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Testicular Pain – Overview

March 12, 2021


“Testicular pain can be very uncomfortable. Most men understand how sensitive that organ is in their body. It can have anywhere from mild to severe issues associated with it. For example, a mild problem that could cause some degree of testicular pain could be an early low-level infection, not necessarily of the testicle, but the epididymis that sits behind the testicle, is fairly common. It seems to come on with heavy lifting or minor trauma. Can be such that it requires an antibiotic and almost always is best remedied by good scrotal support with tight fitting underwear and ice in the early phases, and moving on to heat along with anti-inflammatories. So if it’s an infection it’s beginning, it will become obvious and will need some treatment. Minor trauma. It doesn’t take much to cause a man’s testicle to be uncomfortable. And in fact, sometimes the pain is radiating.

In our early development, in in the womb, the testicles are up near the kidneys and they pass through the abdominal cavity on their way into the scrotum. So if you have an injury to your kidney or in fact have a kidney stone that’s blocking the kidney, causing problems in the kidney, that pain can be radiated to the testicle. So some of these pains are not actually testicular in origin. On the other hand, an abrupt onset of severe testicular pain is most worrisome for a condition called testicular torsion. Testicular torsion means that the testicle has actually twisted on its stock. We call it the spermatic cord. It rotates around and suddenly the blood supply becomes very, very, inadequate. And when something in our body loses blood supply, it hurts a lot. This should prompt, and usually does prompt, an almost immediate trip to the emergency room where an ultrasound demonstrates no flow in that testicle and a urologist fixes the problem, in the operating room.

There is, however, about a six hour time window, on torsion, meaning from the onset to the time of untorsing or detorsing that testicle, the testes can survive, and much beyond that, the testes can be lost due to this twisting phenomenon. When we fix a testicle for torsion, we always go to the opposite side and fix that testicle too, meaning we secure it in the scrotum in a way that it can no longer twist abruptly and develop torsion. So this is important because the testicles that torse tend to have what we call a bell clapper phenomenon. They’re not well-supported, they kind of swivel in the scrotum like bell clappers. So we need to secure, even if the testicle we are operating on fails to survive, we need to secure the opposite side. Testicular cancers, on the other hand, almost never cause pain. They’re slow, sort of indolent growths, what they do cause is a very firm nodule within the testicle. Men should probably, monthly beginning in adolescence, take a quick feel down there and make sure the testicles feel symmetrical. As soon as there’s a knot that’s rock-hard on one testes, that is an immediate need to see a urologist, and to be considered for surgical management. And going back to referred pain.

It’s possibly the only manifestation of inflamed or inflammation in the prostate or prostititus that the testicles hurt. And again, this pain is referred from elsewhere, but a man will come to the office complaining of testicular discomfort and we will discover, he, in fact, has a prostate that’s inflamed or infected. All in all, testicular pain is nothing to scoff about. If it goes away after you bumped yourself, then it’s probably nothing at all, but if it’s persistent and severe, it needs to be addressed immediately. And a trip to the emergency room is probably the best bet.”

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