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Author: Admin | 2025-04-28
Hip (50%). Hip MRI identified overt hip labral tears in 8 men (10/12 hips evaluated, 83%) and labral fraying in the remaining 2 (16.7%).Following MRI, five of the men had a steroid and local analgesic hip injection. Two of the men reported lasting resolution or significant improvement in pain (2 men; 80%, follow-up 3-15 months). Two men had complete resolution of pain with 8 weeks of physical therapy.The authors concluded: “Hip MRI has a high rate of diagnosis of labral tear in appropriately selected men referred to the urologist for chronic orchialgia. Identification of orthopedic pathology may avoid unnecessary antibiotics, opiates, or urological surgery.”In a May 2021 paper in the journal Research and Reports in Urology (7), researchers reviewing current standard practices of care for chronic scrotal pain, in discussing physical therapy, authors noted: “Up to 10% of patients, who present with chronic scrotal pain, are found to have musculoskeletal pain localized to areas that may include the conjoint tendon, the adductor tendon and the pelvic floor. Because of this, patients may benefit from physical therapy such as perineal/pelvic floor exercises. Due to the relative ease of this method, together with its absence of side effects, this should be a first-line option, ideally in conjunction with other non-surgical options. . . ”Restless legs syndrome and chronic testicular painIn May 2022, doctors reported in the Journal of Clinical Sleep Medicine (8) of a possible connection between Restless legs syndrome and chronic testicular pain. Restless legs or leg syndrome, the constant movement of the legs (the legs are “restless”) that occurs mostly and night and causes insomnia and sleep disturbances, is seen in chronic testicular pain. In this paper the researchers presented a case history: “In this case report, the patient presented at the sleep clinic with a chief complaint of insomnia and the classical symptoms of Restless legs syndrome. He also mentioned chronic testicular pain. For over a year, the patient had undergone urologic investigation and empiric treatments (typically those treatments mentioned above, some with a specific focus on a possible bacterial infection), with only mild improvement of the testicular pain. After three months of therapy with pramipexole (a drug commonly given for the treatment of restless leg syndrome and Parkinson’s disease), the Restless legs syndrome symptoms and the chronic testicular pain were no longer present.” The researchers concluded: “Finding an etiology for chronic testicular pain can be challenging and many cases are diagnosed as idiopathic (unknown cause). Restless legs syndrome may be a forgotten and unidentified etiology for chronic testicular pain in typical urological care.” The suggestion is that urologists may be overlooking Restless legs syndrome as a cause of chronic testicular pain.Genitofemoral nerve entrapment at the psoas muscleIn October 2017, doctors at the University of St. Augustine for Health Sciences (9) presented a case study on a patient who had a successful treatment outcome because he was correctly diagnosed with orchialgia symptoms from genitofemoral nerve entrapment at the psoas muscle.The genitofemoral nerve travels through the psoas muscle and then
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