Ouch! What Causes Testicular Pain?
Ouch! Any man who has ever suffered a hard knock to the groin will still cringe at the memory. But apart from direct trauma, what other conditions can result in pain in the testicles?
What are the Testicles?
The testicles, or testes, are two egg-shaped reproductive organs in males located in the scrotum. They produce sperm and sex-hormones (primarily testosterone). As most men are aware, the testes are very sensitive and even the slightest trauma or injury can cause pain and discomfort. While some causes of testicular pain may be mild and self-resolving, there are some serious conditions which require urgent evaluation and treatment.
Common Causes of Testicular Pain & Discomfort
1.) Testicular Torsion (Testicle Twists)
One of the most important things to investigate for in sudden, severe testicular pain is testicular torsion. This occurs when the testicle twists around the spermatic cord, which supplies blood to the scrotum. The reduced blood flow causes pain and swelling and usually needs to be corrected with emergency surgery. If it is not addressed quickly, the testicle may be irreversibly damaged from lack of blood supply and may need to be completely removed. Testicular Torsion is most common in young boys between the age of 12-16 years old, but it can occur at any age. It can develop a few hours after vigorous exercise, but also commonly occurs during sleep or even following a seemingly minor injury. The condition is more likely to occur if you have had it before and did not have proper surgical correction, and can also tend to run in families. Early evaluation and treatment can prevent severe damage and loss of the testicle.
2.) Testicular Infections & Testicular Inflammation
Another common group of men I see with testicular pain and discomfort are those with infections. This occurs when a virus or bacteria invades the tissues and causes inflammation of the testicles (orchitis) or surrounding structures (epididymitis, prostatitis, urethritis, etc.). In younger males, mumps orchitis is a fairly common complication of infection with the mumps virus; however, this is less of a problem nowadays since most people are now vaccinated against it.
In men who are sexually active, gonorrhoea and chlamydia are the most common causes of infection and may be accompanied with symptoms such as testicular swelling, testicular pain while passing urine, or penile discharge.
In older males and men who have sex with men, enteric bacteria (those living in the gastrointestinal tract) are more prevalent; these include E. Coli, Enterococcus, and Klebsiella species. If you suspect any kind of infection, it is important to be evaluated and treated promptly with antibiotics, as they can spread to nearby structures and cause further complications including infertility. As many infections are also sexually transmitted, an std treatment of your partner may be necessary as well.
3.) Testicular Cancer
Testicular cancer can also be a cause of vague discomfort and swelling around the testicles, and may present with a palpable lump. It is actually the most common cancer in males between 18-50 years old, and if detected early can be cured in up to 96% of cases. Leaving it late may allow cancer to spread to other organs in the body, by which time it may be too late to cure completely. It is important to speak to your healthcare provider about proper testicular self-examination so that potential opportunities for early detection are not missed.
4.) Other Causes of Testicular Discomfort & Pain
A few other common but usually more benign causes of testicular discomfort may include varicoceles (leaky blood vessels), spermatocele or hydrocele (caused by fluid build-up), epididymal cysts, and inguinal hernias. Most of these can be picked up by a simple ultrasound scan and do not usually require costly treatment.
The next time you feel pain or discomfort in the testicles, do not ignore it and miss something potentially serious. Most conditions can be treated if detected early. If you are in or around Singapore, visit one of our clinics to get a proper evaluation by our specially-trained doctors in Our Clinics.