Newman David P, Tinkham Nicholas H, Sterbis Joseph R, Soto Adam T
Pain Management, Tripler Army Medical Center, Honolulu, USA.
Urology Service, Tripler Army Medical Center, Honolulu, USA.
Cureus. 2021 Mar 12;13(3):e13850. doi: 10.7759/cureus.13850.
Chronic testicular pain is a condition commonly experienced by males. Potential causes of testicular pain can be pathology localized within the testicle or referred pain from surrounding tissues or spinal conditions. The diagnostic differential is extensive and can be seen as a diagnosis of exclusion after structural disorders specific to the testicle are ruled out. In approximately 50% of the cases, the cause of pain is undetermined. Patients with testicular and inguinal pain may undergo extensive workup that overlooks potential neuropathic and musculoskeletal causes remote to the testicle. This case study describes the application of a conservative treatment program targeting presumptive chronic genitofemoral and/or ilioinguinal nerve entrapment along the course of the inguinal canal for the treatment of chronic testicular pain. By combining sacroiliac joint osteopathic manipulation, iliopsoas stretching, and soft tissue mobilization utilizing a vacuum suction cup, the patient was symptom-free on the fourth visit after suffering from testicular pain for a year. At a one-year follow-up, the patient remains pain-free.
慢性睾丸疼痛是男性常经历的一种病症。睾丸疼痛的潜在原因可能是睾丸内的局部病变,或是周围组织或脊柱疾病引起的牵涉痛。诊断鉴别范围广泛,在排除睾丸特有的结构紊乱后,可视为排除性诊断。在大约50%的病例中,疼痛原因不明。患有睾丸和腹股沟疼痛的患者可能会接受广泛的检查,而忽略了睾丸远处潜在的神经病变和肌肉骨骼病因。本病例研究描述了一种保守治疗方案的应用,该方案针对腹股沟管走行中推测的慢性生殖股神经和/或髂腹股沟神经卡压,用于治疗慢性睾丸疼痛。通过结合骶髂关节整骨手法、髂腰肌拉伸以及使用真空吸盘进行软组织松动,该患者在经历一年睾丸疼痛后,第四次就诊时症状消失。在一年的随访中,患者仍无疼痛。