Several diseases can cause testicular pain. Among them, we find:
- Kidney or ureteral stones;
- Inguinal hernia. Inguinal hernia is a condition in which part of the small intestine or intra-abdominal fat protrudes into the inguinal canal due to a weakness in the wall, causing pain and swelling in the affected area, including the testicles;
- Hydrocele. This condition causes the scrotal sac to fill with fluid due to inflammation, trauma to the scrotal area, or previous testicular surgery. Hydrocele is a benign condition that, if particularly voluminous, can cause pain and discomfort in the testicles;
- Epididymal cysts. These are accumulations of fluid held by a thin membrane that originate in the epididymis or within the spermatic cord. When they contain thick fluid with non-vital spermatozoa, they are called spermatoceles;
- Epididymo-orchitis. Epididymo-orchitis is an inflammation of the testis and epididymis, often caused by a bacterial infection.
- Prostatitis. Prostatitis is prostate gland inflammation, affecting 30% to 50% of sexually active men; occasionally, it is due to a bacterial infection of the gland, although in many cases, no microorganism can be detected (abacterial prostatitis). When symptomatic, prostatitis can cause pain in the pelvic floor, with spasms in the perineal muscles and, often, involvement of the testicular area as well;
- Varicocele. Varicocele is caused by blood reflux from the left renal vein to the testicle, leading to blood stagnation and increased local temperature. The increased temperature can cause a decrease in the production and quality of seminal fluid, going so far as to cause infertility. If high grade, varicocele can cause a sense of discomfort up to even pain in the testicle;
- Testicular torsion. It is the torsion of the spermatic funiculus connecting the testicle to the abdomen. Because the spermatic funiculus is supplied by many blood vessels, in the event of torsion, the blood supply is likely to be interrupted, and this could result in the onset of ischemia and related damage, which is potentially irreversible if not addressed promptly;
- Testicular cancer. Testicular cancer is a rare neoplasm that develops due to an alteration in the cells of the testis, causing them to grow uncontrollably and resulting in the formation of a mass. Most testicular tumors originate from the germ cells, which give rise to spermatozoa. In most cases, testicular cancer arises as an indolent mass, but in a minority of patients, it may present as pain in the affected testis.
Testicular Pain: What to Do?
In case of testicular pain, it is strongly advised to consult the physician as it is necessary to understand the disorder’s underlying cause.
If the pain is mild and probably due to an external cause, such as trauma, it may be sufficient to apply cold objects to the affected area and take painkillers or anti-inflammatory drugs, but always under medical supervision.
If, on the other hand, the pain is so severe that it interferes with normal daily activities and perhaps is prolonged over time or is accompanied by other symptoms such as local swelling, nausea, vomiting, and fever, it is imperative to seek an urgent check-up at the hospital or the andrologist or urologist specialist.
Depending on the diagnosis, the specialist may request further investigations and the most useful instrumental tests to identify the origin of the pain and indicate the most appropriate therapies.