As you very well know, the testicles are very sensitive. They are also not protected by bone and muscle like many other vital organs can be. Trauma caused by some kind of external blow may cause ongoing pain. If you suffer anything more than mild pain in the testicles following some kind of trauma, you should see a urologist for assessment.
Epididymitis is the inflammation or infection of the epididymis – duct behind the testis, along which sperm passes to the vas deferens. This may be the result of a urinary tract infection or sexually transmitted disease, some kind of trauma that has caused bleeding in the scrotum, or autoimmune disease.
Symptoms include a swollen, red or warm scrotum, testicular pain and tenderness, painful urination, and pain or discomfort in the pelvic area. Treatment will involve a course of antibiotics. If the cause of the infection is an STI, your partner will also need to take antibiotics.
Orchitis is an inflammation of the testicles. This can be caused by either bacterial infection or a virus. This may affect both testicles but usually only affects one. Treatment will depend on the cause. For bacterial inflammation, antibiotics will be required.
Swelling and inflammation of the prostate gland is known as prostatitis. It is caused by either a bacterial or non-bacterial infection and can cause pain in the testicles.
Treatment will depend on the type and the underlying cause. Antibiotics are the most common treatment for bacterial prostatitis. The type prescribed will depend on the strain of bacteria causing the infection. Nonbacterial prostatitis may heal on its own.
Sometimes testicular pain can be caused by a inguinal hernia. This when part of the soft tissues in the abdomen (such as the intestine) protrude through an area of weakness or a defect in your lower abdominal muscles. In some cases this can impact on the testicles, causing pain.
Treatment will usually involve surgery, with your surgeon pushing the bulging tissue back into the abdomen, then stitching and reinforcing the portion of the damaged abdominal wall. This is known as inguinal herniorrhaphy.
Varicoceles are enlarged veins located within the scrotum, similar to varicose veins that are commonly seen in the legs. Most of the time they arise during periods of rapid growth, such as during puberty, and grow over time. They are quite common.
Treatment is not always required for varicoceles, particularly if symptoms are mild. But if they are causing pain, testicular atrophy (smaller testicles), or infertility treatment is recommended.
Testicular torsion is an urologic emergency. It is when the spermatic cord, which carries blood to the testicles, twists. As a result, blood flow is reduced and the tissues in the testicle can start to die. It is extremely painful. Testicular torsion is most common in young males, but can also occur in older men and infants. Surgery will be required to treat it. This involves making a small incision in the scrotum and untwisting the cord. The testicle is then sutured in place to ensure it does not twist again (orchidopexy).
Most of the time, testicular cancer is not painful. However, if the tumors grow rapidly or affect the testicle a particular way, they can cause pain.
Treatment will depend on the stage of the cancer. For stage one cancer, removal of the testicle may be the only treatment required. This is known as an orchidectomy. Surgery, chemotherapy and radiotherapy may be required if the cancer has spread.
As a specialist in cancer surgery Dr Arianayagam can guide you through treatment for testicular cancer if needed.