Orchalgia refers to chronic or persistent pain in one or both testicles. It can range from mild discomfort to severe pain that interferes with daily activities. Evaluation by a urologist is important to rule out serious causes such as infection, tumors, or vascular problems.
What is Orchalgia?
Initial Evaluation
Physical Examination
- Careful exam of the testes, epididymis, and spermatic cord.
- Checking for signs of infection, inflammation, tumors, or masses.
- Assessment of tenderness or swelling patterns.
Diagnostic Testing
- Urinalysis and urine culture to check for infection if suspected.
- Antibiotics may be prescribed if infection is confirmed.
- Scrotal ultrasound with duplex studies to evaluate blood flow and rule out vascular problems such as torsion or varicoceles.
Conservative Management
In many cases, orchalgia can be managed with non-invasive treatments before considering further interventions. Common conservative measures include:
- Supportive underwear to provide scrotal support and reduce strain.
- NSAIDs (such as ibuprofen) to reduce inflammation and pain.
- Warm sitz baths for 20 minutes, three times per week, to promote blood flow and relaxation.
- Pelvic floor physical therapy — a commonly underutilized treatment, as chronic pelvic floor muscle strain can sometimes be the source of testicular pain.
When to See a Urologist
If you are experiencing persistent testicular pain lasting more than a few weeks, or if the pain is severe, it is important to see a urologist. Early evaluation helps identify the cause and ensures that serious conditions are not missed. At Advanced Urology, we specialize in diagnosing orchalgia and tailoring a treatment plan for each patient.