Testicular pain can have very diverse causes. Even in young boys, before puberty, testicular pain can occur. Since the pain can occur due to many diseases, a clarification by the doctor should always be made.
What is testicular pain?
In most cases, testicular pain is caused by infections. Often, testicular inflammation is then the cause of the pain. Testicular pain is not a specific condition but occurs as a symptom of many different conditions. Testicular pain can be perceived as diffuse abdominal pain. However, it is usually a pulling pain accompanied by a feeling of heaviness in the testicles. The pain may occur explicitly after sexual intercourse or it may occur for no apparent reason or trigger. Testicular pain can occur as a symptom of many underlying diseases, some of them serious. Therefore, a medical clarification should always be made. In young boys, sudden onset of testicular pain may be an indication of testicular torsion and is therefore an absolute emergency requiring immediate medical attention. Depending on the underlying condition present, the duration and intensity of testicular pain can vary completely.
Causes
In most cases, testicular pain is caused by infections. Often, testicular inflammation is then the cause of the pain. However, an infection with mumps can also be accompanied by testicular pain. Testicular pain due to testicular torsion (twisting of the testicles) is an emergency, especially in young boys, where immediate surgery is necessary to prevent permanent damage to the testicle. However, a fracture of the scrotum or a collection of blood after an injury also manifest as testicular pain. Other causes of testicular pain may include herniated discs and hernias. Testicular pain during or after sexual intercourse can have very diverse causes, which must be clarified urologically. Often it is an inflammation of the epididymis, which causes other symptoms in addition to the usually severe pain. Varicose veins inside the scrotum and testicular tumors can also trigger testicular pain. Harmless testicular pain also manifests itself when there has been a prolonged erection of the penis, for example during cuddling and petting. In this condition, the testicles are also particularly sensitive to touch. If no ejaculation takes place in this context, so that the testicles and penis naturally relax again, the testicles can cause unpleasant sensations. After a few hours, however, these are then also gone again and the testicles no longer hurt.
Diseases with this symptom
- Epididymitis
- Testicular cancer
- Mumps
- Herniated disc
- Hernia
- Undescended testicle
- Testicular inflammation
- Testicular torsion
- Acute scrotum
Diagnosis and course
To diagnose the causes of testicular pain, the doctor will first take the patient’s medical history. This includes duration of the complaints and possibly other complaints of the affected person. Through a physical examination, in many cases conclusions can already be drawn about suspected causes. In the case of inflammation, the testicles are often swollen and hard. The pain subsides when the testicles are lifted in most cases. For further diagnosis, the doctor will in any case perform a blood test. In this way, any inflammatory agents that may be present can be detected. Depending on the suspected cause, further examinations will follow. With the help of an ultrasound examination, the doctor can detect testicular cancer, for example. In exceptional cases, the painful testicle must be exposed by surgery to find the cause of the testicular pain. If other diseases are suspected as the cause, X-ray examinations or computer tomography can also help to find the causes of the testicular pain, depending on the suspected underlying disease. Since the causes can be varied, the course of testicular pain is also not entirely uniform. Acute inflammation usually heals within a week with appropriate treatment, and testicular pain subsides or disappears completely.
Complications
Depending on the underlying condition, testicular pain can carry a wide variety of complications.In testicular torsion, the testicle rotates around the vessels that supply it, resulting in a reduced supply of blood to the testicle, which initially causes severe pain. If left untreated, this can cause permanent damage to the testicle, which can eventually lead to infertility. Furthermore, the risk of infection is increased. Furthermore, inflammation of the epididymis (epididymitis) can also cause pain in the testicle. In addition to equally impaired fertility as in the case of testicular torsion, bacterial infections can lead to accumulation of pus (abscess) and systemic spread of the infection (sepsis), which can be life-threatening. As is well known, a blow or a kick on the testicle can also cause severe pain and thus leave unchangeable damage. Also a kidney stone can radiate pain in the testicle. However, the complications that may arise are more related to the kidney than to the testicle. This can cause permanent damage to the kidney and increase the risk of infection from bacteria. This can also, in the worst case, lead to systemic spread and death of the patient. As the most common cause of tumor in young men, testicular cancer can also cause some complications. These range from infertility to spread of the tumor through metastasis to other organs. However, the consequences depend on the type and size of the tumor.
