Testicular pain

Testicular pain can have very diverse causes. Testicular pain can also occur in young boys, before puberty. Since the pain can occur due to many diseases, a doctor should always clarify the situation.

What is testicular pain?

Testicular pain is not a specific disease but occurs as a symptom of many different diseases. Testicular pain can be perceived as diffuse abdominal pain. Usually, however, it is a pulling pain that is accompanied by a feeling of heaviness in the testicles.

The pain can occur explicitly after sexual intercourse or for no apparent reason or trigger. Testicular pain can arise as a symptom of many, sometimes serious, underlying diseases. Therefore, a doctor should always be examined.

In young boys, sudden testicular pain can indicate testicular torsion, making it an absolute emergency that requires immediate medical attention. Depending on the underlying disease, the duration and intensity of testicular pain can be completely different.

causes

In most cases, testicular pain is caused by infection. Often an inflammation of the testicles is the cause of the pain. But an infection with mumps can also be accompanied by testicular pain.

Testicular pain due to testicular torsion (twisting of the testicles) is an emergency, especially in young boys, that requires immediate surgery to avoid permanent damage to the testicle.

However, a rupture of the scrotum or accumulation of blood after an injury also expresses itself in testicular pain. Other causes of testicular pain can be herniated discs and hernias. Testicular pain during or after intercourse can have a wide variety of causes, which must be clarified urologically.

Often it is an inflammation of the epididymis, which in addition to the usually severe pain, also causes other symptoms. Varicose veins within the scrotum and testicular tumors can also cause testicular pain.

Harmless testicular pain also manifests itself when a long-lasting erection of the penis, e.g. while cuddling and petting has taken place. In this condition, the testicles are also particularly sensitive to touch. If there is no ejaculation in this context, so that the testicles and penis react naturally again, the testicles can cause unpleasant sensations. After a few hours, however, these will disappear again and the testicles no longer hurt.

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Diseases with this symptom

• Epididymitis
• Testicular cancer
• mumps

• disc prolapse
• Inguinal hernia
• Undescended testicles

• Inflammation of the testicles
• Testicular torsion
• Acute scrotum

Diagnosis & course

To diagnose the causes of testicular pain, the doctor will first take the patient's medical history. This includes the duration of the complaints and any other complaints of the person concerned. In many cases, a physical examination allows conclusions to be drawn about suspected causes.

When inflamed, the testicles are often swollen and hard. In most cases, the pain subsides when the testicles are lifted. The doctor will definitely do a blood test for further diagnosis. In this way, any inflammatory agents that may be present can be detected. Further investigations will follow depending on the suspected cause. With the help of an ultrasound scan, the doctor can, for example, determine testicular cancer.

In exceptional cases, the painful testicle must be exposed through an operation to find the cause of the testicular pain. If other diseases are suspected to be the cause, X-ray examinations or computed tomography can also help to find the cause of the testicular pain, depending on the suspected underlying disease.

Since the causes can be varied, the course of testicular pain is not entirely uniform. Acute inflammation usually heals within a week with appropriate treatment and the testicular pain subsides or disappears completely.

Complications

Depending on the underlying disease, testicular pain can lead to a wide variety of complications. In the case of testicular torsion, the testicle rotates around the vessels that supply it, and this leads to an insufficient supply of blood to the testicle, which initially causes severe pain. If left untreated, it can lead to permanent damage to the testicles, which can ultimately also lead to infertility.

Furthermore, the risk of infection is increased. Furthermore, inflammation of the epididymis (epididymitis) can also cause pain in the testicles. In addition to impairment of fertility in the same way as with testicular torsion, bacterial infections can lead to an accumulation of pus (abscess) and systemic spread of the infection (sepsis), which can be life-threatening.

It is well known that a blow or kick on the testicles can cause extreme pain and permanent damage can remain. A kidney stone can also radiate pain in the testicles. However, the complications that can arise affect the kidney more than the testicle. This can cause permanent damage to the kidneys and increase the risk of infection by bacteria.

In the worst case, this can also lead to systemic spread and death of the patient. As the most common cause of tumor in young men, testicular cancer can also cause some complications. These range from infertility to the spread of the tumor through metastases to other organs. However, the consequences depend on the type and size of the tumor.

