Testicular Pain

Testicular pain is pain or discomfort in one or both testicles that can spread into the groin. There are various conditions that cause testicular pain. Some are medical emergencies but most are not. Contrary to popular belief, there are excellent treatments available for testicular pain through medicine and surgery. You do not have to live with pain, and your first step to getting pain-free should involve a urology consultation.

There are two types of testicular pain, acute and chronic. Acute testicular pain occurs immediately and it is something you will definitely notice. All medical emergencies related to the testicles are considered acute.

Chronic testicular pain refers to pain lasting over three months. Pain is either dull or sharp, can come and go, and can significantly impact your lifestyle. Contact Erlanger Urology for treatment for you testicular pain at our Chattanooga, TN office, we often treat patients from Knoxville, Northern Georgia & Huntsville, AL too.

What Causes Testicular Pain?

Even a minor injury can cause pain because the testicles are very sensitive. Common causes are injury, infection, swelling of the sperm ducts or testicles, and a twisting of the testicles, called testicular torsion, which can cut off the blood supply.

Testicular torsion affects young men between the ages of 10 and 20. Torsion is a medical emergency which requires immediate treatment. Untreated testicular torsion can result in the loss of the affected testicle. If surgery is performed within 6 hours, most testicles can be saved.

Acute Testicular Pain Can Be Due To:

• Epididymis cysts containing dead sperm cells (spermatocele). The epididymis is the tube that collects and transports sperm.
• Inflammation of the epididymis usually due to an infection or inflammation.
• A hydrocele which is a fluid filled sac in the scrotum.
• Inflammation of the testicles that causes painful swelling often due to mumps or infection from bacteria, viruses and certain STDs.
• An inguinal hernia or kidney stone.
• Testicular cancer which will cause pain in about 10% of men.
• Direct trauma to the testicles can cause a hematocele ( a collection of blood around the testicles).
• Testicular rupture caused by external trauma can result in blood leaking into your scrotum.

Chronic Testicular Pain Can Be Due to:

• A varicocele (Varicose veins of the scrotum)
• Inflammation of the epididymis usually due to an infection or inflammation
• Orchitis
• Prostatitis
• Back/Spinal nerve injury
• Inguinal hernia repair with mesh can cause nerve entrapment leading to chronic pain
• Hydrocele

When Should You Call a Doctor?

• When you have sudden, severe testicular pain you should seek immediate medical care. If you go to the emergency room, call your doctor.
• When you have had an injury or trauma to the scrotum, and you still have pain one hour later.
• When your pain is accompanied by nausea or vomiting.
• When you feel a lump in your scrotum.
• When you have a fever with testicular pain.
• When your scrotum is warm, tender, swollen and red.
• When you have been in contact with someone who has the mumps.
• When you have chronic testicular pain that affects your daily activities or lifestyle.

How is Testicular Pain Diagnosed?

Your doctor will conduct an exam of your groin, testicles and abdomen. You will be asked about the circumstances surrounding your pain, whether you have suffered an injury, how long you have had this pain, how it started, where the pain is located, how severe and constant the pain is, whether your pain goes into your abdomen or back, and any other symptoms. The cause of your pain can be diagnosed using blood tests, urinalysis, urine culture and imaging studies such as an ultrasound.

Testicular pain should not be ignored. It may be directly related to your testicles or may lead to the discovery of another health condition.

What Is the Treatment for Testicular Pain?

Treatment depends on the cause of the pain. You must be examined by a doctor to determine the course of treatment. The objective of treatment is to restore healthy function, avoid complications and prevent permanent damage that can result in infertility.

Chronic testicular pain can be extremely difficult to manage by healthcare providers and individuals. Luckily, advances in our understanding of testicular anatomy have improved our ability to treat testicular pain. Dr. Shridharani is one the few microsurgeons in the U.S. offering microsurgical spermatic cord denervation. Through 2 cm groin incisions the tissue that inflamed nerves travel through can be cut, preventing the pain signals from traveling from the testis. This procedure is minimally invasive, does not compromise blood flow to the testicles and therefore fertility, and erections are not impaired. Initially a numbing medication is given in the urology clinic to see if the procedure will be successful. If the response to the numbing medication is good, then the procedure has an 80% chance of helping your pain go away permanently.

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