Pelvic and Testicular Pain

Comprehensive Evaluation of Pelvic Pain

Men’s pelvic pain can arise from many causes, including:

• Pelvic floor dysfunction
• Neuromuscular issues
• Chronic prostatitis (infectious or inflammatory)
• Interstitial cystitis–like bladder pain
• Urethral pathology or strictures
• Referred pain from the back, spine, or hips
• Nerve entrapment
• Epididymal or testicular disorders

Our diagnostic process includes physical examination, imaging, targeted testing, evaluation of pelvic floor dysfunction, and review of spine/hip mechanics to determine the true source of symptoms.

Pelvic Floor Dysfunction & Physical Therapy

Many men with pelvic or testicular pain actually have pelvic floor muscle dysfunction rather than a urologic infection.
We partner with specialized pelvic floor physical therapists who address:

• Pelvic muscle tension or spasm
• Trigger points
• Core and posture mechanics
• Low-back or hip dysfunction
• Neuromuscular contributions

This approach often leads to significant improvement.

Chronic Testicular Pain (Orchialgia)

Chronic testicular pain can stem from nerve irritation, pelvic floor dysfunction, epididymal issues, or referred pain from the spine.

Conservative therapies:

• Anti-inflammatory medications
• Neuropathic pain medications
• Pelvic floor therapy
• Supportive care

Advanced procedural options:

• Spermatic cord blocks
• Microsurgical spermatic cord denervation (high success rates)
• Treatment of varicoceles or epididymal pathology when appropriate
• Addressing referred pain from the spine or hips

We offer a structured, stepwise management plan tailored to each patient.

Prostate Pain & Prostatitis

Prostatitis may be:

• Bacterial
• Inflammatory (non-infectious)
• Pelvic floor–related
• Neuropathic
• Referred from bladder or urethra

We treat prostatitis with evidence-based methods:

• Targeted antibiotics only when appropriate
• Anti-inflammatory medications
• Pelvic floor therapy
• Alpha-blockers
• Lifestyle modifications
• Management of inflammatory chronic pelvic pain syndrome

We also rule out stones, strictures, or bladder issues that mimic prostatitis.

Urethral Pathology Evaluation

Persistent pelvic or testicular pain may result from:

• Urethral strictures
• Bladder neck obstruction
• Irritative bladder conditions

We evaluate with cystoscopy, flow testing, and imaging to ensure structural causes are not missed.

Benign Scrotal Conditions: Hydroceles, Spermatoceles & Testicular Lesions

Scrotal swelling, pressure, or discomfort may be caused by benign lesions. RoMIUS Urology evaluates and treats a wide range of common, non-cancerous testicular and scrotal conditions, including:

Hydroceles

A fluid collection around the testicle that can cause heaviness, pressure, or cosmetic concerns.
Treatment:

• Outpatient hydrocelectomy—a safe, effective surgical repair with excellent long-term results.

Spermatoceles / Epididymal Cysts

Benign cystic growths arising from the epididymis that can cause discomfort or a noticeable lump.
Treatment:

• Spermatocelectomy, performed with precision to preserve fertility and testicular function.

Benign Testicular or Epididymal Lesions

Masses or nodules that are non-cancerous but may cause pain or concern.
Treatment:

• Surgical removal when symptomatic
• Careful evaluation to rule out malignancy
• Ultrasound and follow-up surveillance when surgery is not needed

RoMIUS Urology provides expert surgical management with minimally invasive approaches, ensuring fast recovery and excellent long-term outcomes.

Collaboration With Pain Management & Other Specialists

We work with:

• Pain management specialists
• Pelvic floor therapists
• Spine and orthopedic teams
• Neurology
• Behavioral health (when needed)

This comprehensive approach ensures all contributors to pain are addressed.

Our Approach: Personalized, Methodical, Effective

Men choose RoMIUS Urology because we:

• Take pelvic and testicular pain seriously
• Use structured, evidence-based evaluation
• Provide pelvic floor therapy integration
• Offer cord blocks & microsurgical denervation
• Rule out urethral pathology and treat it when present
• Treat prostatitis—infectious or inflammatory—appropriately
• Manage benign scrotal conditions with surgical expertise
• Coordinate with pain management when needed
• Develop long-term, individualized treatment plans