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Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. [5] Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. [5] Large varicoceles present as plexus of veins and may be described as a "bag of worms".
While one may expect the female to have an equal prevalence of pelvic compression syndrome due to the identical embryological origin of the valveless pampiniform plexus, this condition is thought to be underdiagnosed due to the broad differential of the pain pattern: unilateral or bilateral pain, dull to sharp, constant to intermittent pain worsening with any increase in abdominal pressure.
Chronic testicular pain may be caused by injury, infection, surgery, cancer, varicocele, or testicular torsion, and is a possible complication after vasectomy. [2] IgG4-related disease is a more recently identified cause of chronic orchialgia. [4] One author describes the syndromes of chronic testicular pain thus:
Another clinical study has shown that nutcracker syndrome is a frequent finding in varicocele-affected patients and possibly, nutcracker syndrome should be routinely excluded as a possible cause of varicocele and pelvic congestion. [10] In women, the hypertension in the left gonadal vein can also cause increased pain during menses. [10]
Chronic scrotal pain (pain for greater than 3 months) may occur due to a number of underlying conditions. [3] It occurs in 15-19% of men post vasectomy, due to infections such as epididymitis, prostatitis, and orchitis, as well as varicocele, hydrocele, spermatocele, polyarteritis nodosa, testicular torsion, previous surgery and trauma. [3]
The pain is worse during or after sexual intercourse, and can be worse just before the onset of the menstrual period. [ 8 ] Women with pelvic congestion syndrome have a larger uterus and a thicker endometrium . 56% of women manifest cystic changes to the ovaries, [ 9 ] and many report other symptoms, such as dysmenorrhea , back pain, vaginal ...
Pain in this region of the body can be associated with anxiety, depression and other psycho-social factors. In addition, this pain can have effects on activities of daily living or quality of life. Treatment can be symptomatic if the pathology is unknown and managed by physical therapy, counseling and medication.
The primary care physician may diagnose and manage benign causes of scrotal masses such as hydrocele, varicocele and spermatocele. However, if a "must not miss" diagnosis related to testicular masses such as testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer is suspected, the family physician must refer ...