Chronic orchialgia is associated with men having chronic pelvic pain syndrome (CPPS) or chronic prostatitis.
Nerve or muscle pulls in the groin area and pelvic spasms have long been suspected to be the causes, but doctors have not been able to confirm. Idiopathic chronic orchialgia refers to the similar condition except its cause is more difficult to determine. Psychological problems are other possible causes.
Types of pain from anatomical changes
Nociceptive pain is dull or mild aching pain generated from changes in the anatomy of the testicles such as testicular enlargement or shrinkage and degenerating tissues.
The source of the pain can be traced to a common stimulus such as trauma as stated by the aforementioned paper.
Neuropathic pain occurs when the nervous system suffers a lesion (change or damage to the tissue of an organ by trauma). On the upside, causes for the pain in testicles are identifiable in men suffering from the below conditions according to VeryWell Heath.
Epididymitis: It comes as a side effect of urinary tract infection (UTI) or sexually transmitted diseases (STDs). Sometimes, even trauma and autoimmune diseases can cause this inflammation of the epididymis, which refers to a specific duct behind the testicles. In some cases, it can be accompanied by swelling, too.
Solution: When conservative therapy fails as it has been successful in only 4.2 per cent to 15.2 per cent according to studies, epididymectomy, an aggressive surgery, is recommended to patients with benign spermatic cysts present in their epididymis.
Post Vasectomy: After vasectomy, 1 to 2 percent of men experience testicle pain for more than 3 months. Termed as post vasectomy pain syndrome, it can result in sperm leakage, emergence of painful nodules called sperm granuloma and congested epididymitis.
Solution: A vasectomy reversal can be considered by patients not receptive to conservative therapy such as antibiotics, psychotherapy antidepressants, physical exercise elevating the scrotum, pelvic floor physical therapy and acupuncture. Benign sperm granulomas should be removed if tender enough to be surgically operated and if it is causing scrotal pain.
Inguinal Hernia: An unexplained bulge in the groin region of a man caused by weakened groin muscles is referred to as an Inguinal Hernia. Parts of the intestine may be pushed forward through the hole created by these weakened muscles, causing the groin area to bulge out.
Repetitive straining to urinate, forcefully exercising the bowel movements, chronic coughing and smoking are the main causes behind the bulge.
Solution: Surgery is always required either by a colon-rectal specialist or a general surgeon. The surgery will push the hernia sac to its original position and cures the muscle defect with surgical sutures. If the muscular defect is larger, a mesh graft is used to cover the gap. Patients recover from the hernia operation within two to four weeks.
Acute Idiopathic Scrotal Edema: Swelling only restricted to the scrotum area without an identifiable cause can be called Acute Idiopathic Scrotal Edema.
Solution: Anti-Inflammatory medication and scrotal elevation exercises for two or three days can possibly stop the pain.
Testicular Torsion: It is when the man or boy is able to rotate one testicle that ends up twisting the spermatic cord that carries blood to the scrotum, according to Mayo Clinic. Extreme pain and swelling in the scrotum is caused by the reduced flow of blood, leading to testicular torsion.
Abdominal pain, vomiting, frequent urination, fever and testicle placed at a higher angle than usual are the main symptoms. Cold temperatures, minor injuries and vigorous activities are some of the causes and this condition is common between the ages of 12 to 18.
Solution: For cases of testicular torsion, the surgery should be treated as a medical emergency in order to save the testicle. However, if the blood flow has been cut off for a very long time, the testicle will have to be surgically removed.
Source: Medical Daily