Urologist Questions Urologist

Suspected Genitofermoral Neuralgia from blunt pulling trauma?

For 2 months now, I have had dull and also sharp pain, discomfort, throbbing aching, and numbness in my upper/medial scrotal/inguinal area. It also presents very sensitively to the touch once compressed or pinned against the most upper area of the penis. I believe this to be of a blunt trauma comprising of the yanking/pulling and compressing of the vas deferens, vessels, and other scrotal nerves amongst the inguinal canal and left scrotal sack.

Since the trauma, I have experienced a sharp pain and dull pain that has radiated from my testicles and scrotal cord to my pelvis and abdomen at times but also a very strange feeling of discomfort that gets worse with bending and/or certain movements of the leg. What's more is that my left leg has been experiencing spasms in the quadricep and surrounding tissues, exhibiting symptoms such as weakness and neuralgia. When sitting the feeling is worse although after doing some stretches the discomfort seems to be irrelevant for a while.

Sleeping is not so bad, walking can be fine but then also be difficult some days. The only positive difference I can make from one month ago is that I do not feel the hypersensitivity of the 'nerves?' in the inguinal/groin area as much when bending forward, I can only describe what I felt like a loose worm in the area inside of me. In the past two months, I have had no luck at all with a confirmed diagnosis, which is why I reluctantly reach out to those online for any kind of advice and assurance.

History:
I have had 3 ultrasounds which found nothing of note, only what they say is a very mild hydrocele and varicocele not attributing to these symptoms and were there before the trauma, and also what is deemed to be a 16mmx4mm lipoma in the inguinal canal, also deemed to be no concern. I presented to the hospital on day 3 after the trauma with concerns, after testing for torsion and STI's they did not find anything and discharged me with no effort or concern for further testing. Despite my urine and blood tests being normal I was sent home with a two week prescription for Doxycline which I fulfilled to no avail.

I have seen a Urologist in the hope of a definite diagnosis but unfortunately, that was also unsuccessful and costly. Despite everything I mentioned I was told it was probably just tight clothing as the ultrasound results don't show anything to be causing the symptoms. In these weeks I have been studying and researching day and night in an attempt to find anything of help and after eliminating all of the above I can only assume that I have damaged the scrotal nerves in that area by squeezing and pulling one or more of them through. I feel easily dismissed when I have mentioned this to general practitioners but I hope that will not be the case here.

I have been told it will just take a long time to get better but without proper diagnosis. Told to take Ibuprofen, Paracetamol, and only recently been prescribed Pregabalin all of which have made no difference thus far. As a recap, this is a genuine worry, I cannot work nor do any physical activity. The feeling ranges from mild discomfort in the genitals and pelvis one day, to a full spectrum of issues other days with sharp sensitive pain, a feeling of somebody squeezing my spermatic cord, flicking my testicle and a burning nail in my inguinal/pelvic area, left leg weakness and spasming and even lower abdominal tenderness. The affected (left) upper spermatic cord does seem to feel more full and even ruptured than the other side and one of the nerves on that side is very rigid and straight compared to the other side which is way looser.

If you suspect I am correct in identifying the cause please let me know how much longer this may be until it will heal and if there are any other medications or imaging tests that may be of help.

Male | 34 years old
Complaint duration: 2 months
Medications: pregablin 25mg
Conditions: Scrotal trauma/Neuralgia?

1 Answer

Need to see a urologist as it could be a hernia or other tumors. An ultrasound likely will show problem and/or CT scan.