Testicular pain, commonly referred to as orchialgia, is a frequent cause of urological consultation, often presenting treatment challenges. This study investigates the trends in the management of orchialgia using data from the TriNetX database, which includes information on patients with testicular pain treated between 2015 and 2023. The study focused on men aged 18 and older diagnosed with orchialgia (CPT code N50.18), excluding those with testicular neoplasms or a history of orchiectomy. The research analyzed the distribution of treatments, including antimicrobial medications, neuropathic pain medications, and various surgical interventions like vasovasostomy, varicocelectomy, orchiectomy, and spermatic cord denervation. The study included 245,121 patients diagnosed with testicular pain, with the majority receiving either antimicrobial treatments (35.8%) or neuropathic pain medications (40.9%).
Of the total patients, only 1.7% underwent surgical management, with varicocelectomy being the most common procedure. Orchiectomy rates remained stable over time, while there was a slight increase in the use of spermatic cord denervation. The findings revealed that despite the high success rates associated with microsurgical denervation, antimicrobial medications continue to be the most commonly prescribed treatment. This reflects the ongoing trend of using conservative treatments for testicular pain, despite the availability of more invasive surgical options. Additionally, although spermatic cord denervation has gained popularity, the overall rate of orchiectomies has not significantly changed during the study period. The research highlights the diversity in treatment approaches for orchialgia, emphasizing the preference for conservative management strategies, even in the face of effective surgical interventions like spermatic cord denervation.
