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Orchialgia

Dónal Kevin Gordon, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Chronic scrotal pain of at least 3 months duration arising from any intrascrotal structure and negatively affecting quality of life

  • Pain may be intermittent or constant, unilateral or...

DIAGNOSIS

HISTORY

  • Scrotal pain of at least 3 months duration

  • Often dull, throbbing, of varying intensity

  • Pain can be unilateral or bilateral.

  • Interferes with work, social, and/or sexual activities

  • Pain on ...

TREATMENT

GENERAL MEASURES

Avoid aggravating activities. 

MEDICATION

First Line

  • NSAIDs (4)[C]

  • Consider repletion of vitamin B12 and/or testosterone, if patient is deficient (2)[C].

  • Antibiotics only if evide...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Evaluate response to treatment.

  • Modify treatment accordingly.

  • Refer to specialists as indicated.

DIET

No restrictions 

PATIENT EDUCATION

Reassurance t...

REFERENCES

1
Keoghane SR, Sullivan ME. Investigating and managing chronic scrotal pain. BMJ.  2010;341:c6716. [View Abstract on OvidMedline]
2
Cui T, Terlecki R. Prevalence of relative deficiencies ...

CODES

ICD10

  • N50.8 Other specified disorders of male genital organs

  • N45.2 Orchitis

  • N41.9 Inflammatory disease of prostate, unspecified

  • N45.1 Epididymitis

  • S39.94XA Unspecified injury of external genitals, in...

CLINICAL PEARLS

  • The use of empirical antibiotics to treat orchalgia not supported by evidence in the absence of a proven infection

  • Scrotal ultrasound is the initial image of choice for a suspected test...

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