Pain in the testicle or penis is referred to as orchialgia and phallodynia respectively. Currently, no data exists regarding the prevalence of chronic testicular or penile pain, however, as component symptoms of the PPOD syndrome, orchialgia and phallodynia are not uncommon. With respect to orchialgia, the pain is usually described as a deep aching, or sometimes burning pain, and may exhibit a pressure like quality as though the testicle were being squeezed in a vise.
It may be unilateral or bilateral, and when it is present bilaterally, it may be clearly more intense on one side than the other. When bilateral testicular pain is present and is clearly more intense on one side than the other, any accompanying pelvic pain will usually (although not always) be more intense on the side of the dominant testicular pain. Regarding phallodynia, pain in the penis can be somewhat variable in it’s description.
In some cases the pain is described as a sharp or an intense burning pain involving the cutaneous (skin) regions of the penis which makes touch or contact of any type extremely painful, a situation analogous to vulvodynia in the female PPOD patient. Sometimes this painful hypersensitivity will be accompanied by intermittent periods of diminished sensory perception which can create a confusing state of alternating painful hypersensitivity interspersed with periods of numbness that can additionally impair sexual function.
In other cases, the pain is more of an internal pain that extends down the center of the penile shaft along the distribution of the urethra. In these cases urination may provoke a sharp or burning pain within the penis along the urethra. Although usually a painful burning hypersensitivity and/or numbness may involve the majority of the penis, it can be localized or isolated to the distal half of the penis or penile head. Refer to cases 5, 9 and 13 for examples of the response of these symptoms to PPOD syndrome treatment.