Testicular Pain: Symptoms, Causes, and Treatment Options

Q: Testicular Pain: Symptoms, Causes, and Treatment Options

Mr. <br>Lin： Hello, you likely have inflammation of the testicles and epididymis. <br>This condition requires continuous antibiotic treatment for 6 to 12 weeks. <br>During the acute phase, some supportive treatments are necessary, such as local ice application, a diet that minimi

Testis

Hello Dr.
Hsu, I have been experiencing pain in my testicle for almost two weeks now.
The pain occurs daily and is localized to the right testicle, which is noticeably larger than the left.
Sometimes the pain occurs suddenly, and after walking a short distance, it also intensifies.
During the pain episodes, I often experience erections, which lead to the secretion of prostatic fluid, and there is a sensation of impending ejaculation.
Additionally, the pain in the testicle radiates to my kidney area, causing significant discomfort in my right flank.
During this time, I visited a urology clinic where the doctor performed a physical examination and suggested that it might be testicular inflammation.
I was prescribed medication, and I noticed that after taking it, the pain in the testicle decreased somewhat, but I would still experience erections and the urge to ejaculate.
For your reference, I have not engaged in any sexual activity for over a month and do not have any harmful habits.
Furthermore, my testicles have not sustained any trauma.
Dr.
Hsu, could you please help me understand what these symptoms might indicate? Thank you.

Mr. Lin, 30~39 year old female. Ask Date: 2009/02/01

Dr. Xu Weikai reply Urology

Mr.
Lin: Hello, you likely have inflammation of the testicles and epididymis.
This condition requires continuous antibiotic treatment for 6 to 12 weeks.
During the acute phase, some supportive treatments are necessary, such as local ice application, a diet that minimizes irritation, and increased fluid intake.
Activities like ejaculation or erection may involve nerve stimulation, which can lead to localized discomfort or pain.
It is recommended to check your semen and perform a semen culture to identify the specific bacteria.
After determining the strain, diligently taking effective antibiotics for a period should lead to improvement.
If there are any unclear points, feel free to ask again for further discussion and research.
Sincerely, Urology Department, Taitung Hospital, Department of Health, Executive Yuan, Dr.
Hsu Wei-Kai.

Reply Date: 2009/02/01

More Info

Testicular pain, especially when it persists for two weeks, can be concerning and warrants thorough evaluation. Based on your description, it seems you are experiencing pain primarily in the right testicle, which is also noticeably larger than the left. This type of pain can arise from various causes, and understanding the symptoms, potential causes, and treatment options is crucial.

Symptoms
The symptoms you describe include:
- Persistent pain in the right testicle.

- Swelling of the right testicle compared to the left.

- Pain that radiates to the lower back and possibly the kidney area.

- Episodes of pain that coincide with physical activity, such as walking.

- Associated sensations of erection and pre-ejaculatory fluid secretion.

Possible Causes
1. Epididymitis: This is an inflammation of the epididymis, often caused by infections, including sexually transmitted infections (STIs) or urinary tract infections (UTIs). Symptoms typically include swelling, pain, and sometimes fever.

2. Orchitis: This refers to inflammation of the testicle itself, which can occur due to viral infections (like mumps) or bacterial infections.

3. 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 and swelling. Although you mentioned no trauma, it’s essential to rule this out due to the potential for severe complications.

4. Hernia: An inguinal hernia can cause discomfort in the groin and testicular area, especially with physical activity.

5. Varicocele: This is an enlargement of the veins within the scrotum, which can cause discomfort and swelling.

6. Tumors: Although less common, testicular tumors can present with pain and swelling.

Diagnosis
Given your symptoms, a thorough evaluation by a urologist is essential. Diagnostic steps may include:
- Physical Examination: A detailed examination of the scrotum and surrounding areas.

- Ultrasound: This imaging test can help visualize the testicles and surrounding structures to identify any abnormalities, such as swelling, fluid accumulation, or torsion.

- Urinalysis: To check for signs of infection or other abnormalities.

- Blood Tests: To assess for infection or other underlying conditions.

Treatment Options
The treatment will depend on the underlying cause:
- Antibiotics: If an infection is diagnosed, antibiotics will be necessary.

- Pain Management: Over-the-counter NSAIDs (like ibuprofen) can help manage pain and inflammation.

- Rest and Ice: Applying ice to the affected area can reduce swelling and discomfort.

- Surgery: In cases of torsion or significant hernias, surgical intervention may be required.

Recommendations
Since you have already seen a urologist and received medication, it is crucial to follow up if your symptoms persist or worsen. If you experience sudden, severe pain, nausea, vomiting, or fever, seek immediate medical attention, as these could indicate a more serious condition.

In summary, while your symptoms may suggest epididymitis or orchitis, it is vital to rule out other serious conditions. Continued communication with your healthcare provider and possibly seeking a second opinion or further diagnostic testing may be necessary to ensure appropriate treatment and management of your symptoms.

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