Chronic Testicular and Groin Pain
Chronic pain in the testicular and groin area may be caused by surgery or trauma, but the cause is usually unknown. This condition affects 100,000 men every year in the United States. Treatment may include minimally invasive surgery to relieve chronic pain caused by nerve damage.
Common causes of pain include having:
- Hernia surgery
- Infections
- Kidney removal
- Scrotal or pelvic trauma
- Vasectomy
We work with you to lower or eliminate your chronic pain. Our compassionate urologists understand these are difficult conditions to treat and take the time to find the right treatment for you. Our mission is to provide the most innovative and reliable treatment options available to help you manage your condition.
Your treatment options include:
- Acupuncture
- Antibiotics
- Botox injections
- Nerve blocks
- Oral anti-inflammatory medications
- Pelvic floor (muscles that support the bladder, bowel and genitals) rehabilitation therapy
- Robotic-assisted surgery
Spermatocele
A spermatocele, also known as a spermatic cyst or epididymal cyst, is a benign growth that develops in the epididymis, the coiled tube located on the upper back side of the testicle in which sperm is stored. This could be caused by a blockage within the small tubes that drain sperm into the epididymis. Although they are harmless, they may sometimes grow and cause pain, in which case they may require intervention, including surgery to remove the cyst.
Most men who develop spermatoceles do not experience any symptoms, although some patients may have heaviness or dull pain within the scrotum or may be able to palpate a mass behind and above the affected testicle. It may be tender to touch. Spermatoceles are often found incidentally when evaluating the scrotum.
While a spermatocele will not normally disappear on its own, it does not usually require any invasive treatment. Any pain the patient experiences normally can be treated effectively with oral analgesics or anti-inflammatory medication. In cases where a spermatocele grows really large or becomes more troublesome, there are several methods that can be used to remove it, including:
- Surgery to remove the cyst and possible cut some of the nerves around it
- Aspiration to remove the fluid
- Sclerotherapy
Varicocele
Varicocele is a common condition where the veins around the spermatic cord inside a man’s scrotum become enlarged. The condition can appear in very young individuals and it may or may not cause pain or discomfort. A high-grade varicocele can, however, cause a man to become less fertile because it can inhibit sperm production
- A dull ache around the testicles that’s worse when standing up but better when lying down
- A mass above your testicles that may be visible or noticeable by touch
- Pain in the scrotum after exercise
- Infertility
- A testicle that differs in size from the other
- Low testosterone
If the symptoms are mild a varicocele may not require treatment. If the condition is painful, or if it’s interfering with fertility, treatments may include:
- Over-the-counter medications for pain
- Outpatient surgery that involves tying off the veins that have become enlarged
Testicular Cancer
Testicular cancer is the growth of malignant tumor in the testicle. It can occur at any age, but most frequently occurs in men between 15 and 35 years old. It typically only affects one testicle. With an early diagnosis of testicular cancer, it is highly treatable, however, left untreated, it can metastasize and become fatal.
In some instances, testicular cancer is asymptomatic. When symptoms are present, they may include the following:
- Pain or heaviness sensation in the scrotum
- Swelling or enlargement of the testicle
- Lump inside of the testicle
- Dull ache in the back or groin region, generally on one side
- Enlargement or tenderness of breast tissue
- Loss of sexual desire
- Premature puberty in boys
- Swollen lymph nodes in groin
With proper treatment, testicular cancer has a very good prognosis. Your doctor may order tumor markers or imaging to look for spread. The primary treatment is removal of the testicle. Next steps are determined based on pathology, labs, and imaging studies. Treatment methods for testicular cancer include one or a combination of the following:
- Surgery to remove a testicle through an incision in your inguinal region and surgery to evaluate lymph nodes in the groin or abdomen
- Radiation treatment, using high-dose X-rays to destroy cancer cells
- Chemotherapy, using medications to kill cancer cells
- For men who may want to have children, sperm banking and cryopreservation is recommended before treatment of testicular cancer
