Testicular Pain: Is It Varicocele or Something Else?

Is it varicocele?

After intimate moments with my girlfriend, if I don't ejaculate immediately, my testicles start to feel swollen and painful after a while.
Sometimes the pain is so intense that I can't stand up straight.
If I relieve myself through masturbation during this time, the symptoms improve a bit.
I read online that the symptoms of varicocele seem similar to mine, but isn't varicocele related to "venous" obstruction? I think I might have a blockage in the "vas deferens" (where the semen gets trapped in the vas deferens and doesn't get ejaculated).
Additionally, I don't experience testicular pain during intense exercise or when straining my abdomen.
When I palpate, there doesn't seem to be any worm-like protrusions, but I do feel that my testicles are very swollen and hard.
I'm quite confused.
There seems to be a condition called spermatocele that resembles my situation, but the information indicates that spermatocele shouldn't be painful, right? Will my condition affect my fertility? Could you please provide me with some answers, doctor? I would greatly appreciate it.

robert, 20~29 year old female. Ask Date: 2003/10/13

Dr. Lin Hexing reply Urology

Hello Robert, experiencing a feeling of swelling or soreness in the testicles during sexual activity without ejaculation is a normal response.
Typically, during the final stages of sexual activity, the prostate gland also becomes engorged.
If one frequently engages in sexual activity without ejaculation, it may lead to conditions such as benign prostatic hyperplasia.
The symptoms you described are not indicative of varicocele.
A spermatocele is a cystic structure that arises from the epididymis, usually located above the testicle, and may result from inflammation, obstruction, or trauma, rather than the hardness of the testicle as you mentioned.
Your condition should not affect your fertility; however, it is advisable to have a proper understanding of normal sexual behavior.
If you are not married, it is important to practice safe sex with your girlfriend and avoid situations where you engage in sexual activity without ejaculation, as this can be detrimental to your health.

Reply Date: 2003/10/13

More Info

Testicular pain can be a complex issue, and it's understandable that you're feeling confused about your symptoms. Based on your description, it seems like you are experiencing discomfort in your testicles after sexual arousal without ejaculation, which can lead to a feeling of fullness or pressure. This is a common phenomenon known as "blue balls" or epididymal hypertension, where the blood flow to the testicles increases during arousal, and if ejaculation does not occur, it can result in discomfort or pain.

You mentioned the possibility of a varicocele, which is an enlargement of the veins within the scrotum. Varicoceles can cause a dull ache or a feeling of heaviness in the testicles, and they are often more noticeable when standing or during physical activity. However, the pain associated with varicocele typically does not occur specifically after sexual arousal and is usually more chronic in nature.
Your concern about a blockage in the vas deferens (the duct that carries sperm from the testicles) is also valid. If there is a blockage, it could potentially lead to a buildup of sperm, which might cause discomfort. However, this condition is less common and usually presents with other symptoms, such as swelling or a noticeable mass in the scrotum.

You also mentioned spermatocele, which is a cyst that can develop in the epididymis (the tube that stores and carries sperm). While spermatoceles are generally painless, they can sometimes cause discomfort if they become large enough or if they exert pressure on surrounding structures.

Regarding your concern about fertility, while testicular pain itself does not directly affect fertility, the underlying cause of the pain could potentially have implications. For instance, if there is a significant blockage or if a varicocele is present, it could impact sperm production or quality. It’s important to have a thorough evaluation to determine the exact cause of your symptoms.

In summary, your symptoms could be related to several conditions, including epididymal hypertension, varicocele, or possibly a blockage in the reproductive tract. It is advisable to consult a urologist who can perform a physical examination and possibly order imaging tests, such as an ultrasound, to assess the condition of your testicles and surrounding structures. This will help in diagnosing the issue accurately and determining the best course of action for treatment.
In the meantime, if you find that ejaculation alleviates your discomfort, it may be a temporary solution, but it’s crucial to address the underlying cause to prevent any long-term complications. Remember, open communication with your healthcare provider is key to managing your symptoms effectively.

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