Testicular Pain: Varicocele, Hydrocele, or Other Causes?

Hello doctor, I experience a dull pain 5 centimeters above my left testicle during and after taking a hot shower?

Hello, I am currently 18 years old.
Three years ago, I was diagnosed with left-sided varicocele, which has not been treated.
I had right inguinal hernia surgery earlier this year, but the pain on the left side has not changed before or after the treatment.
Normally, varicocele does not cause pain, so I do not wish to undergo surgery.
However, recently, I have been experiencing a dull pain in the affected area during and after taking hot showers.
This pain is not constant but comes in episodes.
I do not experience any issues upon waking up.
I am wondering if this could be caused by the varicocele or if it is due to excessive masturbation (2-3 times a day).
This situation has only arisen recently; previously, I would only masturbate once a day.
If it is simply due to varicocele, I would feel relieved, but I am worried it could be a more serious condition (like a tumor).
I was also concerned about the hernia being a tumor, which is why I decided to have surgery.
Additionally, when varicocele causes pain, does it resolve completely afterward, or can it lead to adverse long-term effects (excluding issues with semen quality)? I kindly ask for your guidance on this matter.

A Bao, 10~19 year old female. Ask Date: 2015/02/23

Dr. Xu Weikai reply Urology

Hello, varicocele is a condition that may require surgical treatment when severe.
The general indications for surgery are: 1.
Pain that cannot be alleviated by medication or physical therapy 2.
Impact on sperm quality 3.
Aesthetic concerns or other subjective factors (such as difficulty walking) that lead the patient to request surgery.
If none of these conditions are present, surgery is not necessary.
If you have any further questions, feel free to ask, and we can discuss and research together.
Online responses should only serve as a reference; it is essential to seek medical care at a healthcare facility if needed.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/02/23

More Info

Understanding testicular pain can be complex, especially when considering conditions like varicocele and hydrocele, among others. In your case, you have a history of left-sided varicocele diagnosed three years ago, and you recently underwent surgery for a right inguinal hernia. It's important to note that while varicocele often does not cause pain, some individuals may experience discomfort, particularly in certain situations, such as after hot showers or during physical activity.

Varicocele and Pain
Varicocele is characterized by enlarged veins within the scrotum, similar to varicose veins in the legs. While many individuals with varicocele do not experience pain, it can lead to a dull ache or discomfort, especially after prolonged standing or physical exertion. The pain you describe, which occurs intermittently after hot showers, could be related to the dilation of blood vessels in response to heat, leading to increased blood flow and pressure in the affected veins. This is not uncommon and may not necessarily indicate a worsening of your condition.

Other Potential Causes of Testicular Pain
1. Hydrocele: This is a fluid-filled sac surrounding the testicle, which can cause swelling and discomfort. Hydroceles are typically painless but can lead to a feeling of heaviness or pressure.

2. Epididymitis: Inflammation of the epididymis can cause pain and swelling. This condition is often associated with infections and may present with acute pain rather than the dull ache you describe.

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

4. Inguinal Hernia: Since you have a history of hernia, it's worth considering that residual discomfort could be related to this condition, especially if there was any complication during or after surgery.

5. Psychogenic Pain: Anxiety and stress can manifest as physical symptoms, including pain. Your concerns about potential serious conditions like tumors may contribute to heightened sensitivity to discomfort.

Frequency of Masturbation
Regarding your concern about masturbation, it is generally considered a normal activity and does not typically cause testicular pain unless done excessively or in a manner that leads to physical irritation. The frequency you mentioned (2-3 times a day) is within the range of normal for many young men. However, if you notice that this activity correlates with increased discomfort, it may be worth moderating your frequency to see if symptoms improve.

Long-term Effects of Varicocele
As for the long-term implications of varicocele-related pain, many individuals find that while they may experience intermittent discomfort, it does not lead to significant long-term issues. However, if pain becomes chronic or worsens, it may warrant further evaluation. Varicocele can sometimes affect fertility, but since you mentioned wanting to exclude semen quality issues, it may be beneficial to discuss this with a healthcare provider if you have concerns about reproductive health.

Conclusion
In summary, while your symptoms could be related to the varicocele, other conditions should also be considered. If the pain persists, worsens, or is accompanied by other symptoms such as swelling, redness, or fever, it is crucial to seek medical evaluation. Regular check-ups with a urologist can help monitor your condition and address any concerns you may have about testicular health. Remember, it's always better to err on the side of caution when it comes to your health.

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