbuehl T, et al. Chronic scrotal pain syndrome: management among urologists in Switzerland. Eur Urol 2005;47:812-6. 10.1016/j.eururo.2005.01.003 - DOI - PubMed

LinkOut - more resources