Chronic Neuropathic Anterior Thigh Pain Following Testicular Trauma with Nocturia - #19940
I am a male patient, weight 68 kg. I have been suffering from chronic pain for about two years, which started after a direct trauma and strong compression to the left testicle during a physical altercation. Initially, the pain was localized to the left testicle, and blood appeared in the semen once only after the injury. After about one year, the pain shifted to the anterior thigh only (no lower back pain). The pain has neuropathic characteristics, including: Tingling Burning or electric-shock–like sensations It worsens with prolonged sitting or certain lying positions and improves significantly with warm showers or heat. After taking medications such as Etnoplex, Inibrex, and Eximal, the pain intensity decreased, but I started experiencing nerve irritation and electric sensations at the pain site. Additional symptoms include: Nocturia: waking up approximately every 4 hours at night to urinate, with real urine output and no burning sensation. Persistent clumps in semen for several months. Investigations: Testicular ultrasound showed normal testes and good blood flow. No known lower back or kidney pathology. Request: Evaluation of chronic neuropathic pain of the anterior thigh following testicular trauma, consideration of appropriate neuropathic pain treatment, and assessment of nocturia.
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Doctors’ responses
Your presentation is most consistent with chronic post-traumatic peripheral neuropathy involving the ilioinguinal/genitofemoral nerve, with referred pain to the anterior thigh. This is a recognized but underdiagnosed condition, and it is treatable, though recovery can be gradual. The nocturia is likely functional or neurogenic rather than urologic disease. With proper neuropathic pain management and targeted evaluation, significant improvement is achievable.
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