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Chronic Scrotal Pain

Chronic scrotal pain refers to constant or intermittent scrotum pain lasting more than three months. The pain may be around one or both testicles or change from side to side. The pain can also originate in the epididymis, a crescent-shaped organ around the testicle responsible for sperm transport and storage. The discomfort may be experienced as an aching, burning, or heaviness. It can also feel like a groin pull. Some men report that their symptoms occur in combination with lower back pain or pain in their upper thighs or legs. Sexual activity or heavy manual work can aggravate the pain, and it may also worsen when sitting for long periods, such as at a desk job or driving.

Chronic scrotal pain has many potential causes, including infection, testicular torsion, tumour, varicoceles or spermatoceles. The pain syndrome can follow trauma to the testicles or after surgery on the scrotum or groin, such as a vasectomy or inguinal hernia repair. Factors external to the scrotum can also cause pain referred to the scrotum, including back problems, hip problems or kidney stones. Most conditions that cause scrotal pain are easily diagnosed and can be treated effectively through medication, surgery, and other therapies. About a quarter of scrotal pain have no known underlying cause.

We understand the frustration and the debilitating effect of chronic scrotal pain. We take a multidisciplinary approach to the problem, addressing it stepwise, including history, examination and scans to exclude any reversible cause of the pain. If none is found, a review by a pain physician to trial medications or local anaesthetic and steroid injections that target nerve pain. Physiotherapy may be indicated. Surgery in chronic scrotal pain is considered the last resort and will only be discussed if all else has failed.

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