Testicles hurt when touched

We all know that testicular pain is one of the common clinical symptoms of men's medicine. Orchitis is a common cause of testicular pain. In addition, testicular torsion, testicular injury, and testicular ischemic pain are the main causes of testicular pain. The treatment of testicular pain should be based on the determination of its cause. If the cause cannot be found for the time being, sedative and analgesic treatment can be used. Then let's find out what is going on when the testicles feel a little painful!

Chronic testicular pain is intermittent or persistent unilateral or bilateral testicular pain for more than three months, which seriously affects the quality of life and is a common and frequently occurring disease in urology and men's department. Most patients have clear causes: such as testicular inflammation, injury, torsion and tumor; epididymitis, cysts and tumors; varicocele, post-vasectomy, inguinal hernia and hydrocele; urinary stones, prostatitis and prostatic hyperplasia. However, foreign studies have found that 18.6% to 25% of patients are idiopathic and have no clear cause. Idiopathic chronic testicular pain is a puzzle for urologists and patients because of its unknown cause, and the treatment is quite difficult. A careful and detailed history, physical examination and auxiliary examination are necessary. Treatment methods include non-surgical treatment, minimally invasive treatment and surgical treatment. Surgical treatment includes microspermatic cord denervation, epididymisectomy and orchiectomy. Microspermatic cord denervation (MDSC) is a surgical method for the treatment of idiopathic chronic orchial pain that has been widely recognized abroad in recent years. The effective rate is 71% to 96%, and it is minimally invasive, safe and effective.

In 1978, Devine pioneered spermatic cord denervation to treat 2 cases of chronic testicular pain and achieved success. In 2008, Levine et al. used MDSC to treat the largest group of 95 patients with chronic testicular pain, with an average age of 40 years and an average pain duration of 62 months (5 to 252 months); causes: 43% were idiopathic, 8% were after vasectomy, 7% were after trauma, 9% were after hernia repair, and 9% were after epididymitis; the complete pain relief rate was 71%, and the partial relief rate was 17%. Further analysis of cases that underwent MDSC surgery from 2006 to 2010 found that MDSC also had a good pain relief rate in a group of patients with chronic testicular pain who had a history of scrotal surgery.

The main advantage of MDSC is that the testicles and epididymis are preserved, and the patient is more psychologically and physiologically compliant; the goal of the surgery is to separate and sever all structures that may contain nerve fibers in the spermatic cord, while preserving the arteries (testicles, levator testis, and vas deferens), some lymphatic vessels (to reduce the occurrence of hydrocele), and the vas deferens (if it has not been previously ligated). The key to choosing MDSC is that it has a temporary pain relief effect on the spermatic cord closure. Informed consent from the patient before surgery is very important, because although the pain after surgery rarely increases, it may continue. There is also a risk of similar surgical complications such as scrotal hematoma, hydrocele, testicular atrophy, and hypogonadism.