Testicular Pain: When to Seek Urological Evaluation

Q: Testicular Pain: When to Seek Urological Evaluation

Mr. <br>Chen： 1. <br>There is a dull pain at the upper right corner of the penis, about 3 cm in, accompanied by testicular discomfort. <br>This could be due to the pain from the testicles radiating through the nerves to the mentioned area. <br>Possible causes of testicular pain i

Should I get tested?

Hello, Doctor.
I am experiencing pain in my testicles, and sometimes I feel a dull ache in the upper right side of my penis, about 3 centimeters from the tip.
Additionally, my testicles occasionally feel sore.
What could be the cause of this? I have also noticed that my semen is always a yellowish color.
Does this indicate a problem with my testicles? Should I undergo a semen analysis?
I haven't masturbated for a while; will this affect the quality of the semen sample? Should I ejaculate a few days before the test and then wait another three days before providing a sample for analysis? Sometimes my testicles feel swollen and painful; what could be the reason for this? Should I also get a testicular ultrasound? What is the procedure for this examination? Will I receive the results immediately?
Are testicular ultrasounds and semen analyses covered by health insurance? If not, what are the approximate costs? Should I make an appointment with a urologist for these issues? Thank you for addressing my questions, Dr.
Hsu.

Mr. Chen, 20~29 year old female. Ask Date: 2007/11/14

Dr. Xu Weikai reply Urology

Mr.
Chen: 1.
There is a dull pain at the upper right corner of the penis, about 3 cm in, accompanied by testicular discomfort.
This could be due to the pain from the testicles radiating through the nerves to the mentioned area.
Possible causes of testicular pain include prolonged periods without ejaculation, testicular inflammation, trauma, or varicocele.
2.
The ejaculate is yellowish in color? A semen analysis should be performed to determine if there are any issues, particularly infections.
Generally, semen color can range from clear, slightly white to slightly yellow, and it is not possible to make an accurate diagnosis based solely on color.
3.
How is semen quality assessed? The standard procedure is to abstain from ejaculation for 3-5 days before collecting the sample.
In other words, as you mentioned, after ejaculation, wait 3-5 days before collecting a sample for analysis.
This is typically done to evaluate sperm count and motility; however, if the goal is just to check for infection, a sample can be taken at any time without the aforementioned restrictions.
4.
Sometimes the testicles may swell and be painful? This could be due to prolonged periods without ejaculation leading to semen accumulation; other factors, such as varicocele, may also be involved.
5.
Regarding testicular ultrasound examination: The procedure is similar to a standard ultrasound, except the transducer is placed on the scrotum.
The results can be known immediately, and you can ask the performing physician on-site.
6.
Is there insurance coverage for testicular ultrasound and semen analysis? In your case, it should be covered.
Note: If the examination is needed due to infertility, it will require out-of-pocket payment.
7.
Should I make an appointment with the urology department? Yes, that is correct.
If there are any unclear points, feel free to ask again for further discussion and exploration.
Department of Urology, Taitung Hospital, Ministry of Health and Welfare, Director Xu Weikai.

Reply Date: 2007/11/14

More Info

Testicular pain can be a concerning symptom and may arise from various causes, including infections, trauma, or underlying medical conditions. Based on your description, it sounds like you are experiencing discomfort in the area around the testicles and the penis, as well as changes in your semen. Here’s a comprehensive overview of your concerns and when to seek urological evaluation.

Understanding Testicular Pain
1. Location and Nature of Pain: The pain you describe in the upper right side of the penis and the testicular area can be attributed to several factors. It could be related to nerve irritation, muscle strain, or even referred pain from other areas. Testicular pain can also be associated with conditions such as epididymitis (inflammation of the epididymis), orchitis (inflammation of the testicle), or even testicular torsion, which is a medical emergency.

2. Semen Quality and Color: The observation that your semen is a yellowish color can be normal, but it can also indicate an underlying issue, such as an infection or the presence of white blood cells. A semen analysis can provide valuable information about sperm count, motility, and morphology, which are essential for assessing fertility.

3. Frequency of Ejaculation: Regarding your question about the timing of semen analysis, it is generally recommended to abstain from ejaculation for 2-7 days before the test to ensure the best quality sample. If you have not ejaculated for an extended period, it may affect the consistency and quality of the semen.

4. Swelling and Discomfort: The sensation of swelling in the testicles, along with the associated pain, could indicate conditions such as hydrocele (fluid accumulation), varicocele (enlarged veins), or even a hernia. These conditions can lead to discomfort and require evaluation.

When to Seek Medical Attention
You should seek urological evaluation if you experience any of the following:
- Severe or sudden onset of testicular pain
- Swelling or changes in the size of the testicles
- Pain accompanied by fever, nausea, or vomiting
- Changes in urination, such as burning or increased frequency
- Persistent changes in semen color or consistency

Diagnostic Procedures
1. Ultrasound: A testicular ultrasound is a non-invasive imaging technique that can help visualize the structures within the scrotum. It is typically performed in a urology clinic and can help identify conditions such as tumors, cysts, or infections. The results are usually available shortly after the procedure.

2. Semen Analysis: This test is performed by collecting a sample of semen, which is then analyzed in a laboratory. The results can take a few days to process, and your healthcare provider will discuss the findings with you.

Insurance and Costs
Regarding insurance coverage, many health insurance plans cover diagnostic tests like ultrasounds and semen analyses, but it’s essential to check with your provider for specifics. If not covered, the costs can vary widely depending on the facility and location. Generally, a semen analysis may cost between $100 to $300, while an ultrasound can range from $200 to $500.

Conclusion
Given your symptoms, it is advisable to consult a urologist who can perform a thorough evaluation, including a physical examination and necessary diagnostic tests. Early intervention can help address any underlying issues and alleviate discomfort. Remember, it’s always better to err on the side of caution when it comes to your health, especially with symptoms involving the reproductive system.

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