Testicular Pain: Causes and When to Seek Medical Help

Testicular pain issues?

Hello Doctor, I haven't had this issue before, but recently, after starting to date a girlfriend, I've experienced prolonged erections during our dates.
After a while, my testicles (or possibly the nerves) start to ache subtly, which is quite uncomfortable.
Sometimes the pain lasts so long that my abdomen also hurts.
The only way to relieve it is to go home and masturbate, which makes me feel a bit better (sometimes during masturbation, the pain can be intense enough to make ejaculation difficult).
However, after one or two dates, I've only resolved the pain through masturbation and haven't paid attention to other issues.
During this recent date, my testicles started to hurt again.
When I got home, I touched the area above my left testicle (similar to where the epididymis is located) and felt a round mass inside.
If I don't touch it, the pain is just mild, but when I press on that round mass, it feels like the pain associated with the urge to ejaculate without being able to.
The round mass above the testicle is somewhat noticeable, resembling a small testicle growing above it.
I only discovered this issue today, and after some time post-masturbation, the pain in my testicles has subsided, and the small round mass in the epididymis area has disappeared.
Doctor, what condition do I have? Should I seek medical attention promptly?

Awei, 20~29 year old female. Ask Date: 2017/07/23

Dr. Xu Wencang reply Urology

You can go for an outpatient examination.

Reply Date: 2017/07/23

More Info

Testicular pain can be a concerning symptom, and it's important to understand the potential causes and when to seek medical help. Based on your description, it sounds like you may be experiencing a condition related to the testicles, possibly involving the epididymis, which is the structure located at the back of the testicle that stores and matures sperm.

Potential Causes of Testicular Pain
1. Epididymitis: This is an inflammation of the epididymis, often caused by infections, including sexually transmitted infections (STIs) or urinary tract infections. Symptoms can include swelling, pain, and sometimes fever.

2. Testicular Torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. Symptoms include sudden, severe pain, swelling, and nausea. This condition requires immediate medical attention.

3. Varicocele: This is an enlargement of the veins within the scrotum, which can cause a dull ache or discomfort, particularly after prolonged standing or physical activity.

4. Hernia: An inguinal hernia can cause pain in the groin or scrotum, especially when lifting or straining.

5. Hydrocele: This is a fluid-filled sac surrounding a testicle, which can cause swelling and discomfort.

6. Trauma or Injury: Any direct injury to the testicles can lead to pain and swelling.

7. Tumors: Although less common, testicular tumors can present as a lump or swelling in the testicle, accompanied by pain.

When to Seek Medical Help
Given your symptoms, especially the presence of a "round" mass near the epididymis and the pain associated with it, it is crucial to seek medical attention. Here are some guidelines on when to see a doctor:
- Persistent Pain: If the pain continues or worsens, it is essential to consult a healthcare provider.

- Swelling or Lumps: Any new lumps or swelling in the testicles should be evaluated by a doctor.

- Accompanying Symptoms: If you experience fever, nausea, vomiting, or changes in urination, seek medical help immediately.

- Pain During Sexual Activity: If you notice that sexual activity consistently leads to pain, this is a sign that something may be wrong.

Diagnostic Approach
When you visit a healthcare provider, they may perform a physical examination and may order tests such as:
- Ultrasound: This imaging test can help visualize the structures within the scrotum and identify any abnormalities.

- Urinalysis: To check for signs of infection.

- Blood Tests: To look for signs of infection or other underlying conditions.

Conclusion
In summary, while some testicular pain can be benign, your symptoms warrant a thorough evaluation by a healthcare professional. It's important not to ignore these symptoms, especially since you mentioned the presence of a lump and the pain associated with it. Early diagnosis and treatment can prevent complications and ensure your reproductive health is maintained. Please make an appointment with a urologist or your primary care physician as soon as possible to discuss your symptoms and receive appropriate care.

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