Anyone have experience of a suspected overactive cremaster muscle?

Men's health
1

After experiencing testicular pain (started in July 23) my husband (T) went to his GP. He has been prescribed antibiotics (Ciprofloxacin, Doxycycline - full courses completed) and anti-inflammatories (Naproxen, Diclofenac - didn’t complete the course, due to side effects) with no success. He’s also had two scans on his scrotal area, which came back clear. In addition, T is experiencing soreness and irritation on his penis and was instructed by his GP to go to the Sexual Health Clinic. The Doctor there indicated it could be Lichen Sclerosus and T was prescribed a barrier cream (Zeroderm) and a steroid cream (Dermovate ointment). These have been applied for approximately a month with some easing of symptoms.

Another visit to a different GP, indicated the testicular pain could be caused by an overactive cremaster muscle. After a private Urologist consultation, the consultant suggested it could be this but he couldn’t 100% definitively say it was. His solution would be surgery which he called “fixation of testes”. Has anyone had experience of this surgery and its success rate of curing testicular pain?

In addition, T (w/c 25/9/23) been prescribed Amitriptyline by his G.P. but it is too early to comment on its effect. Recently, he has also been having weekly physio, due to back and hip pain and will have a pelvic physio assessment this week.

In an article written by an American Urologist, it was suggested that medical botox into the cremaster muscle could help alleviate pain. Has anyone experienced this and if so please can you tell me where you had the treatment?

This situation has impacted on T’s quality of life and he is unable to work due to the pain. We are banging our heads about what to do next, so any advice would be greatly appreciated - thank you in advance.

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Hi Staffielover, sorry to hear T is suffering like this.

I (a 34M) had a fixation of the testicles (orchiopexy) in Oct 2021 due to having bell clappers deformity, which was causing intermittent testicular tortion (and so a lot of pain). The operation was a complete success. I was up and walking around within 6 weeks of the operation (although I would say to I wasn’t fully 100% recovered until 9 months later). I also did 3 months of PF therapy which worked wonders to cure this un-diagnosable pelvic and abdominal pain I had. It turned out I had an incredibly tight PF which was seizing up and causing pain.

My pain was not related to an overactive cremaster muscle though, so I’m not sure if any of that is helpful for you, but there it is. However, I’m surprised to hear an orchiopexy is being recommended as a treatment for an overactive cremaster muscle as my understanding was that is usually treated via a microsurgical subinguinal cremaster muscle release.

Are you located in London? If yes I can recommend my Urologist if you are looking for a second opinion, he really was excellent, everything he diagnosed on day 1 turned out to be correct.

Thanks - hope it works out!

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Hi Daniel, thank you for taking the time to respond. T has been seeing a specialist pelvic physiotherapist which seems to be helping. She is convinced that the testicular pain is related to T’s hip and back pain which no other medic has mentioned. She and his GP have advised not to go down the surgical route so we are taking this advice for the time being. Did you see your Urologist privately or was it through the NHS? Thanks for all your help.