Definition
Pain in the testicles is first of all a very general symptom which can have different causes. The pain can have different characters. They can manifest themselves as pulling in the testicles, pressure or stinging in the testicles or scrotum and can radiate into the groin region.
The pain can vary in duration, intensity and severity and can be quite different depending on how you feel. However, the intensity of the pain cannot be used to determine the severity or nature of the disease or the cause. The causes of testicular pain can be very diverse and range from traumatic experiences (i.e. accidents or injuries) to diseases of the urogenital tract or the testicles themselves.
Testicular pain after accidents
One of the most common causes of a painful testicle are previous accidents. This has led to a direct injury such as a contusion, abrasion or crushing of the testicle. This injury is often referred to as a “pain of destruction”, i.e. an acute pain of the highest degree.
This can even lead to a “testicular luxation”, i.e. a transfer of the testis from the scrotum to the groin or perineal area. For clarification the cause of the accident should be reconstructed and the testicle should be examined. In addition, an ultrasound of the testis can be performed to detect fluid in the testis or to identify a hematoma in the scrotum.
The forms of therapy differ depending on the extent of the injury. In the case of minor injuries, the testicle should be elevated and cooled. To relieve the pain, painkillers can be taken.
If a hematoma of the testicle or a testicular torsion occurred during the accident, this is an indication for surgical therapy. In case of a hematoma, the testicle is relieved. In the case of testicular torsion, the testicle is repositioned and reattached.
If the testicular tissue is completely crushed and destroyed, the testicle may be removed (orchiectomy).
- Therapy
Inflammation of the testes (orchitis) can be caused by various pathogens, most of which have caused a general infection in which the testes are also inflamed. Examples are the mumps virus (mumpsorchitis), but also mononucleosis (Ebstein-Barr virus), Coxsackie virus infection, varicella and others can cause inflammation of the testes.
Also a previous trauma can cause an inflammation. Similarly, antibody formation against sperm and testicular tissue can cause inflammation of the testicular tissue. These antibodies radiate mainly into the groin region and the back.
In addition, the testicle swells and is severely reddened (reddening of the scrotal skin) and a fever can occur. In the particular case of mumpsorchitis, the first symptom was an inflammation of the parotis (salivary gland) and a somewhat delayed (3-4 days) inflammation of the testicles, which occurs in 10% of cases on both sides. The diagnosis is made by a detailed anamnesis and a urological examination.
In addition, an ultrasound of the testicles can be done to exclude a possible abscess. An increased number of leukocytes can be detected in the blood (so-called leukocytosis, an increase in white blood cells) and in the case of mumpsorchitis, antibodies against the mumps virus. As therapy, bed rest and painkillers are recommended.
In the case of mumpsorchitis in adults, alpha-interferons and glucocorticoids can also be administered against the inflammation and the immune reaction. If abscesses occurred during the inflammation, they can be surgically opened and drained. Complications can be a reduction in sperm quality.
Especially in the case of inflammatory destruction of the testicular tissue, atrophy (tissue loss) and fibrosis (scarring) of the testis occurs and in this process, if both testicles are affected, sterility, i.e. infertility, occurs. As this is one of the dangers of mumpsorchitis, vaccination against the mumps virus in combination with measles and rubella (MMR) is recommended as a prophylaxis in children. This is administered once at the age of 12-15 months and a second time at the end of the 2nd year of life.
- Diagnosis
- Therapy
- Complication
