Department of Acupuncture and Manual Therapy, Yunnan University of Traditional Chinese Medicine, Kunming, China.
Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA.
J Man Manip Ther. 2022 Apr;30(2):124-131. doi: 10.1080/10669817.2021.1985693. Epub 2021 Oct 17.
Male genital pain, which is neither related to genitourinary nor other obvious pathology, is an uncommon symptom in male patients and not frequently treated using manual therapy. The purpose of this case study is to describe a clinical reasoning process in combination with anatomy-based differential diagnosis and manual treatment for genital pain.
A male patient with a 3-week acute onset of genital pain was hospitalized and referred for evaluation and treatment after unsuccessful treatment with medication and acupuncture. Clinical examination was performed indicating a possible nerve entrapment followed by interventions of ligamentous articular strain, high-velocity low-amplitude (HVLA) manipulation, and strain- and counterstain, coupled with soft tissue stretching to lumbar and inguinal areas to address a possible lumbar referral potentially from L1 and/or ilioinguinal nerve entrapment.
After 4 consecutive days of manipulative treatment, pain decreased from 9/10 to 0/10 and the Barthel Index improved from 50 to 95. A 6-month follow-up revealed complete resolution of symptoms with no recurrence.
This case illustrates that a detailed history and examination along with a reasoned diagnostic process to determine an appropriate intervention strategy may improve patient care using manual therapy techniques.
By utilizing a deductive reasoning process related to the penile area, clinicians may better apply manual therapy techniques for successful treatment.
男性生殖器疼痛既与泌尿生殖系统无关，也与其他明显的病理无关，是男性患者中一种不常见的症状，且不常采用手法治疗。本病例研究的目的是描述一种临床推理过程，结合基于解剖学的鉴别诊断和生殖器疼痛的手法治疗。
一名男性患者，生殖器疼痛急性发作 3 周，在药物和针灸治疗无效后住院并转来接受评估和治疗。临床检查提示可能存在神经卡压，随后进行了韧带关节劳损、高速度低幅度（HVLA）手法、牵伸-对抗牵伸的干预，以及腰骶部和腹股沟区的软组织拉伸，以解决可能来自 L1 和/或髂腹股沟神经卡压的腰部牵涉痛。
经过 4 天连续的手法治疗，疼痛从 9/10 降至 0/10，巴氏指数从 50 提高到 95。6 个月的随访显示症状完全缓解，无复发。
本病例表明，详细的病史和检查，以及合理的诊断过程，以确定适当的干预策略，可能会改善使用手法治疗技术的患者护理。
通过运用与阴茎区域相关的演绎推理过程，临床医生可以更好地应用手法治疗技术进行成功治疗。
