Pain in the Scrotum: Causes and When to Seek Help

Pain in the scrotum between the testicles?

Doctor, I recently noticed that the area in the middle of my scrotum (the junction between the two testicles) hurts when I press down on it, which I didn't experience before.
There is some pain during erections, and sometimes mild pain even when not erect.
After ejaculation, I find it difficult to fall asleep, and I wake up even during nocturnal emissions, making it hard to get back to sleep.
I've also noticed a decrease in the frequency and duration of erections.
What could this indicate? I haven't been under much stress lately.
If I need to undergo tests, what kind of examinations should I consider?

Yangguang Nanbai, 20~29 year old female. Ask Date: 2006/09/26

Dr. Liu Jianting reply Urology

Are you feeling restless? Is there tenderness in the scrotal area? It could be prostatitis or urethritis.
Please visit a hospital to see a urologist for an examination.

Reply Date: 2006/09/26

More Info

Pain in the scrotum can be a concerning symptom, and it is important to understand the potential causes and when to seek medical help. The scrotum houses the testicles and is sensitive to various conditions that can lead to discomfort or pain. Here are some common causes of scrotal pain and the appropriate steps to take.

Common Causes of Scrotal Pain
1. Epididymitis: This is an inflammation of the epididymis, the tube that carries sperm from the testicles. It can be caused by infections, including sexually transmitted infections (STIs) or urinary tract infections (UTIs). Symptoms may include swelling, redness, and pain in the scrotum.

2. Testicular Torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. Symptoms include sudden, severe pain, swelling, and nausea. Immediate medical attention is required.

3. 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 scrotum, especially when lifting or straining.

4. Varicocele: This is an enlargement of the veins within the scrotum, similar to varicose veins. It can cause a dull ache or discomfort, especially after prolonged standing or physical activity.

5. Hydrocele: This is a fluid-filled sac around a testicle that can cause swelling and discomfort. It is usually painless but can lead to discomfort if it becomes large.

6. Trauma or Injury: Any injury to the groin area can lead to pain and discomfort in the scrotum.

7. Testicular Cancer: While less common, testicular cancer can present with pain or discomfort in the scrotum, often accompanied by a lump or swelling.

When to Seek Help
It is crucial to seek medical attention if you experience any of the following:
- Sudden, severe pain in the scrotum
- Swelling or redness in the scrotum
- Pain accompanied by nausea or vomiting
- A lump or mass in the testicle
- Changes in urination or sexual function
- Persistent pain that does not improve with rest or over-the-counter pain relief

Recommended Tests and Evaluations
If you are experiencing scrotal pain, a healthcare provider may recommend several tests to determine the cause:
1. Physical Examination: A thorough examination of the scrotum and testicles to check for swelling, tenderness, or abnormalities.

2. Ultrasound: This imaging test can help visualize the structures within the scrotum and identify conditions such as epididymitis, testicular torsion, or tumors.

3. Urinalysis: A urine test can help detect infections or other abnormalities.

4. Blood Tests: These may be performed to check for signs of infection or other underlying conditions.

5. STI Testing: If an infection is suspected, testing for STIs may be necessary.

Conclusion
Scrotal pain can arise from various conditions, some of which require immediate medical attention. Given your symptoms of pain during erection, discomfort after ejaculation, and changes in sexual function, it is advisable to consult a healthcare provider as soon as possible. They can conduct the necessary evaluations to determine the underlying cause and recommend appropriate treatment. Early intervention is key to preventing complications and ensuring optimal health.

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