Associated symptoms
The spermatic neuralgia usually manifests itself as an attack-like, shooting pain in the groin and scrotum or, in less frequently affected women, in the groin and large labia. Furthermore, in men with spermatic neuralgia, the so-called cremasteric reflex is often weakened or completely absent. This can be checked by gently stroking the skin of the inner side of the thigh: In healthy persons, this leads to a lifting of the equilateral testis by the Musculus Cremaster (hence the name of the reflex) in the direction of the abdomen, which can be interpreted as a protective measure. In patients with spermatic neuralgia, there is no or only a very weak reaction. Since the extent of the reaction is difficult for the layperson to classify, you should leave the assessment to a physician.
Treatment
If spermatic neuralgia is based on a clearly definable cause (e.g. tumor or abscess), the removal of the cause is the focus of the therapy. In most cases, a tumor is removed surgically, while most abscesses can be emptied by means of targeted puncture (pricking) to the outside. If this does not lead to complete freedom from symptoms or if no such cause has been discovered in the first place, an attempt can be made to achieve an improvement by regularly injecting local anesthetics (local anesthetics). Alternatively, carbamazepine or baclofen can be used, which are considered to be proven remedies for nerve pain of various causes.
Duration
The duration of spermatic neuralgia varies greatly from one individual to another. In the case of clearly defined causes (e.g. tumor or abscess), immediate improvement can often be achieved by eliminating the cause and relieving symptoms as soon as possible. If no cause can be identified, a local anesthetic therapy is usually started first. The local anaesthetics reliably make the pain disappear immediately after their injection, but it often returns when the effect of the drugs wears off.If this is the case, baclofen or carbamazepine can be used alternatively, but the optimal dose is often only found after some readjustments. In this way, it can sometimes take several weeks to several months before the doctor and patient can get a lasting grip on the spermatic neuralgia and, at best, even make them forget it completely.