Team AckoSept 25, 2023
Testicular Pain (TP) can be a disturbing symptom. This is compounded by the fact that such pain could even mean an emergency, warranting immediate medical attention. Whether it’s a chronic ache or a sudden, sharp sensation, here is all you need to know about TP to take prompt action.
Testicular Pain is a condition characterised by discomfort in one or both of the testes that has been linked to many different causes.
The testicles or testes are the male reproductive organs. They are a pair of oval-shaped structures that are present outside the abdomen in a sac called the scrotum. The main function of the testes is to produce testosterone (the male sex hormone) and sperm required for reproduction.
Depending on the duration of pain, it can be acute (short duration since onset) or chronic (long-standing). Depending on the cause, the pain can be sharp or dull in nature.
Here are some of the commonly associated symptoms seen in people with Testicular Pain:
Swelling: There can be swelling or lumps in the scrotal region on one or both sides. The swelling can be red, warm, and painful in case of an infection. The swelling may be soft (hydrocele) or hard (tumours) in consistency.
Radiating pain: TP can radiate down the leg(s) and to the back. Sometimes it is associated with pain in another region that radiates into the scrotum (example, kidney stones).
Urinary issues: TP can be associated with difficulty in passing urine, burning sensation on passing urine, decreased urine output, poor urinary stream, dribbling of urine, and feeling of incomplete voiding. Sometimes, there may be blood or pus in the urine.
Local bruising: This can be seen in some cases of injury to the testicular region.
Fever: Fever is particularly seen when there are infectious causes, and is also a sign of the infection spreading.
Vomiting: Nausea and vomiting are commonly associated constitutional symptoms that are seen with many different causes of TP like infections and kidney stones.
As the treatment of TP varies widely depending on the cause, both have been discussed together in this section. Some of the most common causes of Testicular Pain are listed here.
One of the most common causes of TP is trauma or injury to the region. As the testes are present outside the abdominal cavity and are only covered by a thin sac, they are susceptible to blunt force trauma, even accidentally. It can occur during exercise, playing sports, driving etc.
The treatment for pain that occurs due to trauma mainly involves the following.
Application of ice pack
Use of over-the-counter painkillers like paracetamol
Supportive underwear, cups, etc.
Infection and inflammation of the testes or the surrounding structures of the male reproductive system can present as TP.
Orchitis: Inflammation of the testes is referred to as orchitis. Orchitis can also be seen in children if they get mumps.
Epididymitis: The epididymis is a curved tube-like structure present behind the testis. This is a part of the male reproductive system. This can get infected resulting in severe pain, swelling, and fever.
This can be an outcome of Urinary Tract Infections and Sexually Transmitted Diseases like chlamydia, gonorrhoea, and less commonly syphilis. This can also occur as a complication following any surgery of the nearby structures. It is diagnosed by clinical examination, and usually with the help of an Ultrasound scan.
The primary treatment for these infections is with appropriate antibiotics. Apart from this, supportive treatment with fever reducers, painkillers, etc., can be given. Very rarely, there may be a need to surgically remove these structures. These procedures are only done as a last resort, as they can result in sterility.
Testicular torsion refers to a condition where the testicular structures twist around themselves. The testes are suspended by cord-like structures called spermatic cords. This can twist around itself resulting in testicular torsion. When this occurs, the blood vessels that supply the testes can get blocked causing permanent damage.
This occurs mostly in newborns, adolescents undergoing puberty & young adults up to the age of 25. It presents with severe pain, vomiting, a change in position of the testis, and discoloration of the testis.
An inguinal hernia is a protrusion of the contents of the abdomen (intestine, covering layers) through a weakened part of the abdominal wall. Inguinal or groin hernias can extend all the way up to the base of the scrotum. It is advised that if you have a hernia, it is better to schedule an elective surgical repair of it before it becomes complicated and lands you in trouble.
Usually, hernias are not associated with pain. However, when there is pain associated with hernia, it can be an indication of strangulation, where the blood supply to a part of the intestine is cut off resulting in necrosis. Both testicular torsion and strangulation in hernia are surgical emergencies. Immediate operation is the only way to prevent life-threatening outcomes.
Kidney stones can cause what is known as referred pain in the testicles. Although kidney stone pain is usually limited to the back and hips, Testicular Pain may also occur.
The treatment for the following conditions primarily involves surgical repair.
Hydrocele: A hydrocele is a collection of clear fluid in between the layers surrounding the testis. It is usually painless. However, it can cause Testicular Pain if it becomes infected.
Spermatocele: A spermatocele is a cystic (fluid-filled), non-cancerous swelling that forms near the epididymis behind the testis. These are usually painless but larger lesions can cause testicular discomfort due to compression of the nearby structures.
Varicocele: A varicocele is a swelling that occurs due to abnormal engorgement of the veins that drain the testes. It is associated with pain, swelling, and heaviness, with relief in pain noted on lying down. Varicoceles can also cause infertility in men.
Testicular cancer presents with a swelling or lump of one or both testes often hard in consistency, sharp shooting pain in the testes, dull aching abdominal pain, and a feeling of heaviness in the groin with lower back pain. Testicular cancers usually affect those between the age group of 15-35 years.
The prognosis depends upon the type of testicular cancer. Treatment involves surgery which is usually the removal of the affected testis, resulting in infertility. Chemotherapy and radiation are also used successfully in the treatment of testicular cancers.
Most men already have a lot of misconceptions about vasectomies such as that they affect sex drive or make sex less enjoyable. While these may not be true, for a small group of patients the procedure isn’t quite painless. They may develop long-standing, sometimes debilitating pain in the testicular and genital region referred to as PVPS. Patients present with the following.
Continuous, dull pain
Pain on physical activity
Pain on engaging in sexual intercourse/gaining an erection
Pain on ejaculation
Many causes of Testicular Pain are easily fixable if treatment is started promptly.
Any sudden, severe Testicular Pain warrants an immediate visit to the emergency room.
A simple self-examination of the testes to check for lumps and visiting the doctor promptly can also go a long way in avoiding a situation where the pain becomes unbearable.
Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.
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