Testicular Pain
- The testicles (testes) are small egg-shaped reproductive (sex) organs inside a thin pouch of skin called the scrotum.
- The functions of the testes are to produce both sperm and androgens, primarily testosterone.
- Testicular pain is a condition that can affect males at any age.
- However, the pain may not actually be coming from your testicles themselves. The pain may be coming from another part of your body such as the stomach or groin. This type of pain is called referred pain.
- Testicular pain can be either acute (sudden and short) or chronic (gradual and long-lasting).
- Testicular pain can be severe because the testicles have many sensitive nerves.
Causes:-
- Injury or trauma: An injury to your testicles may happen during sports, exercise or an accident.
- Orchitis: Inflammation in one or both testicles may be caused by a bacterial or a viral infection. In children, the mumps virus is also a possible cause of orchitis. In the case of mumps the swelling usually starts four to six days after the start of the mumps.
- Inguinal hernia:- An inguinal hernia occurs when part of your intestine pushes through a weak part of your abdominal muscles near the groin. It’s usually not dangerous but it can be painful. If it is painful, you should seek immediate medical attention as you may require urgent surgery.
- Epididymitis: This condition is due to inflammation of the epididymis. The epididymis is a tightly coiled group of thin tubes carrying sperm from the testicles to the sperm duct and out of the body. Epididymitis symptoms include pain and inflammation. The scrotum may be swollen and hot to the touch. This can last for days to weeks. Chronic epididymitis lasts longer than six weeks.
- Spermatocele: A spermatocele is a space filled with fluid that can form inside the epididymis near the testicle. These cysts aren’t cancerous and are usually not painful, but at times they can grow to a large size and become uncomfortable.
- Hydrocele: A hydrocele forms when fluid builds up around the testicles. Hydroceles are common, and sometimes they can cause pain or become infected.
- Hematocele: A hematocele occurs when blood surrounds the testicle. This is usually the result of an injury.
- Varicocele: A varicocele is a group of abnormally large veins near the testicles. These large veins may cause a dull discomfort in the affected testicle during daily activities. The testicle pain usually improves when lying down. Varicoceles may sometimes affect the ability to have children, and are sometimes surgically treated.
- Testicular torsion: Torsion is the twisting of the blood supply to the testicle. This cuts off the blood supply to the testicle and results in a severe, sharp pain. Torsion can occur at any time. This condition needs immediate surgery to save the testicle.
- Kidney stones: Kidney stones happen more commonly when you are dehydrated. Stones can get stuck in the ureters (tubes draining urine from the kidney into the bladder), causing pain in the back, groin or scrotum. Small stones may pass if fluids are increased. Larger stones may need surgery.
- Post-vasectomy pain syndrome: Men who have had a vasectomy sometimes get testicular pain afterwards. This pain can be caused by higher pressure in the vas deferens (tubes carrying sperm) or epididymis and can result in a post-vasectomy pain syndrome.
- Testicular cancer: Testicular cancer is the most common cancer in men aged 15-35. It can sometimes present with a dull ache or pain in the groin or testicles, testicular swelling or heaviness and aching in the lower abdomen or scrotum. Imaging methods can be used to examine the testicles for signs of testicular cancer.
Symptoms:-
Some other symptoms may include:-
- Pain
- Bruising
- Nausea and vomiting
- Swelling
- Fever
- Urination problems
Investigations:-
- Your doctor will examine you standing up and lying down.
- You’ll be asked questions about when the pain started, how long you have had it, how much it hurts and exactly where you hurt.
- You’ll also be asked about your sexual, medical and surgical history. Tell your doctor if any activities make your pain better or worse, like going to the bathroom, exercise, sex or sitting.
- Blood or urine tests can help to rule out infections as a possible cause.
- Ultrasonography
- Radionuclide imaging
- CT Scan or a kidney/ureters/bladder x ray.
Treatment:-
Treatment of testicular pain depends on the diagnosis and the root cause identified by your doctor.
- In the case of infections(eg.,Epididymitis) in testicle is treated with antibiotics.
- If the testicular pain is due to the radiation of pain from the kidney due to the presence of kidney stones, treatment of kidney stones is done to get rid of the pain in testicles.
- If the testicular pain is due to the presence/growth of testicle tumors, a piece of testicle tissue is sent for biopsy to determine if they are benign or cancerous.
If a cancer tumor is found, then you will be referred to the oncology department for treatment of testicular cancer, if not, the tumor may be surgically removed.
- If the testicular pain is due to an injury then NSAIDS and Pain killers will be prescribed.
- Treatment for Orchitis depends on the type of infection. Antibiotics, pain killer medicines and anti-inflammatory medicines will be the first line of approach to treat the infection. Scrotal support and ice packs may be advised.
