Testicular Pain and Its Impact on Sexual Health

Issues related to the testicles and epididymis?

Hello, Dr.
Hsu.
A year ago, while sitting cross-legged, I accidentally compressed my testicle, causing severe pain in the area behind the testicle, similar to the sensation of a torn ligament (it felt like the epididymis was being pulled).
Since then, the "white membrane" behind the testicle has almost completely disappeared, and I have very little sexual desire.
I also do not experience morning erections.

1.
Can the white membrane behind the testicle naturally recover, or is surgery or other methods necessary?
2.
How should I treat this type of epididymal injury?
3.
Is there a possibility that the seminiferous tubules have been damaged?
4.
Is the decrease in sexual desire related to this condition? I have seen a doctor, but they said there is no problem.
However, my body's responses have left me very confused.
What should I do to resolve this situation? I would greatly appreciate your assistance.
Thank you!

Xiao P, 20~29 year old female. Ask Date: 2014/03/05

Dr. Xu Weikai reply Urology

Hello, has the white membrane completely disappeared? How do you know? Note: If the white membrane has truly disappeared, the substances within the testicles would disperse and not form properly.
How do you know if the epididymis is injured? Note: An injury to the epididymis would cause significant swelling, potentially increasing in size by 2 to 5 times.
I cannot determine if the seminiferous tubules are affected.
It may be advisable to visit a medical center for relevant tests, which might provide clarity.
External appearance alone cannot be used for assessment.
Sexual desire involves many factors, including psychological, physiological, and neurovascular aspects, as well as the atmosphere and the partner, all of which can have an impact.
It cannot be judged in isolation.
Since the physician has stated that there are no issues with your body, if you are still concerned, you should go to a medical center, such as National Taiwan University Hospital, Veterans General Hospital, or Chang Gung Memorial Hospital, for specialized examinations to confirm.
Note: General small hospitals may not have the necessary equipment.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Answers found online should only serve as references; if necessary, it is best to seek medical care at a healthcare facility.
This response is provided by Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2014/03/05

More Info

Testicular pain and its impact on sexual health can be a complex issue, often involving multiple factors that can affect both physical and psychological well-being. Based on your description, it sounds like you experienced significant trauma to your testicles, specifically to the epididymis, which is the structure located at the back of the testicle responsible for storing and maturing sperm.
1. Recovery of the Membrane: The "white membrane" you refer to may be the tunica albuginea, which is a fibrous covering of the testicle. If this membrane has been damaged or altered due to trauma, its ability to heal naturally can depend on the extent of the injury. In some cases, minor injuries can heal on their own, while more severe damage might require surgical intervention. It is crucial to have a thorough examination by a urologist who can assess the extent of the injury and recommend appropriate treatment options.

2. Treatment for Epididymal Injury: If the injury to the epididymis is confirmed, treatment may vary based on the severity of the damage. In cases of mild trauma, conservative management such as rest, ice application, and over-the-counter pain relief may be sufficient. However, if there is significant injury or complications such as a hematoma (a localized collection of blood outside of blood vessels), surgical intervention may be necessary to repair the damage or to remove any obstructive tissue.

3. Impact on the Spermatic Ducts: The spermatic ducts, or the vas deferens, can also be affected by trauma. If there is a concern about injury to these structures, imaging studies such as an ultrasound or MRI may be warranted to evaluate for any potential blockages or damage. A urologist can provide guidance on whether further diagnostic testing is needed based on your symptoms.

4. Decreased Libido: The decrease in sexual desire (libido) you are experiencing could indeed be related to the trauma. Physical injuries can lead to psychological effects, including anxiety and depression, which can further impact sexual health. Additionally, hormonal changes resulting from testicular trauma can also affect libido. It is essential to discuss these symptoms with a healthcare provider who can evaluate your hormonal levels and overall sexual health.

Given your ongoing symptoms and concerns, it is advisable to seek a second opinion from a urologist if you feel your current physician has not adequately addressed your issues. A thorough evaluation, including a physical examination and possibly imaging studies, can help clarify the situation and guide appropriate treatment.
In summary, testicular trauma can have lasting effects on sexual health, and understanding the underlying issues is crucial for recovery. Addressing both the physical and psychological aspects of your condition will be essential in restoring your sexual health and overall well-being. Don't hesitate to advocate for your health and seek the care you need to address these concerns.

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