Editorial Comment: Pelvic Floor Dysfunction: A Common Cause of Chronic Orchialgia
Year: 2023
Type: editorial
Abstract: This study1 not only quantifies the prevalence of chronic orchialgia with pelvic floor dysfunction which has been described previously but also goes on to describe the symptoms that may be a clue to this diagnosis. The results indicate the importance of asking about urinary, bowel, and sexual dysfunction in these patients. The symptoms of urinary hesitancy (P < .01), constipation (P < .01), and painful ejaculation (P < .01) may distinguish these patients from those with chronic orchialgia from a different etiology. An important next step in the pelvic floor patients is also to make sure that there is not pain in other areas of the pelvis, such as the penis, pain with bladder filling, and perineum that would indicate the more global diagnosis of NIH category III chronic prostatitis/chronic pelvic pain syndrome.2 If men are diagnosed with pelvic floor dysfunction, it means also that if more conservative measures are not effective for the pain, they can be referred for pelvic floor physical therapy. Another potentially important finding from MAPP network researchers is that the pelvic floor muscles can be stimulated not only by the brain areas directly innervating them but also are activated in synergy with the gluteal muscles.3 Patients with orchialgia should to be sent to a physiatrist if there are possible abnormalities in other pelvic muscles that could be contributing to the pelvic floor dysfunction and pain. Orchialgia is a common office problem that may be thought to be just an isolated problem in one organ. These data reinforce that it could be from abnormal pelvic floor muscles. In addition to more ominous diagnoses, such as a testicular tumor, this must be on the differential diagnosis of every man walking in the office with scrotal pain.
Source: JU Open Plus
Author: Michel A. Pontari
Institution: Temple University
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4388565017