Persistent Testicular Tightness After Ejaculation: Causes and Solutions

Recently, there has been a persistent tightness in the testicles after ejaculation?

Initially, my testicles were fine, but over the past week, I've been experiencing a tight, tense sensation in the area of the testicles (possibly the cremaster muscle).
This sensation has persisted, and I later realized it might be related to ejaculation.
After resting for a day, it seemed to improve, but after masturbating, the discomfort returned, and I'm unsure if there's a connection.
I am 19 years old and typically masturbate about 1 to 2 times a day, which shouldn't be excessive, right? Recently, I visited a urologist regarding the discomfort in my testicles.
After a physical examination, the doctor said there was nothing significant to worry about and prescribed pain relief medication, but it hasn't improved my condition.

In May, I underwent surgery for a hernia and a varicocele ligation in the groin area, and it has been nearly 160 days since then.
During this recent examination, a different doctor noted that the blood vessels were still quite large.
Does this indicate that the initial surgery was ineffective? However, prior to the surgery, I did not experience these symptoms, so it seems illogical that the discomfort would increase after the procedure (the primary reason for my surgery was the hernia).
Is it possible that my right testicle is also experiencing discomfort? I hope the doctor can provide some answers, as this issue has been a significant source of distress for me.
If I continue to focus on this discomfort, it adds mental pressure, and I hope to find a resolution and identify the cause soon.

A-Gao, 10~19 year old female. Ask Date: 2015/10/13

Dr. Xu Weikai reply Urology

Hello, during an erection, muscle tension and soreness may occur.
Therefore, analgesics and muscle relaxants are administered.
For varicocele, it generally takes about 3 to 6 months for complete regression.
If the blood vessels do not shrink, it may be due to vascular regrowth or other issues.
Additionally, there may be multiple blood vessels, and some smaller vessels might not be detected during surgery because the main large vessels were ligated, allowing the smaller vessels to gradually enlarge again.
It is important to monitor the situation for a while.
If there is no complete correction after 6 months, a second surgery may be necessary.
Regarding discomfort caused by hernia surgery, it is advisable to discuss this with the surgeon.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; if necessary, it is best to seek medical attention at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/10/13

More Info

Persistent testicular tightness or discomfort after ejaculation can be a concerning symptom for many individuals, especially when it disrupts daily life and causes anxiety. In your case, it seems that you have experienced this tightness for about a week, and it appears to be associated with ejaculation. You have also mentioned that you have a history of inguinal hernia surgery and varicocele ligation, which adds complexity to your situation.

Possible Causes
1. Muscle Tension: The tightness you are feeling could be related to the cremaster muscle, which is responsible for raising and lowering the testicles. This muscle can become tense due to various factors, including anxiety, overactivity, or even sexual arousal. If you are engaging in masturbation frequently (1-2 times a day), it may lead to muscle fatigue or tension, resulting in discomfort.

2. Post-Ejaculatory Pain: Some individuals experience discomfort or pain after ejaculation, known as post-ejaculatory pain syndrome. This condition can be caused by inflammation or irritation in the prostate or seminal vesicles, which can lead to a sensation of tightness in the testicular area.

3. Varicocele: Given your history of varicocele ligation, it is possible that the condition has recurred or that there is residual varicocele. Varicoceles can cause a feeling of heaviness or discomfort in the testicles, especially after physical activity or sexual activity.

4. Nerve Irritation: Sometimes, nerve irritation in the pelvic region can lead to sensations of tightness or discomfort in the testicles. This can be due to previous surgeries or other underlying conditions.

5. Infection or Inflammation: Although your urologist did not find any significant issues during the examination, infections such as epididymitis or orchitis can cause discomfort. These conditions may not always present with obvious symptoms but can lead to persistent discomfort.

Recommendations
1. Follow-Up with a Urologist: Since you have already seen a urologist, it may be beneficial to seek a second opinion or follow up with the same specialist. Discuss your symptoms in detail, including the timing of the discomfort in relation to ejaculation and any other associated symptoms.

2. Imaging Studies: If the discomfort persists, your doctor may recommend imaging studies such as an ultrasound to evaluate the blood vessels and structures in the scrotal area. This can help rule out any complications from your previous surgery or identify any new issues.

3. Pain Management: While you have been prescribed pain medication, it may be worth discussing alternative pain management strategies with your doctor, including physical therapy or relaxation techniques to alleviate muscle tension.

4. Lifestyle Modifications: Consider reducing the frequency of masturbation temporarily to see if it alleviates the discomfort. Additionally, practicing relaxation techniques such as deep breathing or meditation may help reduce anxiety and muscle tension.

5. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any activities that seem to exacerbate or relieve them. This information can be valuable for your healthcare provider in diagnosing the issue.

Conclusion
While it is understandable to feel anxious about persistent testicular tightness, many potential causes are manageable with appropriate medical care. It is crucial to communicate openly with your healthcare provider about your symptoms and concerns. With the right approach, you can find relief and address any underlying issues contributing to your discomfort.

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