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Orchialgia

Chirag N. Shah, MD and Ashley A Keifer, Doctor of Osteopathic Medicine Reviewed 06/2022
 


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.

  • Consider multidisciplinary approach to include primary care, urology, pain-management specialists, psychiatry, physical therapy.

MEDICATION

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Evaluate response to treatment.

    • Consider use of Chronic Orchalgia Symptom Index (COSI)

  • Modify treatment accordingly.

  • Refer to specialists as indica...

REFERENCES

1
Parekattil SJ, Ergun O, Gudeloglu A. Management of chronic orchialgia: challenges and solutions—the current standard of care. Res Rep Urol. 2020;12:199–210.
2
Cui  T, ...

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 in the absence of a proven infection is not supported by evidence.

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

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