Testicular and Lower Abdominal Pain: Causes and Solutions

Testicular and lower abdominal pain?

Hello, my condition is that for the past week, I have frequently been visiting many pornographic websites, resulting in prolonged erections and the release of a significant amount of prostatic fluid.
I have experienced repeated long-lasting erections without ejaculation, which has led to testicular pain, a feeling of heaviness, and pain on both sides near the pubic area in the lower abdomen.
There is also tenderness when pressure is applied, and at times, I feel a burning sensation in the perineum or anal area.
These pain symptoms are more pronounced when standing, while lying down seems to provide slight relief.
The symptoms tend to improve the next day after waking up, but they recur with any sexual arousal or erection.
Essentially, the pain does not subside unless I am asleep, and it has persisted for five days.
I have visited a clinic, where they advised me to take pain relievers and urological medication, as well as undergo blood and urine tests, and return for a follow-up to determine the cause.
However, I am struggling to tolerate this pain, so I would like to ask the doctor which part might be problematic: the testicles or the prostate? What should I do? Thank you!

Niming, 20~29 year old female. Ask Date: 2016/03/29

Dr. Li Xinyi reply Urology

Frequent sexual activity may indicate a loss of balance in life, which is generally not good.
It sounds like there may be prostatitis.
Recovery will take time, so it's important to rest well and maintain a healthy lifestyle.
Continue to follow up with urology for examinations and medication treatment to gradually improve.

Reply Date: 2016/03/29

More Info

Understanding testicular and lower abdominal pain can be quite complex, especially when symptoms are intertwined with sexual arousal and prolonged erections. Based on your description, it appears that you are experiencing a combination of discomfort in the testicular area, lower abdomen, and perineum, which may be linked to a few potential causes.

Possible Causes
1. Epididymitis: This is an inflammation of the epididymis, often caused by infection or trauma. Symptoms typically include testicular pain, swelling, and sometimes fever. The pain can be exacerbated by sexual arousal or prolonged erections.

2. Testicular Torsion: Although this is less likely given that your symptoms have persisted for several days without acute severe pain, it is a medical emergency that involves the twisting of the spermatic cord, cutting off blood supply to the testicle. This condition usually presents with sudden, severe pain and requires immediate medical attention.

3. Prostatitis: Inflammation of the prostate gland can cause pain in the lower abdomen, perineum, and testicles. It can be acute or chronic and may be associated with urinary symptoms.

4. Pelvic Floor Dysfunction: Prolonged sexual arousal without ejaculation can lead to pelvic floor muscle tension, resulting in discomfort in the pelvic region, including the testicles and lower abdomen.

5. Nerve Irritation: Sometimes, nerve irritation in the pelvic area can lead to referred pain in the testicles and lower abdomen. This can be exacerbated by activities that involve prolonged sitting or certain sexual activities.

Recommendations for Management
1. Pain Management: Since you have already been prescribed pain relief and medications for urinary symptoms, continue to follow your doctor's advice. Over-the-counter NSAIDs (like ibuprofen) can also help reduce inflammation and pain.

2. Avoid Prolonged Arousal: It may be beneficial to limit activities that lead to prolonged erections without ejaculation. This can help reduce the discomfort associated with pelvic congestion.

3. Pelvic Floor Exercises: Engaging in pelvic floor exercises (Kegel exercises) can help strengthen the muscles in that area and may alleviate some discomfort. However, if you experience pain while doing these exercises, stop and consult a healthcare provider.

4. Hydration and Diet: Ensure you are well-hydrated and maintain a balanced diet. Sometimes, dietary changes can help with pelvic health.

5. Follow-Up with Healthcare Provider: Since your symptoms have persisted for five days, it is essential to follow up with your healthcare provider. They may recommend further diagnostic tests, such as an ultrasound of the scrotum or a urinalysis, to rule out any serious conditions.

6. Consider a Urologist Consultation: If your symptoms do not improve or worsen, consider seeing a urologist who specializes in male reproductive health. They can provide a more in-depth evaluation and tailored treatment options.

Conclusion
While the symptoms you are experiencing can be distressing, they are often manageable with appropriate care and lifestyle adjustments. It is crucial to communicate openly with your healthcare provider about your symptoms and any changes you notice. They can help you navigate this situation and ensure that any underlying issues are addressed effectively. Remember, your health and comfort are paramount, and seeking help is a positive step towards resolution.

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