Hip issues may cause pain in testes or scrotum. Please read this resource (under the heading 4.1 referred pain);
Any organ that shares the same nerve pathway with the scrotal contents can present with pain in this region. Pain arising in the ureter, hip
, intervertebral disc prolapse and entrapment neuropathies (pinched nerves) of the ilioinguinal or genitofemoral nerve, often due to inguinal hernias or following their repair are some of the secondary causes of chronic testicular pain.
Apart from hip pathology causing your groin and testes pain; there may be other concomitant issues which may need to be looked for.
Diabetic neuropathy is also the cause of the chronic testes pain (may be considered if you have personal or family history).
Since you have osteoarthritis in hip; there is likelihood that you may have degenerative arthritis in lower back too. Lower back issues (pinched nerves) can also cause the referred pain to groin and scrotum / testes. Chronic scrotal pain is usually related to noninflammatory conditions but chronic infections also should be considered. Because the testes arise embryologically in close proximity to the kidneys
, pain arising in the kidneys or retroperitoneum may also be referred to the testes. So an abdominal ultrasound, intravenous pyelography, MRI of the back and a CT scan of the abdomen also should be done to evaluate testicular pain.
A urine and sperm culture for pyogenic organisms and mycobacterium should be done for chronic testes pain. This should be able to point towards the chronic infection and give the guidelines for the further management. A prostatitis may cause testicular pain. Urine culture after the prostate massage and semen culture would be helpful in diagnosing the chronic prostatitis.
Following other causes to be considered for the pain are;
1) Recurrent torsion
2) Torsion or inflammation of the appendix of the testes
3) Infectious epididymitis
4) Noninfectious epididymitis; occur due to reflux of urine through the ejaculatory ducts and vas into the epididymis, producing a "chemical" inflammation
5) Referred pain - the genitofemoral, ilioinguinal, or posterior scrotal nerves CAN CAUSE REFERRED PAIN. Other causes of referred pain are abdominal aortic aneurysm, ureteric stone, lower lumbar or sacral nerve root impingement, retrocecal appendicitis, retroperitoneal tumor, etc.
6) Idiopathic cause; cause not ascertainable.
Thus, your testes pain should be reinvestigated. A urologist working in a academic center like hospital attached to a medical school would be the best to consult; for working up your symptoms. Please see the causes of testes pain this authentic resource;
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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