Chronic orchialgia. A diagnostic and therapeutic hypothesis

OBJECTIVE: The objective of this study is to offer patients with chronic testicular pain and no physico-pathological finding, a likely cause not usually taken into account such as uricemia. The hypothesis of an intracanalicular deposit of uric crystals and/or the resulting alteration in nerve endings is suggested. METHOD: The study involved a total of 60 patients with chronic orchialgia and no detectable testicular pathology seen over a 5-year period. Mean age 35.6 years. They were all evaluated with routine laboratory tests, uricemia, uricosuria and in specific cases uroculture and Stamey's method. Orchidometry, vascular doppler and ultrasound were used in all cases. RESULTS: Presence of hyperuricemia was corroborated in 61.6% cases. Based on figures found, patients were divided into three groups. Patients were treated with a low-purine diet plus Allopurinol 300 mg/day, and symptoms receded in 81.06% cases. CONCLUSIONS: Due to the high incidence of hyperuricemia and the significant symptomatological relief obtained with specific treatment, we believe its determination should become routine.