Testicular Pain: Causes, Concerns, and When to Seek Help

Q: Testicular Pain: Causes, Concerns, and When to Seek Help

Hello： 1. <br>If you're still concerned, you should go to the hospital for an examination. <br>However, the critical time for addressing a torsion has already passed, so it's likely not the case. <br>2. <br>It can be painful, but some people are able to tolerate it, which is why

Testicular issues

Hello Doctor: I would like to ask you a few questions.
Recently, I have been experiencing a dull ache in my right testicle, specifically in the area near the pubic hair and the inner thigh, rather than directly on the testicle itself.
Last Wednesday, I felt the pain once, but after sleeping, it went away.
Then, this Monday, I started to feel discomfort again, but once again, it improved after sleeping.
However, after some activity, the discomfort returned.
The pain is not severe; since the announcement of graduate school results, I have been sitting at my computer desk most of the time, although I do occasionally get up to move around.
Yesterday, I visited a nearby urology clinic, and after an examination, the doctor suggested that the discomfort might be due to prolonged sitting causing venous congestion, and he indicated that it is unlikely to be testicular torsion.
He mentioned that if it were torsion, I would be in severe pain and would be crying out in agony, and that torsion typically occurs during puberty and is more common at night.
Since I am 23 years old, the likelihood is lower.
The doctor prescribed medication but did not perform an ultrasound.
Therefore, I would like to inquire: 1.
Should I go to the hospital for an ultrasound? Currently, I am experiencing a dull ache, but it is not severe pain, and the scrotum appears to have a normal shape.
When I palpate, lift, or pull the testicle, it does not hurt, and both testicles feel the same size.
2.
Does testicular torsion cause severe pain? Are there patients who do not experience pain? 3.
I found that varicocele is more common on the left side, but I am experiencing it on the right side? 4.
Can varicocele lead to testicular necrosis? I apologize for the many questions, and I appreciate your response!

Weiwei, 20~29 year old female. Ask Date: 2017/01/25

Dr. Du Shixi reply Urology

Hello: 1.
If you're still concerned, you should go to the hospital for an examination.
However, the critical time for addressing a torsion has already passed, so it's likely not the case.
2.
It can be painful, but some people are able to tolerate it, which is why they may miss the opportunity for treatment.
3.
You probably do not have varicocele to a significant degree; it may just be poor circulation due to prolonged sitting.
The extent can be assessed using ultrasound.
4.
Thank you for your inquiry.
I recommend that you avoid sitting for too long (make sure to get up and move around periodically, and drink plenty of water).

Reply Date: 2017/01/25

More Info

Testicular pain can be a concerning symptom, and it's important to understand the potential causes, when to seek medical help, and how to manage the discomfort. Based on your description, it seems you are experiencing discomfort primarily in the right testicle, near the groin and inner thigh area. This type of pain can arise from various factors, and it's good that you've already consulted a urologist.

1. Should You Get an Ultrasound?
Given that your pain has persisted for several days and is recurring, it may be prudent to consider further imaging, such as an ultrasound. While your urologist assessed that it might be related to prolonged sitting and venous congestion, an ultrasound can help rule out other potential issues, such as testicular torsion, epididymitis, or even a hernia. An ultrasound is a non-invasive procedure that can provide valuable information about the structure of the testicles and surrounding tissues.

2. Understanding Testicular Torsion
Testicular torsion is a medical emergency that occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle. This condition typically presents with sudden, severe pain, often accompanied by nausea and vomiting. While it is true that torsion is more common in adolescents, it can occur at any age. In some rare cases, individuals may experience less intense pain, but this is not typical. If you ever experience sudden, severe pain, swelling, or changes in the appearance of the testicle, seek immediate medical attention.

3. Varicocele and Its Implications
You mentioned concerns about varicocele, which is an enlargement of the veins within the scrotum. While it is more commonly found on the left side, it can occur on the right side as well. Varicoceles can lead to discomfort and may affect fertility, but they do not typically cause testicular necrosis (death of the testicle). However, if left untreated, they can lead to complications over time. If your discomfort persists or worsens, discussing the possibility of varicocele with your urologist might be beneficial.

4. Potential Causes of Your Symptoms
The discomfort you are experiencing could be attributed to several factors, including:
- Muscle Strain: Prolonged sitting can lead to muscle tension or strain in the groin area, which may cause referred pain to the testicle.

- Nerve Irritation: Nerves that innervate the testicular area can become irritated due to posture or prolonged sitting.

- Infection or Inflammation: Conditions such as epididymitis (inflammation of the epididymis) can cause discomfort and may require antibiotic treatment.

5. When to Seek Help
You should seek immediate medical attention if you experience:
- Sudden, severe pain in the testicle
- Swelling or changes in the appearance of the testicle
- Nausea or vomiting accompanying the pain
- Fever or chills
In conclusion, while your symptoms may not currently indicate a severe condition, it is essential to monitor them closely. If the discomfort persists or worsens, or if you develop new symptoms, do not hesitate to follow up with your healthcare provider. An ultrasound may provide peace of mind and help rule out any serious conditions. Remember, taking care of your health is paramount, and seeking help when needed is a sign of strength.

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