Testicular Pain: Causes, Concerns, and Treatment Options

Testicular issues

Last Sunday night, I fell asleep and suddenly felt a lot of discomfort in my leg, later realizing it was actually pain in my right testicle.
On Monday, I noticed that the right testicle had ascended, but I didn't pay much attention to it.
By Tuesday, the pain had subsided, and it seemed like the scrotum had returned to its original position, but the right side appeared larger and the skin seemed thicker.
The next day, out of curiosity, I examined myself and found that the right testicle was still lower, while the left testicle could move around freely; only the right testicle was immobile and painful.
The pain has persisted for two days now.
Today is Friday, and I am unsure of the cause.
I hope a doctor can provide some answers.
Sitting or lying down does not cause pain, but walking does; any movement triggers discomfort.
It's not unbearable, but I am concerned that if it is testicular torsion lasting more than six hours, would it necessitate removal? If so, how long would the surgery take, and how many days would I need to stay in the hospital? I have an upcoming exam, so I hope to take the test before undergoing surgery.
Is it possible to postpone it until next Saturday or Sunday? I read online that a necrotic testicle can affect the healthy one, so I am unsure if I can wait that long.
One more question: if I lose my right testicle during puberty, what issues might arise? Since testicles produce male hormones, I am 16 years old and wonder if this will impact my future life or make me less masculine.

Xiao Xiao, 10~19 year old female. Ask Date: 2019/01/11

Dr. Liu Mingyue reply Urology

Hello, testicular swelling and pain are often due to inflammation.
If torsion occurs beyond the critical time window, surgical removal is necessary.
It is recommended to see a urologist for an examination as soon as possible.

Reply Date: 2019/01/11

More Info

Testicular pain can be a concerning symptom, especially when it presents suddenly and is accompanied by changes in the position or size of the testicles. Based on your description, it seems you are experiencing pain primarily in the right testicle, which has also shown signs of swelling and a change in its position. This situation warrants careful consideration and evaluation.

Causes of Testicular Pain:
1. Testicular Torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. Symptoms typically include sudden, severe pain, swelling, and sometimes nausea. If not treated within a few hours, it can lead to the loss of the testicle.

2. Epididymitis: This is an inflammation of the epididymis, often caused by infections. Symptoms may include pain, swelling, and tenderness in the affected testicle.

3. Inguinal Hernia: This occurs when tissue protrudes through a weak spot in the abdominal muscles, which can cause pain in the groin and testicular area.

4. Trauma or Injury: Any direct injury to the testicles can result in pain and swelling.

5. Varicocele or Hydrocele: These conditions involve swelling due to enlarged veins or fluid accumulation around the testicle, respectively, and can cause discomfort.

Concerns:
Given that you have experienced pain for several days and noted changes in the size and position of your right testicle, it is crucial to seek medical attention as soon as possible. Testicular torsion, if present, requires immediate surgical intervention to prevent irreversible damage. The longer the testicle remains twisted, the higher the risk of losing it.

Treatment Options:
1. Immediate Evaluation: You should see a healthcare provider or go to the emergency room for a thorough examination. An ultrasound may be performed to assess blood flow to the testicle and to identify any abnormalities.

2. Surgical Intervention: If testicular torsion is confirmed, surgery is typically performed to untwist the spermatic cord and secure the testicle to prevent recurrence. The procedure is usually done under general anesthesia and can often be completed within an hour.

3. Recovery: Post-surgery, most patients can go home the same day or the following day, depending on their condition. Pain management and follow-up care will be provided.

4. Long-term Considerations: If a testicle is lost due to torsion, it can affect hormone production and fertility, but many men lead normal lives with one testicle. Hormonal levels can be monitored, and if necessary, testosterone replacement therapy can be discussed.

5. Psychological Impact: Concerns about masculinity or sexual function are common, but it’s important to remember that many men with one testicle lead healthy, fulfilling lives. If you have concerns about your body image or masculinity, speaking with a counselor or therapist can be beneficial.

Conclusion:
Do not delay seeking medical attention. The potential for serious complications from conditions like testicular torsion makes it imperative to act quickly. Your health and well-being should take precedence over any upcoming exams. A healthcare professional can provide you with the best advice tailored to your situation, ensuring that you receive the appropriate care and support.

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