Left Testicular Pain: Causes, Symptoms, and Treatment Options

One night, I felt an urge to have a bowel movement, which resulted in pain in my left testicle?

Two years ago, I started experiencing a sensation of incomplete bladder emptying.
During the past two years, I faced significant stress from moving twice.
I have a habit of drinking craft beer, about 600ml twice a week, with an alcohol content of 8-10%.
In the last three months, I changed jobs and have been doing more squatting movements, which adds to my stress, spending about one to three hours a day in a squatting position, only standing up to urinate.
At night, I have a habit of kicking off the blanket, so I am often exposed to the air conditioning and fan, which cools my abdomen and feet.
Recently, due to the hot weather, I have been taking cold showers to save on electricity.

About six weeks ago, I experienced symptoms of balanitis, which I treated with medication.
However, three to four weeks later, I woke up around 5 AM with pain in my left abdomen and left testicle, feeling a pulling sensation on both sides.
After having a bowel movement, the pain improved significantly, but I then began to experience persistent pain in the left testicle, abdominal pain, and soreness extending to my left thigh, which has become increasingly noticeable.
Lying down does not alleviate the pain; instead, it continues to feel bloated and sharp.
I visited a urology clinic where the doctor performed a physical examination and diagnosed me with mild varicocele, prescribing pain relievers and muscle relaxants.
After three days with little effect, I endured the pain for another three days before going to a larger hospital.
There, the doctor conducted a physical examination and a urinalysis, stating that everything was normal with no bacteria or red blood cells, and it was not varicocele.
The doctor mentioned that many cases have unknown causes and prescribed Suprax 250mg, two tablets a day for two weeks.
I have been taking it for six days and feel a very slow improvement, although I still occasionally experience sharp pain.
While riding my motorcycle, I feel a slight fullness in my testicles, but it is not very pronounced.
This situation has left me physically and mentally exhausted.
Currently, I have taken a week off work, sit on a small stool, avoid alcohol, drink more water, eat walnuts and pumpkin seeds, ensure the air conditioning does not blow directly on me, and take warm showers.
I also had a decayed tooth extracted.
I would like to ask the doctor what disease this might be, how I should manage it, and what steps I can take to improve my condition further.
Could you also recommend a hospital in Taichung City? Thank you for your help and assistance, doctor.

Qi, 30~39 year old female. Ask Date: 2016/08/21

Dr. Sun Hongshun reply Urology

Hello, since you have already consulted two urologists, I am unable to provide further advice on urological conditions based on your description.
I recommend that you visit a nearby family medicine clinic to help identify the underlying cause.
Conditions such as work-related strains, spinal compression, liver issues due to long-term alcohol consumption, and bowel habits could all potentially contribute to the symptoms you are experiencing.
Identifying the cause is essential for further treatment.

Reply Date: 2016/08/21

More Info

Understanding left testicular pain can be complex, as it may stem from a variety of causes, ranging from benign to more serious conditions. Based on your description, it seems that your symptoms have evolved over time and are associated with several factors, including lifestyle changes, stress, and previous medical issues.

Potential Causes of Left Testicular Pain
1. Epididymitis: This is an inflammation of the epididymis, often caused by infections. Symptoms typically include swelling, pain, and sometimes fever. Given your previous experience with glans inflammation, this could be a possibility, although you mentioned that it has resolved.

2. Varicocele: You mentioned that a urologist diagnosed you with mild varicocele. This condition involves the enlargement of veins within the scrotum and can lead to discomfort and pain, especially after prolonged standing or physical activity. It is often described as a "pulling" sensation, which aligns with your experience.

3. Inguinal Hernia: This occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. It can cause pain in the groin and testicular area, particularly when lifting or straining.

4. Testicular Torsion: Although this is a medical emergency, it is characterized by severe, sudden pain and swelling. It typically requires immediate surgical intervention. Your symptoms do not seem to align with this condition, but it’s important to be aware of it.

5. Nerve Irritation or Compression: Given your history of prolonged sitting and deep squatting, it’s possible that nerve irritation in the lumbar or sacral region could be contributing to your pain. This might explain the radiating discomfort to your thigh and abdomen.

6. Psychosomatic Factors: Stress and anxiety can manifest as physical symptoms, including pain. The stress from moving, changing jobs, and lifestyle adjustments could be exacerbating your discomfort.

Recommended Management Strategies
1. Continued Medical Evaluation: Since you have already seen multiple specialists, it may be beneficial to consult with a urologist who specializes in chronic pelvic pain or a pain management specialist. They can provide a more comprehensive evaluation and possibly recommend imaging studies like an ultrasound to rule out any structural issues.

2. Pain Management: You mentioned that you have been prescribed medication, including a muscle relaxant and pain relievers. If these are not effective, discussing alternative medications or therapies with your doctor may be warranted. Options could include nerve blocks or physical therapy.

3. Lifestyle Modifications: You are already making positive changes by avoiding alcohol, staying hydrated, and using warm baths. Continuing these practices can help reduce inflammation and improve overall well-being. Additionally, consider incorporating gentle stretching and strengthening exercises for your pelvic floor and lower back, which may alleviate some discomfort.

4. Stress Management: Since stress can exacerbate physical symptoms, engaging in relaxation techniques such as mindfulness, yoga, or deep-breathing exercises may help manage both your mental and physical health.

5. Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment as necessary. If your symptoms worsen or new symptoms arise, seek immediate medical attention.

Recommendations for Hospitals in Taichung
While I cannot provide specific hospital recommendations, I suggest looking for hospitals with a reputable urology department or those known for their pain management clinics. You can also check online reviews or ask for referrals from your primary care physician.

In conclusion, left testicular pain can arise from various causes, and a thorough evaluation is essential for effective management. By continuing to work closely with your healthcare providers and making lifestyle adjustments, you can improve your symptoms and overall quality of life.

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