I have chronic pelvic pain syndrome. Do I need physiotherapy or surgery?

Question

Hello doctor,

My question is regarding chronic testicular pain and the possible treatment options. For the past six months, I have experienced on and off bilateral discomfort in my testicles. It was uncomfortable but not too painful. It would go away for a couple of weeks before returning for a few days at a time. About a month ago, the discomfort returned, changed to pain and got progressively worse. The pain was at times so severe that I could not walk and was bedridden. The pain was at a level of 8 or 9. I went to my GP thrice, the ER twice and the urologist twice. I read about chronic pelvic pain syndrome and started doing some pelvic floor stretches about a week ago. My pain started to significantly subside. But, I am still experiencing a 2 or 3 level of pain. The urologist wants to do spermatic cord denervation surgery. But I think I should try pelvic floor physical therapy first. What is your opinion?

Answer 1

Hello,

Welcome to icliniq.com.

Relax and do not worry. Yes, you are suffering from chronic orchialgia. It is a part of chronic pelvic pain syndrome. Now regarding the pelvic exercises, if you are feeling better and your pain remains only 2 or 3, then I feel you should continue it at present along with other oral painkillers. I also feel you should have semen culture done. If any infection is there then take antibiotics. If not, then also it is better to take one full course of antibiotics like tablet Niftran (Nitrofurantoin) 100 mg in the morning and evening for seven days, then tablet Niftran 100 mg in the evening for 21 days. Yes, you may require denervation but do not just rush into it. Try to delay it as much as possible. If the pain is only 2 or 3 and not interfering with your lifestyle, then continue with this.

Thanks.