Neuropathic testicular pain
A 41 year old gentleman was seen in the clinic complaining of needle-like stabbing pains in the left testicle.
Examination findings in neuropathic testicular pain
On examination, there was tenderness at the top of the testicle and an increase in temperature. There was no hernia present. There was also no pain on light touch (allodynia) or pain on prick sensation (hyperalgesia). Of note, when he coughed or sat forward, the left testicle contracted noticeably. I note he had undergone multiple procedures for cysts on the scrotum and a diagnosis of neuropathic pain secondary to this was made.
Treatment of neuropathic testicular pain
He was started on Pregabalin 75 mg twice per day. He was seen approximately once month later but unfortunately, had got no benefit with the Pregabalin. It was then decided to then move on to interventional pain management in the form of a combined ilioinguinal and iliohypergastric block.
Outcome following treatment for neuropathic testicular pain
This was done and at follow up, approximately 8 weeks later, all his pain symptoms had disappeared although one testicle was still contracted. He was very happy that the pain had disappeared and we agreed to discharge him from the clinic.