Testicular Pain and Erectile Issues: A Urology Perspective

Obstruction... slight pain?

Hello, I previously asked a question (on 8/12).
Currently, the "hematospermia" is no longer visible (should be resolved, right?).
However, I am still troubled by the softening of the penis or poor engorgement during DIY or intercourse.
I have noticed that when I get an erection, the left testicle experiences slight pain, and the penis, which already has poor engorgement, suddenly becomes soft.
It's hard to describe the exact location of the pain; I would say it is around the surface blood vessels of the left testicle and the vessels or nerves extending above it towards the middle of the penis.
I want to know when sexual activity will return to normal.
Is it really just stress? I don't think so; I don't feel any pressure.
Thank you for your response.
Feeling helpless.

ABC, 20~29 year old female. Ask Date: 2005/10/25

Dr. Xu Weikai reply Urology

Hello, after experiencing conditions such as hematospermia or other penile discomfort, it is common to have temporary sexual dysfunction, which may not necessarily be a physical issue and can sometimes be accompanied by psychological factors.
Generally, any pain in the penis can indeed affect erectile function, and it may take some time for it to gradually recover.
In clinical practice, I recommend that patients apply local heat therapy to help accelerate the resolution of local congestion.
This can be done for 5-10 minutes at a time, using a warm towel, at least three times a day.
As for when you can regain your sexual vigor, I cannot provide a specific answer.
Sincerely, Dr.
Hsu Wei-kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2005/10/25

More Info

Testicular pain and erectile issues can be complex and multifactorial, often requiring a thorough evaluation to determine the underlying causes. Based on your description, it seems you are experiencing discomfort in the left testicle during erections, along with erectile dysfunction (ED) characterized by poor blood flow and difficulty maintaining an erection. Let's break down these symptoms and discuss potential causes and treatment options.

Understanding Testicular Pain
Testicular pain can arise from various sources, including:
1. Injury or Trauma: Any recent injury to the groin area can lead to pain in the testicles.

2. Infection: Conditions like epididymitis (inflammation of the epididymis) or orchitis (inflammation of the testicle) can cause pain and swelling.

3. Varicocele: This is a condition characterized by enlarged veins within the scrotum, which can lead to discomfort and may affect fertility.

4. Hernia: An inguinal hernia can cause pain in the groin and testicular area.

5. Testicular Torsion: A medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. This usually presents with severe pain and requires immediate attention.

Given that you mentioned pain radiating from the left testicle to the penis, it could indicate vascular issues or nerve-related pain. Conditions like a varicocele or nerve entrapment could be contributing factors.

Erectile Dysfunction (ED)
Erectile dysfunction can be influenced by both physical and psychological factors:
1. Physical Causes: These can include vascular issues, hormonal imbalances (like low testosterone), neurological conditions, or side effects from medications.

2. Psychological Factors: Stress, anxiety, and depression can significantly impact sexual performance. Performance anxiety, in particular, can create a cycle of fear and dysfunction.

Diagnostic Approach
To address your symptoms effectively, a comprehensive evaluation is necessary. This may include:
- Physical Examination: A urologist will perform a physical examination to check for any abnormalities in the testicles and surrounding structures.

- Ultrasound: This imaging test can help identify issues like varicoceles, tumors, or other abnormalities.

- Blood Tests: Hormonal levels, including testosterone and other relevant markers, can be assessed.

- Urinalysis: To rule out infections or other urinary tract issues.

Treatment Options
1. Medications: Depending on the diagnosis, medications may be prescribed. For example, antibiotics for infections, or medications like phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) for erectile dysfunction.

2. Surgery: If a varicocele or hernia is diagnosed, surgical intervention may be necessary.

3. Lifestyle Changes: Addressing lifestyle factors such as diet, exercise, and stress management can improve overall health and potentially alleviate symptoms.

4. Counseling: If psychological factors are contributing to your erectile dysfunction, speaking with a mental health professional or sex therapist may be beneficial.

Conclusion
It is essential to consult with a urologist who can provide a tailored approach based on your specific symptoms and medical history. Early intervention can lead to better outcomes, so do not hesitate to seek professional help. Remember, you are not alone in this, and many men experience similar issues. With the right support and treatment, it is possible to regain confidence and improve your sexual health.

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