Orchalgia (Chronic Testicular Pain)
Learn how urologists evaluate and manage orchalgia, also known as chronic testicular pain, with a focus on careful diagnosis and conservative treatment options.
Educational content only; not a substitute for medical advice.
What is Orchalgia?
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.
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.