Testicular Pain: Causes and When to Seek Help - Urology

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Testicular pain can be a concerning symptom, and it’s important to understand the potential causes and when to seek further medical help. Based on your description, it seems you are experiencing intermittent pain in the left testicle, particularly in the area behind and below it. You also mentioned that this pain feels similar to a bruise and that you can sometimes feel what seems like a blood vessel in that area.
There are several possible causes for testicular pain, and they can range from benign to more serious conditions. Here are some common causes:
1. Epididymitis: This is an inflammation of the epididymis, the tube that stores and carries sperm. It can cause pain and swelling in the testicle and is often due to infection, which can be bacterial or viral. Symptoms may include redness, warmth, and tenderness in the affected area.

2. Orchitis: This is inflammation of one or both testicles, which can be caused by infections, including viral infections like mumps. Orchitis can lead to swelling and pain.

3. Testicular torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. It usually presents with sudden, severe pain and requires immediate surgical intervention.

4. Varicocele: This is an enlargement of the veins within the scrotum, which can cause a dull ache or discomfort. It is often described as feeling like a "bag of worms."
5. Hernia: An inguinal hernia occurs when tissue protrudes through a weak spot in the abdominal muscles. This can cause pain in the groin or scrotum.

6. Trauma: Any injury to the testicles can lead to pain and discomfort, which may feel like bruising.

7. Tumors: Although less common, testicular tumors can cause pain and should be evaluated by a healthcare professional.

Given that you have already seen a urologist and they did not find any signs of varicocele or hernia, it is possible that your symptoms could be related to epididymitis or another benign condition. However, the fact that you are experiencing intermittent pain and that it seems to be localized to a specific area warrants further investigation.

Here are some recommendations:
- Keep a symptom diary: Note when the pain occurs, its intensity, and any activities that may trigger it. This information can be helpful for your healthcare provider.

- Follow up with your urologist: Since the pain persists, it would be wise to return to your urologist for further evaluation. They may consider additional tests, such as an ultrasound, to assess for any underlying issues that may not have been apparent during your initial visit.

- Avoid self-diagnosis: While it’s tempting to try to diagnose yourself based on symptoms, it’s crucial to rely on professional medical advice. Conditions like epididymitis can sometimes be treated with antibiotics if an infection is present.

- Monitor for additional symptoms: If you experience swelling, redness, fever, or any changes in urination, seek medical attention promptly, as these could indicate a more serious condition.

In conclusion, while your symptoms may be benign, it’s essential to keep an open line of communication with your healthcare provider and seek further evaluation if the pain persists or worsens. Testicular pain should never be ignored, and timely intervention can help prevent complications.