When should you see a doctor?
Testicular pain or even painless induration in the testis can be the cause of more or less serious diseases. In the case of abnormalities in the prostate or testicles, a doctor should be consulted in any case. The first thought in case of testicular pain is that cancer could be the cause. However, cancer is not always the first disease and does not usually cause pain. Nevertheless, changes should be clarified. Testicular inflammation may be the cause of the pain. In addition, fever and swelling and redness of the testicles may indicate inflammation. Prompt medical treatment is important to avoid secondary damage. Infertility and permanent destruction of testicular tissue can follow untreated testicular inflammation. A pulling pain does not necessarily indicate a disease of the testicle. The surrounding areas – the groin, for example – can also be affected. Accompanying symptoms are severe pain when coughing and sneezing: A hernia must be treated immediately by a doctor or urologist.
Treatment and therapy
In the case of testicular pain, treatment is always based on the triggering cause. If the pain is caused by viral diseases, bed rest, cooling and elevation of the testicles are usually sufficient. Bacterial infections are usually treated with antibiotics. In rare cases, purulent abscesses can form in the testicles as a result of the inflammation. These must then be removed by surgery. Testicular tumors are treated by radiation therapy, and in some cases by surgery. If testicular torsion, i.e. twisting of the testicles, is the cause of testicular pain, immediate surgery is necessary. This is the only way to avoid damage to the testicles. If other underlying diseases, such as herniated discs, inguinal hernias or varicose veins, are the cause of the testicular pain, these are treated depending on the clinical picture. A correct and comprehensive diagnosis is extremely important to treat testicular pain in a sustainable and correct way.
Outlook and prognosis
If the pain results from a twisting of the testicles on the spermatic cord, the affected testicle can usually be saved by timely surgery. In a testicular fixation procedure, the scrotum is opened, the twisting is corrected, and the testicle is fixed with a suture inside the scrotum. The procedure is usually performed prophylactically on the other testicle as well. The testicular tissue dies after the blood supply is cut off for about six to eight hours. If the patient has sought medical treatment too late, amputation is the only option in the case of testicular torsion. The removal of a testicle reduces the density of sperm in the ejaculate and, as a consequence, the ability of the affected person to conceive. However, the missing testicle can be replaced by a plastic implant and thus at least the visual impairment can be remedied.If a testicular tumor is responsible for the pain, the affected person must expect that it not only grows rapidly, but also forms metastases in the inguinal and pelvic lymph nodes as well as in the lungs and bones. In advanced stages, sufferers experience general weakness, severe weight loss and fever. However, if testicular cancer is detected in time, the chances of cure are close to 100 percent.
Prevention
Testicular pain cannot be prevented in all cases. However, preventive measures can very well be taken against the most common causes, viral diseases and bacterial infections. In the case of viral diseases, mumps is often the trigger of the symptoms. It is therefore advisable to be vaccinated against mumps. Vaccination is already possible in infancy and can reliably protect against infection with mumps. Bacterial infections are often caused by the gonorrhea pathogens. The best protection against gonorrhea is the use of condoms during sexual intercourse. In some cases, however, the pain has other causes. Then prevention against testicular pain is hardly possible.
This is what you can do yourself
In most cases, testicular pain is harmless. They occur mainly after accidents or blows in this area and can be relatively painful. Here, the testicles can be cooled, thus the testicular pain is relieved. If the pain is very severe, painkillers can also be taken. However, these should not be taken for a long period of time. Testicular pain after sex is a common symptom. Light massages and cooling of the testicles help here. Raising the testicles can also help relieve the pain. To do this, the testicles must be moved from their hanging position to an elevated position by, for example, placing rolled-up socks underneath them. In some cases, too tight underwear can also lead to the testicular pain. In this case, the patient should buy loose underwear and not tight underwear. In many cases, the testicular pain also occurs as cavalier pain when the man fails to ejaculate during sexual intercourse. In this case, the testicular pain is completely harmless and disappears when ejaculation has occurred. Also, a permanent erection can extend to the testicles and thus cause the testicular pain. In this case, the erection should be stopped. If, in addition to the testicular pain, there is also pain during urination, a doctor should be consulted. In this case, it may be testicular cancer or inflammation.
