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Testicular pain / pain on the testicles

Testicular pain / pain on the testicles


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Testicular pain manifests itself as pulling, pushing or stinging in the testicle area and can be caused by a wide variety of diseases or injuries to the testicles. The testicular pain is often accompanied by swelling, reddening and hardening in the testicle area. Since testicular pain can also be a sign of serious diseases such as testicular cancer, testicular torsion or epididymitis, those affected should urgently seek help from a doctor in order to enable a clear determination of the causes of pain and to exclude far-reaching health risks.

Testicular pain - brief overview

A quick classification of the testicular pain is of crucial importance, since with some causes there is little time left to initiate a promising treatment. Here is a brief summary of the most important facts:

  • Contact emergency callif the testicular pain suddenly begins, becomes increasingly severe, swelling and redness (unilateral or bilateral) occur and / or radiating pain in the groin region and the abdomen are added, as testicular torsion may be present. Similar complaints can occur with a testicular rupture (usually as a result of external force), in which the emergency services should also be contacted immediately.
  • causes: so-called cavalier pain, testicular diseases such as testicular inflammation, epididymitis, testicular bruise, testicular rupture, testicular torsion or testicular cancer; Varicose veins in the testicle area, inguinal hernia, kidney stones.
  • diagnosis: Thorough medical history with questioning about the occurrence of the complaints, the exact location of the pain, its intensity and duration, known previous illnesses, sexual behavior and any complaints when urinating; Palpation of the scrotum, ultrasound examination of the testicles and, if necessary, direct surgical opening of the scrotum.
  • treatment: Depending on the causes, in the case of the medical emergencies mentioned surgical intervention, in the case of bacterial testicular inflammation, if necessary with antibiotics, for some causes, however, only cool and wait.

Different testicular pain

Depending on the causes of the testicular pain, the complaints can vary significantly in intensity and duration, although slight testicular pain can also indicate serious illnesses, i.e. the intensity of the pain does not necessarily relate to the severity of the illness. Estimates assume that around every second man in this country will suffer from testicular or prostate problems at least once in the course of his life. However, not every painful pinch in the testicle area has to indicate a testicular disease. For example, complaints perceived as testicular pain can also be caused by diseases of the surrounding organs that radiate down to the testicles.

In addition, testicular pain is sometimes the result of sexual arousal without subsequent ejaculation or particularly long-lasting erections. In these cases, the complaints are known as so-called cavalier pains. From a medical point of view, however, these are rather harmless and the pain usually goes away on its own.

Testicular inflammation as a cause of testicular pain

Testicular inflammation (orchitis) is often the cause of testicular pain, which usually occurs in connection with inflammation of the epididymis (epididymitis). The inflammation is caused by viruses or bacteria and often causes symptoms such as swollen testicles and reddening of the scrotum. Testicular pain is also a typical consequence of such inflammation. The pain begins with a slight, barely noticeable pull and increases continuously as the disease progresses.

The testicular and epididymitis can take an acute or chronic course of the disease. The inflammation is usually accompanied by fever, urinary problems and other non-specific symptoms of the disease. Inflammation of the testicles or epididymis is usually relatively easy to determine on the basis of a blood test and with the aid of ultrasound examinations. In individual cases, however, the testicle must also be surgically exposed to confirm the diagnosis.

Important: In the event of chronic inflammation of the testicle or epididymis, those affected are at risk of irreversible damage to the testicular tissue, which can impair fertility and even sterility. In addition, abscesses can form in the course of testicular inflammation, which in the worst case trigger blood poisoning. If you have any complaints, a doctor should be consulted urgently.

Testicular pain due to varicose veins and inguinal hernia

A varicose vein can also cause swelling and pain in the area of ​​the testicles, whereby the dilation of the vessels can often be seen with the naked eye. The pain typically occurs here under increased physical exertion. Surgical removal or sclerotherapy of the varicose veins is recommended for treatment. Another possible cause of testicular pain is hernia. The pain of a hernia often radiates in the direction of the testicles and is perceived by those affected as a very painful feeling of pressure. Parts of the intestine press on the spermatic cord or blood vessels due to the “rupture” of the peritoneum, causing pain in the area of ​​the testicles. Correction of an inguinal hernia requires surgery.

Testicular pain due to testicular torsion

Another cause of acute testicular pain is a testicular torsion (twisted testicle), in which a twisting of the testicles around its own axis cuts off the blood supply and causes massive pain. The pain is usually accompanied by symptoms such as abdominal pain, swelling of the scrotum, nausea and vomiting. If surgical treatment is not carried out immediately, in which the testicles are brought back to their original position, the tissue threatens to die off after only a few hours and the affected testicle must then be completely removed. Testicular torsion occurs most frequently in children and adolescents, but the likelihood of such an injury decreases significantly with age.

