The tight pants syndrome that I first observed some 15 years ago varies from the syndrome described by Bessa1 in the June 14, 1993, issue of the Archives.
The patients presented complaining of groin pain and bilateral testicular pain. Examination, urinalysis, and urological referrals failed to demonstrate the cause of the pain until it was appreciated that the then current change in men's fashions included the slim look with removal of pleats of trousers and narrowing of the width of pants.
The diagnostic pearl consisted of the patient informing the physician that symptoms were exacerbated in the sitting position, particularly at athletic events where one could not extend his legs.
Fortunately, the condition has become rare in the last 5 years, with the return of the Italian look in men's clothing where the trousers are now wide and include several pleats. Thus, the condition has been alleviated by the
Matis JD. Another Form of Tight Pants Syndrome. Arch Intern Med. 1994;154(2):226. doi:10.1001/archinte.1994.00420020150019