Testicular Trauma: Symptoms, Hormonal Impact, and Fertility Concerns

Testicular issues

Hello Doctor: When I was in middle school, I sustained an impact to my right testicle, which caused immediate pain so severe that I could not breathe.
Since then, I have experienced ongoing pain, and even now while studying in graduate school, I still occasionally feel discomfort, although it is bearable.
After the injury, my right testicle has become very prone to twisting, and I experience pain even when it is not twisted, particularly when it changes position to horizontal.
When I touch it, the position of the testicle and the epididymis (the soft tissue on top of the testicle) feels unusual; it seems like the epididymis is not properly attached to the testicle.
Could it be that the epididymis has shifted and is no longer fixed to the testicle? Additionally, could the injury to the testicle affect hormone secretion? I have noticed that my hair has been falling out more easily since then, which raises concerns about potential endocrine disorders.
Lastly, I would like to know if this long-standing issue could lead to infertility or other symptoms, as I have observed that my semen has become increasingly thin, with varying amounts and sometimes a yellowish tint instead of white.
I am also curious if the spermatic cord or other nearby organs could be pressing on my bladder, as I did not used to experience frequent urination, and now I urinate less each time, with a weaker stream (could this be related to a previous incident of holding it in too long?).
The symptoms began after that incident.
Thank you, Doctor! I really hope you can provide me with answers, as I am eager to understand the reasons behind these issues.

Xiao Ming, 20~29 year old female. Ask Date: 2018/03/22

Dr. Xu Wencang reply Urology

You can go for an outpatient examination.

Reply Date: 2018/03/22

More Info

Testicular trauma can have a variety of implications, including pain, hormonal changes, and potential fertility issues. Based on your description, it seems that you experienced a significant injury to your right testicle during middle school, which has led to ongoing discomfort and changes in your testicular anatomy and function.

Symptoms of Testicular Trauma
The symptoms you are experiencing, such as persistent pain, changes in the position of the testicle, and discomfort during certain movements, are not uncommon following a traumatic injury. Testicular trauma can lead to conditions like testicular torsion, where the spermatic cord becomes twisted, cutting off blood supply to the testicle. This can cause severe pain and requires immediate medical attention. If you feel that your testicle is moving or positioned abnormally, it is crucial to seek evaluation from a healthcare professional.

Hormonal Impact
Regarding hormonal impact, the testicles are responsible for producing testosterone, which plays a vital role in male health, including hair growth, libido, and overall well-being. Trauma to the testicles can potentially affect hormone production. If you have noticed increased hair loss, it could be related to hormonal imbalances, possibly stemming from your injury. However, hair loss can also be influenced by various factors, including genetics, stress, and overall health.

Fertility Concerns
As for fertility, testicular trauma can impact sperm production and quality. The changes you described in your semen, such as decreased volume and color changes, could indicate underlying issues. The consistency and appearance of semen can be affected by various factors, including hydration, frequency of ejaculation, and potential damage to the reproductive system. If you are concerned about fertility, it would be wise to undergo a semen analysis and consult with a urologist or fertility specialist.

Urinary Symptoms
Your urinary symptoms, including increased frequency and decreased force of urination, could be related to several factors. While it is less common for testicular trauma to directly affect bladder function, it is possible that the injury has led to some degree of nerve damage or pelvic floor dysfunction. Additionally, if there is any swelling or structural changes in the area, it could potentially impact the bladder or urethra. If these symptoms persist, it is advisable to consult a healthcare provider for a thorough evaluation.

Conclusion
In summary, the ongoing pain, changes in testicular position, hormonal fluctuations, and urinary symptoms you are experiencing warrant a comprehensive evaluation by a healthcare professional. It is essential to address these concerns, as they could indicate underlying issues that may affect your overall health and fertility. A urologist can provide a detailed examination, possibly including imaging studies and hormone level assessments, to determine the best course of action for your situation. Early intervention can often lead to better outcomes, so do not hesitate to seek medical advice.

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