Testicular cancer as a cause of testicular pain

The formation of tumors can also be responsible for the testicular pain, whereby the testicular cancer - in addition to the pain - causes palpable swelling and hardening of the testicles. If in doubt, the diagnosis can be verified with the help of an ultrasound examination. Testicular cancer also urgently needs medical treatment, but the chances of a cure are pleasingly high at more than 90 percent. After the surgical removal of the testicle in question, radiation or chemotherapy is used if necessary, which in most cases enables successful therapy. Here too, the principle applies to testicular cancer: the earlier the diagnosis is made and treatment started, the higher the likelihood of a successful course of therapy. According to the German Cancer Society, the cure rate for testicular cancer reaches up to 98 percent in the early stages.

Testicular bruise as the cause

External influences such as bumps, blows or kicks can cause testicular bruises with long-term pain in the testicle area. In addition to the pain, there is a hematoma in the area of ​​the testicles and a corresponding swelling of the scrotum. It usually only helps cool and be patient. The pain can last for several days, but usually disappears on its own. The hematoma is usually accompanied by a bluish, greenish discoloration of the testicles, which, however, also decreases over time. Since other injuries to the testicles can also be caused by the external force, a medical examination should be carried out in the event of a bruised testicle.

Testicular pain from kidney stones

Acute testicular pain can also be caused by kidney stones and bladder stones, which usually form as deposits in the urinary tract such as the kidney, ureter and bladder. In addition to testicular pain, symptoms such as nausea and vomiting, problems with urination or blood in the urine are typical signs of kidney and bladder stones.

During the treatment, smaller deposits are removed as part of a bladder mirroring, larger stones have to be crushed using various methods and then removed. Surgical intervention may also be necessary.

In the event of testicular pain, see a doctor urgently

All in all, there can be numerous serious illnesses behind the testicular pain, which in case of doubt - such as testicular torsion - require medical measures to be taken within a few hours to rule out more far-reaching health risks. Men who have pain in the testicle area should therefore not be afraid to immediately seek medical help (urologist). As a rule, the cause of the complaints can be determined promptly with a few simple steps and appropriate treatment steps can be initiated. The basis for a successful therapy of testicular pain is always a diagnosis that is as precise as possible.

Diagnosis

First of all, a thorough medical history with questioning of those affected about the occurrence of the symptoms, the exact location of the pain, its intensity and duration, known previous illnesses, sexual behavior and any complaints when urinating are required. Careful examination of the testicles and palpation of the scrotum can provide further important clues (e.g. redness, swelling, visible varicose veins).

If necessary, an ultrasound examination of the testicles can also be carried out to determine the cause of the complaints. However, further examinations (tests for certain pathogens) or even an operative opening of the scrotum may be necessary to finally confirm the diagnosis.

Testicular pain - treatment

The treatment of the testicular pain should always be based on the respective causes and, if necessary, only a few hours remain to avoid further health problems by means of a surgical intervention. This applies not only to testicular torsion, but also, for example, if the inguinal hernia is jammed. By cooling the testicles, the pain can often be relieved by bridging until a doctor is consulted, but the success of the cooling must not hide the fact that a serious illness can be behind the symptoms. Medical clarification is therefore essential.

Treatment of testicular inflammation

Depending on whether viruses or bacteria triggered the testicular inflammation, different treatment methods are then considered. Therapy for a viral infection mainly provides measures to support healing, such as bed rest, cooling of the scrotum and taking anti-inflammatory drugs. If mumps viruses trigger the symptoms, conventional medicine uses interferon to fight the inflammation. Bacterial-induced testicular inflammation can, however, be treated relatively successfully with antibiotics, whereby therapy should be started as early as possible in order to avoid the transition to a chronic course of the disease. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • A. Klotz, O. Moormann; Special pain conditions in urology; in: The urologist, October 2009, springer.com/
  • B.-S. Schneevoigt: Acute testicular pain - an emergency !; in: MMW - medical advances, Volume 153, Issue 8, pages 38-42, February 2011, springer.com
  • Chirag G. Gordhan, Hossein Sadeghi-Nejad: Scrotal pain: Evaluation and management; in: Korean Journal of Urology, Volume 56, Issue 1, page 3-11, January 2015, icurology.org
  • Misgav Rottenstreich, Yuval Glick, Ofer Natan Gofrit: Chronic scrotal pain in young adults; in: BMC Research Notes, Volume 10, Article number 241, July 2017, biomedcentral.com
  • Havish Srinath: Acute scrotal pain; in: Australian Family Physician, Volume 42, No. 11, pages 790-792, November 2013, racgp.org.au
  • German Society for Pediatric Surgery (DGKCH), German Society for Urology (DGU): Treatment guideline - Acute scrotum in children and adolescents (retrieved on 03.10.2019), awmf.org


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