Testicular Trauma: Symptoms, Recovery, and When to Seek Help

Q: Testicular Trauma: Symptoms, Recovery, and When to Seek Help

Hello Mr. <br>Wu： Regarding what you mentioned, all of the above are possible, and a single ultrasound examination can address all your concerns. <br>Please come to the outpatient clinic so we can arrange for the ultrasound. <br>Otherwise, even if we tell you that everything is f

Testicular trauma?

Dear Doctor,
I apologize for reaching out again, as my previous concerns were not fully addressed by the last physician.
In early December, I sustained a strong impact to my left testicle (it was hit hard by a hand).
After visiting the hospital, the doctor performed a physical examination and visual inspection, stating that there was no significant issue and no bleeding.
The doctor mentioned that externally it appeared normal, and an ultrasound would yield the same results, so I was not given an ultrasound.
I was told it would improve in three to five days.
However, it has been three weeks, and although there has been some improvement, I still experience discomfort, including occasional sharp pain, especially when walking quickly or during vehicle vibrations (the pain is located approximately from the upper left side of the scrotum to the lower left groin area; I cannot pinpoint the sharp pain directly by touching the testicle).
Although the pain is frequent, it is not constant.
Taking a hot shower and lying flat provides some relief, but sitting upright in a chair causes a slight uncomfortable pressure on the left testicle.
Additionally, I feel that the left testicle is positioned significantly more forward compared to the right (more noticeable than before the injury).
I would like to ask you, Doctor Sun:
1.
Is it possible for a testicle to sustain internal damage or bleeding despite appearing asymptomatic externally after being struck?
2.
Can it take this long for a testicle to heal without any obvious external injury?
3.
Under what circumstances might testicular atrophy occur following trauma?
I am concerned that there may be internal damage or unseen blood clots within the scrotum leading to ischemic atrophy of the testicle.
4.
Should I return for further examination, or is it advisable to wait for natural recovery? (I consulted two different clinics the day after the injury and over a week later, both stating there was no issue, without performing an ultrasound, and prescribed pain relief medication.)
5.
If there are issues with the scrotum or epididymis, would they be visibly apparent?
I apologize for the numerous questions and appreciate your patience in addressing them.
Thank you, Doctor.

Wu, 20~29 year old female. Ask Date: 2020/12/24

Dr. Sun Hongshun reply Urology

Hello Mr.
Wu: Regarding what you mentioned, all of the above are possible, and a single ultrasound examination can address all your concerns.
Please come to the outpatient clinic so we can arrange for the ultrasound.
Otherwise, even if we tell you that everything is fine, it may not ease your mind.
With ultrasound, "seeing is believing." If everything is normal, congratulations, you can continue with your life; if there are issues, we will address them immediately to avoid delaying treatment.
What do you think?

Reply Date: 2020/12/24

More Info

Testicular trauma can be a concerning issue, especially when symptoms persist after an initial injury. Based on your description, it seems you experienced a significant impact to your left testicle, and while initial examinations suggested no major issues, you are still experiencing discomfort. Let’s address your questions one by one.

1. Can testicular trauma cause internal damage or bleeding without external symptoms?
Yes, it is possible for testicular trauma to result in internal injuries that are not immediately visible. The testicles are surrounded by a protective layer, and while external bruising may not be present, internal bleeding or damage to the testicular tissue can occur. This is why follow-up care is essential, as some injuries may not manifest symptoms until days or weeks later.

2. Is it normal for testicular trauma to take a long time to heal without obvious external signs?
Recovery from testicular trauma can vary significantly from person to person. While some individuals may heal quickly, others may experience lingering discomfort for weeks or even months. Factors such as the severity of the impact, individual pain tolerance, and any underlying conditions can influence recovery time. The intermittent sharp pain you describe, especially during movement, could be a sign of lingering inflammation or irritation.

3. Under what circumstances can testicular atrophy occur after trauma?
Testicular atrophy can occur if there is significant damage to the blood supply of the testicle, leading to ischemia (lack of blood flow). This can happen if there is a hematoma (a localized collection of blood outside of blood vessels) that compresses the blood vessels supplying the testicle. If the testicle is deprived of blood for an extended period, it may shrink or atrophy. Symptoms of atrophy may not be immediately noticeable, but changes in size or shape can occur over time.

4. Should you return for further evaluation or wait for natural recovery?
Given that you are still experiencing discomfort three weeks post-injury, it would be prudent to seek further evaluation. While initial assessments may have indicated no significant issues, persistent pain warrants a more thorough investigation. An ultrasound can provide valuable information about the internal structures of the testicle and help identify any potential complications, such as fluid accumulation or internal bleeding.

5. Will issues with the scrotum or epididymis be visibly apparent?
In many cases, problems with the scrotum or epididymis can present with visible signs such as swelling, redness, or changes in the shape of the testicle. However, not all issues will be externally visible. Conditions like epididymitis (inflammation of the epididymis) or a testicular torsion (twisting of the testicle) may present with pain but may not always show obvious external symptoms.
In conclusion, while the initial assessments may have indicated no serious injury, your ongoing symptoms suggest that further evaluation is necessary. It’s important to communicate your concerns with a healthcare provider who can perform a detailed examination and possibly order imaging studies to ensure that there are no underlying issues that need to be addressed. Remember, it’s always better to err on the side of caution when it comes to your health, especially with injuries involving the reproductive system.

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