Intermittent Pain in Left Testicle: Causes and Treatment Options - Urology

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Intermittent pain in the left testicle?


Hello doctor, the night before I was supposed to fall asleep, I suddenly experienced severe discomfort due to acute pain in my testicles.
I went to the emergency room for an examination.
The results showed that the doctor used an imaging device to check the blood flow to my testicles, which was normal, thus ruling out testicular torsion.
However, my urinalysis showed no abnormalities.
At that moment, I still experienced testicular pain, but it subsided after about two hours.
Could you please tell me what symptoms I am experiencing and how to treat them?

Ge Da Pao, 10~19 year old female. Ask Date: 2022/09/28

Dr. Li Minghui reply Urology


Hello: Generally, there is no clear reason.
It is important to observe and avoid engaging in strenuous exercise for the time being.
Wishing you good health.

Reply Date: 2022/09/28

More Info


Intermittent pain in the left testicle can be concerning and may arise from various causes. Given your recent experience of acute pain that prompted an emergency visit, it's essential to consider several potential conditions that could lead to such symptoms.

1. Epididymitis: This is an inflammation of the epididymis, the tube that carries sperm from the testicle. It can be caused by infections, including sexually transmitted infections (STIs) or urinary tract infections (UTIs). Symptoms often include swelling, tenderness, and pain in the affected testicle, which may be intermittent.

2. Orchitis: Similar to epididymitis, orchitis is inflammation of the testicle itself, often due to viral infections (like mumps) or bacterial infections. It can cause significant discomfort and swelling.

3. Testicular Torsion: Although your doctor ruled this out based on blood flow assessment, it's worth noting that testicular torsion typically presents with sudden, severe pain and requires immediate medical attention. It occurs when the spermatic cord becomes twisted, cutting off blood supply to the testicle.

4. Inguinal Hernia: An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. This can cause pain in the groin or testicle, especially when straining or lifting.

5. Varicocele: This condition involves enlarged veins within the scrotum and can cause a dull ache or discomfort, particularly after prolonged standing or physical activity.

6. Referred Pain: Sometimes, pain in the testicle can be referred from other areas, such as the lower back or abdomen. Conditions affecting the kidneys or ureters, like kidney stones, can also cause testicular pain.

Given that your pain was intermittent and resolved after a couple of hours, it may suggest a less acute issue, such as epididymitis or a mild strain. However, since you experienced significant discomfort, it’s crucial to monitor your symptoms closely.


Treatment Options:
1. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage discomfort.
2. Rest and Ice: Applying ice packs to the affected area and resting can alleviate pain and reduce swelling.

3. Antibiotics: If an infection is suspected, your doctor may prescribe antibiotics, especially if symptoms suggest epididymitis or orchitis.

4. Follow-Up Care: Since your symptoms are intermittent, it’s advisable to follow up with a urologist. They may recommend further tests, such as an ultrasound, to rule out any underlying conditions that might not have been evident during your emergency visit.

5. Lifestyle Modifications: Avoiding heavy lifting and strenuous activities until the pain resolves can help prevent exacerbation of symptoms.

6. Surgical Options: In cases where a structural issue is identified (like a hernia or varicocele), surgical intervention may be necessary.

In conclusion, while your initial evaluation ruled out some serious conditions, ongoing monitoring and follow-up with a healthcare provider are essential to ensure that any underlying issues are addressed. If you experience any worsening symptoms, such as increased pain, swelling, fever, or changes in urination, seek medical attention promptly.

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