When should you go to the doctor?

Testicular pain or painless hardening of the testicles can be the cause of more or less serious illnesses. In the event of abnormalities in the prostate or testicle area, a doctor should always be consulted. The first thought in the case of testicular pain is that cancer may be the cause. However, cancer is not always the first disease and usually does not cause pain. However, changes should be clarified.

Inflammation of the testicles can be the cause of the pain. In addition, a fever and swelling and redness of the testicles may indicate inflammation. Rapid medical treatment is important to avoid consequential damage. Infertility and permanent destruction of testicular tissue can follow untreated testicular inflammation.

Pulling pain does not necessarily indicate a disease of the testicle. The surrounding areas - the ledges, for example - can also be affected. Accompanying symptoms are severe pain when coughing and sneezing: An inguinal hernia must be treated immediately by a doctor or urologist.

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Treatment & Therapy

For testicular pain, the treatment always depends on the triggering cause. If the pain is caused by a viral disease, bed rest, cooling and elevation of the testicles are usually sufficient. Bacterial infections are usually treated with antibiotics.

In rare cases, the inflammation in the testicle can cause purulent abscesses to form. These then have to be removed by surgery. Testicular tumors are treated with radiation therapy, and in some cases also surgically. If testicular torsion, i.e. twisting of the testicles, is the cause of testicular pain, an immediate operation is necessary. This is the only way to avoid damage to the testicles.

If other underlying diseases, such as herniated discs, hernias or varicose veins, are the cause of the testicular pain, these are treated depending on the clinical picture. A correct and comprehensive diagnosis is extremely important in order to treat testicular pain effectively and sustainably.

Outlook & forecast

If the pain results from a twisting of the testicles on the spermatic cord, the affected testicle can usually be saved through timely surgery. With a testicle fixation, the scrotum is opened, the twist corrected and the testicle is fixed with a suture inside the scrotum. The procedure is usually carried out prophylactically on the other testicle.

The testicular tissue dies after an interruption of the blood supply of about six to eight hours. If the patient has sought medical treatment too late, the only option for testicular torsion is amputation. The removal of a testicle reduces the sperm density in the ejaculate and consequently the fertility of the person concerned. The missing testicle can, however, be replaced by a plastic implant and at least the visual impairment can be eliminated.

If a testicular tumor is responsible for the pain, the person affected must expect it not only to grow rapidly, but also to form metastases in the inguinal and pelvic lymph nodes as well as in the lungs and bones. In advanced stages, the sick suffer from general weakness, severe weight loss and fever. If the testicular cancer is detected in time, the chances of recovery are almost 100 percent.

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prevention

Testicular pain cannot be prevented in all cases. However, preventive measures can very well be taken against the most common causes, the viral diseases and bacterial infections. In viral diseases, mumps is often the cause of the symptoms. It is therefore advisable to get vaccinated against mumps accordingly. Vaccination is possible as early as infancy and can reliably protect against infection with mumps.

Bacterial infections are often triggered by the pathogens causing gonorrhea. The best protection against gonorrhea is to use condoms during sexual intercourse. However, in some cases the pain has other causes. Then a prevention against testicular pain is hardly possible.

You can do that yourself

In most cases, testicular pain is harmless. They occur mainly after an accident or blow in this area and can be relatively painful. Here the testicles can be cooled, so the testicular pain is relieved. If the pain is very severe, pain killers can also be taken. However, these should not be taken over a long period of time.

Testicular pain after sex is a common symptom. Light massages and a cooling of the testicles help here. Elevating the testicles can also provide relief. To do this, the testicles must be removed from their hanging position by e.g. put rolled up socks underneath in an elevated position. In some cases, underwear that is too tight can lead to testicular pain. Here the patient should buy loose and not tight underwear.

In many cases, testicular pain also occurs as cavalier pain if the man does not ejaculate during intercourse. Here the testicular pain is completely harmless and disappears once ejaculation has occurred. A permanent erection can also extend into the testicles and cause testicular pain. In this case the erection should be stopped. If you experience painful urination in addition to testicular pain, a doctor should be consulted. In this case, it could be testicular cancer or inflammation.