Affiliates in Urology Mahmood Hai MD, Muzammil Ahmed MD,
Vijay Kotha MD, Kashif Siddiqi MD,
Amarnath Rambhatla MD
Ph. (734) 595-1166, Fax: (734)-595-6821
Main location: 33545 Cherry Hill, Westland MI 48186

Testicular, Perineal and Groin Pain: Myofascial syndromes

The myofascial syndrome is a term used to describe the type of pain some men experience in their testicles, groin and prostate. Prior to this diagnosis, a thorough history, physical exam, urine tests, and occasionally, radiology tests are performed.

First, a quick anatomy lesson: sperm are made in the testicles. They then travel trough the spermatic cord and into the prostate and urethra where they are emitted during ejaculation. The spermatic cord is attached to the testicle. It runs though the groin and inguinal canal, then down to the deep pelvis where the prostate is located. Around the entire cord is a layer of muscle, called the cremastaric muscle and its fibers. The prostate also is composed of muscles and gland-forming cells.

After an injury or infection, the organs in this area become inflamed, which can cause pain. This pain can radiate anywhere along the spermatic cord, depending on the intensity of the inflammation. Often, the inflammation persists and recurs even though the original injury or infection has passed. Because all the muscles and fibers are connected, inflammation originating in the testicle can cause pain to radiate all the way up the cord and to the prostate and penis. It is not uncommon to have impotence associated with flare-ups of this condition.

A detailed diagnostic evaluation is needed to rule out other problems. After the cause of the symptoms is known, treatment can be initiated. Treatment for these symptoms consists of the following:

  1. Diet changes: Food high with stimulants (i.e. caffeine) and acidity (i.e orange juice, tomatoes) tend to worsen spasms and inflammation in the bladder and prostate. Drinking lots of water and urinating regularly keeps the urine dilute and also reduces symptoms.
  2. Antibiotics: a long course of antibiotic is required to permeate the organs involved and eradicate any persistent bacteria causing the inflammation
  3. Anti-inflammatory drugs: these drugs reduce inflammation in the affected region. They must be taken regularly in order to maximally reduce the symptoms.
  4. Warm soaks: Soaking the groin and bottom in a luke-warm tub for 5-10 minutes a day (at least) will allow vessels and muscles in the area to dilate. This optimizes the effect of the medications and also assists the body's own defense system.
  5. Stress reduction: Increased stress leads to activation of steroids and other metabolites which exacerbates spasms and pain
  6. Pain Clinics: Chronic pain clinics can provide injections and other interventions to suppress nerve and muscle spasms that cause the chronic pain.

While the treatment is usually effective, it is common to have occasional flare-ups that can be caused by a variety of factors. When this occurs, a repeat treatment course is often prescribed. Testing is required to ensure that other possible problems are not missed. There is no known relationship between prostatitis and prostate cancer.

Contacting Your Physician

Your doctor can be contacted by calling (734) 595-1166 during business hours. If the office is closed, call the answering service at (313) 396-0736. Finally, you may call the hospital at (734) 467-4000 to have them contact us. Please do not hesitate to call with any questions or concerns.