Testicular pain is one of the most common complaints seen in the urologist’s office. An underdiagnosed cause of it is what is known as a hyperactive cremaster muscle reflex resulting in testicular retraction causing pain. The cremaster muscle is a cylindrical muscle that envelopes the structures of the spermatic cord including the blood vessels to and from the testicle, the vas deferens, and lymphatic channels. The cremaster reflex results in a contraction of this muscle which allows the testicle to rise upwards. A hyperactive cremaster reflex; however, can pull the testicle up far too high into the groin, and men with this condition may have to actually push the testicle back down to the scrotum which may result in pain. This most commonly occurs in these men with exercise, intercourse, and going from the sitting to standing position or vice versa.
Dr. Kavoussi has published his outcomes on a simple, minimally invasive surgery, which he performs microsurgically through a 1-inch incision in the groin to release the cremaster muscle circumferentially to remedy this hyperactive reflex, testicular retraction, and pain. His data shows excellent results with this technique, allowing these men to return to an improved quality of life.
To read Dr Kavoussi’s study, click here:
https://onlinelibrary.wiley.com/doi/full/10.1111/and.13493