title: Chronic testicular pain as a symptom of pelvic floor dysfunction.
abstract: OBJECTIVE
  We determined whether chronic testicular pain is related to pelvic floor overactivity after ruling out other disease pathology.
  
  
  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.
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands. erikplanken@hotmail.com
authors.forename: Erik
authors.initials: E
authors.lastname: Planken
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Voorham-van der Zalm
authors.forename: August A B
authors.initials: AA
authors.lastname: Lycklama A Nijeholt
authors.forename: Henk W
authors.initials: HW
authors.lastname: Elzevier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004576:Electromyography; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D017773:Pelvic Floor / Q000503:physiopathology*; D013737:Testis; D055815:Young Adult