Testicular Pain: Causes and When to Seek Help

What are the causes of testicular swelling and pain?

Hello, thank you for taking the time to answer my questions.
Recently, I experienced mild pain and itching in the urethra during urination, along with cloudy discharge in the morning.
I visited a urologist who prescribed antibiotics due to inflammation.
After about two weeks, my condition did not improve, and upon follow-up, the inflammation worsened.
The doctor was concerned it might be gonorrhea and intensified the antibiotic treatment.
Three days later, during another follow-up, although there was no discharge, I still experienced mild pain and itching.
The doctor prescribed an out-of-pocket medication that has the same effect as an injection, a total of six pills: four on the first day and two on the second day.
After completing the medication, my condition improved, and there was no inflammation during the follow-up.
However, I later experienced a feeling of fullness in the lower abdomen and mild intermittent pain in the testicles.
Could this be a complication or a misdiagnosis? Is there a need for special medical attention? Thank you.

Dennis, 30~39 year old female. Ask Date: 2015/12/19

Dr. Li Yilun reply Urology

You have already consulted with a physician regarding these issues.
It is advisable to discuss your condition with the attending physician, who has conducted some examinations and may have a better understanding of your situation.
It is important to clarify that a simple description from you cannot determine the condition; a thorough medical history, along with a physical examination and diagnostic tests, is often necessary for the physician to establish a diagnosis and treatment plan.
If your symptoms worsen or do not improve, it is still recommended to seek medical attention.

Reply Date: 2015/12/19

More Info

Testicular pain can be a concerning symptom and may arise from various underlying causes. In your case, it appears that you have already experienced some urinary symptoms, including mild pain and discharge, which led to a diagnosis of inflammation and subsequent treatment with antibiotics. While it is encouraging that your symptoms have improved and there is no longer any discharge or inflammation, the new symptoms of abdominal fullness and intermittent testicular pain warrant further attention.

Possible Causes of Testicular Pain
1. Epididymitis: This is an inflammation of the epididymis, often caused by bacterial infections, including sexually transmitted infections (STIs) like gonorrhea or chlamydia. Symptoms may include pain, swelling, and tenderness in the testicles, along with urinary symptoms.

2. Orchitis: This is inflammation of the testicle itself, which can occur alongside epididymitis. It may be viral or bacterial in origin and can cause similar symptoms.

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, swelling, and sometimes nausea. This condition requires immediate surgical intervention.

4. Hernia: An inguinal hernia can cause discomfort in the groin and may lead to pain in the testicular area. This occurs when tissue protrudes through a weak spot in the abdominal muscles.

5. Varicocele: This is an enlargement of the veins within the scrotum, which can cause a dull ache or a feeling of heaviness in the testicles.

6. Referred Pain: Sometimes, pain in the testicles can be referred from other areas, such as the abdomen or lower back.

When to Seek Help
Given your recent history of urinary symptoms and the current sensations of fullness and pain in the testicular area, it is important to monitor your symptoms closely. Here are some guidelines on when to seek further medical attention:
- Persistent Symptoms: If the testicular pain or fullness persists or worsens, it is crucial to consult a healthcare provider. This could indicate an ongoing issue that needs to be addressed.

- Acute Pain: If you experience sudden, severe pain in the testicles, this could be a sign of testicular torsion, which is a surgical emergency.

- Accompanying Symptoms: If you develop additional symptoms such as fever, nausea, vomiting, or changes in urination, you should seek medical attention promptly.

- Changes in Appearance: Any noticeable swelling, redness, or changes in the appearance of the testicles should be evaluated by a healthcare professional.

Conclusion
In summary, while your initial symptoms have improved with antibiotic treatment, the new sensations of abdominal fullness and testicular pain should not be overlooked. It is advisable to follow up with your urologist or a healthcare provider to discuss these symptoms further. They may recommend additional tests, such as an ultrasound, to rule out any complications or other underlying conditions. Early intervention can help prevent potential complications and ensure appropriate management of your symptoms.

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