Chronic Testicular Pain as a Symptom of Pelvic Floor Dysfunction

PURPOSE: We determined whether chronic testicular pain is related to pelvic floor overactivity after ruling out other disease pathology. MATERIALS AND METHODS: A total of 41 patients with chronic testicular pain evaluated at our Pelvic Floor Department at a tertiary academic center were included in this retrospective study. All patients underwent standard pelvic floor investigation, including history using a standardized questionnaire and electromyography registration of the pelvic floor. In the questionnaire patients were asked about complaints in 3 domains (micturition, defecation and sexual function) suggestive of pelvic floor dysfunction. Electromyography registration of the pelvic floor was performed. The resting tone of the pelvic floor was considered increased at 3 muV or greater. RESULTS: Mean patient age was 48 years. Of the patients 93% had at least 1 symptom suspicious of pelvic floor dysfunction. A total of 22% had complaints in 1 of the domains of micturition, defecation or sexual function, 24% had complaints in 2 domains and 49% had complaints in all 3 domains. On electromyography registration of the pelvic floor 88% of patients appeared to have an increased resting tone of the pelvic floor muscles at a mean of 6.7 muV (normal less than 3). The patients with a normal pelvic floor resting tone were significantly older than those with an increased resting tone (65.6 vs 45.6, p = 0.0001). CONCLUSIONS: Chronic testicular pain can be a symptom of pelvic floor overactivity, especially in younger patients. A diagnostic evaluation should be performed when no pathophysiology can be found.