Testicular Pain: Causes and Concerns for Men - Urology

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Testicular pain can be a distressing symptom for many men, and understanding its potential causes is crucial for effective management. Based on your description, it seems you are experiencing pain localized to the right testicle, which worsens when sitting and may radiate to the lower abdomen and thigh. Additionally, you mentioned experiencing a burning sensation during urination, particularly after sexual activity or masturbation.

Potential Causes of Testicular Pain
1. Epididymitis: This is an inflammation of the epididymis, the tube that stores and carries sperm. It can cause localized pain and may be associated with urinary symptoms. This condition is often caused by infections, including sexually transmitted infections (STIs) like chlamydia or gonorrhea.

2. Testicular Torsion: Although you mentioned that you have had a fixation procedure in the past, torsion can still occur in rare cases. This is a medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. Symptoms include sudden, severe pain and swelling.

3. Varicocele: This condition involves the enlargement of veins within the scrotum, similar to varicose veins. It can lead to a feeling of heaviness or aching in the testicle, especially after prolonged sitting or standing.

4. Hernia: An inguinal hernia can cause pain in the groin and may extend to the testicular area. This occurs when tissue pushes through a weak spot in the abdominal muscles.

5. Nerve Pain: Sometimes, pain can be referred from other areas, such as the lower back or abdomen, due to nerve irritation or compression.

6. Chronic Testicular Pain: This can occur without a clear cause and may be related to previous injuries or surgeries.


Urinary Symptoms
The burning sensation during urination, especially after sexual activity, could indicate a urinary tract infection (UTI) or prostatitis (inflammation of the prostate). These conditions can cause discomfort during urination and may be associated with other symptoms like increased frequency or urgency.


Recommendations
1. Medical Evaluation: Given the persistence and nature of your symptoms, it is essential to seek a thorough evaluation from a healthcare provider, preferably a urologist. They may perform a physical examination, ultrasound, and possibly urine tests to identify any underlying conditions.

2. Avoid Irritants: Until you can see a doctor, consider avoiding activities that may exacerbate your symptoms, such as prolonged sitting or vigorous sexual activity.

3. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen may help alleviate discomfort, but consult with a healthcare provider before taking any medication.

4. Hydration and Hygiene: Ensure you stay well-hydrated and maintain good genital hygiene, especially after sexual activity, to reduce the risk of infections.

5. Monitor Symptoms: Keep track of your symptoms, including their frequency, intensity, and any associated factors, to provide your healthcare provider with detailed information during your visit.


Conclusion
While some testicular pain can be benign, it is crucial to address any persistent or worsening symptoms with a healthcare professional. Early diagnosis and treatment can prevent complications and provide relief. Your history of vascular changes in the left testicle may also warrant further investigation, as it could be related to your current symptoms. Remember, it’s always better to err on the side of caution when it comes to your health.