Changes in Testicular Position After Injury

Q: Changes in Testicular Position After Injury

Danny： Hello, it is possible that there is bleeding in the testicle, causing a change in its appearance. <br>However, after a month of rest, it should have healed, and what remains may just be residual blood clots that will gradually be absorbed over time. <br>If convenient, I re

After the testicle was hit, its position changed?

Dear Dr.
Hsu,
About a month ago, I accidentally bumped my right testicle against a table while walking.
It was extremely painful at the moment, but the pain subsided after about half an hour.
When I took off my pants to check, I noticed that the position and orientation of my testicles had changed.
Initially, both testicles were at the same height and symmetrical, but after the incident, one is now lower than the other.
The right testicle is two centimeters lower than the left and feels like it has turned sideways (from vertical to horizontal).
This causes discomfort when sitting, as I have to adjust my position slightly (the left testicle tends to move up towards my thigh, but the right one does not).
The same issue occurs when I run or exercise; the right testicle seems to hang lower, as if it lacks some support, and does not move with my body like it used to.
Whether I am lying down or squatting, the right testicle continues to hang lower, which is very uncomfortable.
I visited a urologist who examined and palpated the area, asking if it hurt, to which I replied no.
The doctor said it was fine, but I would like to ask you, Dr.
Hsu, what exactly has happened? Why has my right testicle changed like this? What should I do? It has really changed, and it makes me very uncomfortable.
Thank you so much for your help! Wishing you and Director Chuang all the best!

Dani, 20~29 year old female. Ask Date: 2015/08/25

Dr. Xu Weikai reply Urology

Danny: Hello, it is possible that there is bleeding in the testicle, causing a change in its appearance.
However, after a month of rest, it should have healed, and what remains may just be residual blood clots that will gradually be absorbed over time.
If convenient, I recommend getting a testicular ultrasound to verify the diagnosis and to check how much blood clot remains, as well as to see if there are any complications such as abscess formation.
If it is not convenient to seek medical attention, you can apply local heat.
Use a warm towel at about 40-45 degrees Celsius for 5-10 minutes, 3-6 times a day, which should help accelerate the absorption of the blood clot.
It is important to note that if heat application causes increased pain, it indicates there may be other issues, and you should seek medical attention promptly.
If you have any concerns, you can visit a nearby medical facility for relevant tests or further treatment.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Online responses should only be used as a reference; if necessary, it is still important to seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/08/25

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the changes in the position of your right testicle following the injury you experienced about a month ago. It’s understandable to feel anxious about such changes, especially when they affect your comfort and daily activities.

From your description, it appears that you have experienced a significant alteration in the position of your right testicle after the trauma. The immediate pain you felt was likely due to the impact, which can cause various injuries to the testicles, including bruising, swelling, or even torsion. The fact that the pain subsided after half an hour is a positive sign, but the subsequent changes in position and orientation of the testicle are concerning.

The testicles are held in place by a structure called the spermatic cord, which contains blood vessels, nerves, and the vas deferens. When trauma occurs, it can lead to a few potential outcomes:
1. Hematoma Formation: This is a localized collection of blood outside of blood vessels, which can occur after an injury. A hematoma can cause swelling and may affect the position of the testicle.

2. Testicular Torsion: Although you mentioned that there is no pain currently, torsion can sometimes occur after an injury. This condition involves the twisting of the spermatic cord, which can compromise blood flow to the testicle. However, since you have been evaluated by a urologist and no acute issues were identified, this may be less likely.

3. Changes in the Scrotal Support: The injury may have affected the ligaments or tissues that support the testicle, leading to a change in its position. This could explain why your right testicle feels lower and does not move as freely as it used to.

4. Potential Varicocele or Hydrocele: Sometimes, trauma can lead to the development of a varicocele (enlarged veins within the scrotum) or a hydrocele (fluid accumulation around the testicle), both of which can affect the position and comfort of the testicle.

Given that you have already consulted with a urologist who performed a physical examination, it is reassuring that there was no immediate cause for alarm. However, if you continue to experience discomfort or if the position of the testicle does not return to normal, I would recommend the following steps:
- Follow-Up Appointment: Schedule a follow-up visit with your urologist. It may be beneficial to have an ultrasound performed to assess the blood flow to the testicle and to check for any abnormalities such as a hematoma, varicocele, or hydrocele.

- Monitor Symptoms: Keep track of any changes in pain, swelling, or discomfort. If you experience any acute pain, swelling, or changes in color, seek medical attention immediately.

- Supportive Measures: Wearing supportive underwear can help alleviate some discomfort by providing additional support to the scrotum.

- Avoid Strenuous Activities: Until you have a clearer understanding of the situation, it may be wise to avoid activities that could exacerbate the discomfort, such as heavy lifting or high-impact sports.

In conclusion, while the changes you are experiencing may be related to the trauma, it is essential to continue monitoring the situation and maintain open communication with your healthcare provider. Your comfort and health are paramount, and further evaluation may provide clarity and reassurance.

Wishing you a speedy resolution to your concerns.

Best regards,
Doctor Q&A Teams

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