Testicular pain

definition

The most common testicular pain is caused by inflammation of the testicles. Furthermore, infectious diseases cause pain in the testicles.

Below you will find an overview of possible diseases of the testicles.

introduction

Testicular pain can have many different causes. On the one hand, there are those that are not immediately acute Present problems and rather need long-term therapy. But there are also some who have an immediate, emergency surgical therapy is required to prevent permanent damage to the Testicle to prevent.

Of course, there can be a process in the testicle itself, be it inflammation or a tumorto be responsible for the testicular pain. On the other hand, processes in the neighboring organs, e.g. a Inflammation of the bladder, urethra or prostate trigger the pain.
Even the nerves themselves responsible for the Pain and sensation transmission from the testicles are responsible Testicular pain cause. Regardless of where the actual damage is located in the nerve course. In this sense, injuries and diseases of the Spinehow about a Herniated disc of the lumbar spine, manifest as testicular pain.

But also a so-called Testicular torsion, which represents an acute emergency, is a possible cause. Just like Water retention in the testicles (Hydrocele), but with a relatively obvious one swelling go along, or Inguinal hernias.

If the cause of testicular pain is unclear, because of the many possible underlying problems, always a thorough one medical evaluation respectively.

Pain character and strength

The nature of the pain is very different depending on the underlying disease. Light pain rather point to one Inguinal hernia, one Varicocele (Varicose veins in the testicle area) or one Testicular tumor down. At a Testicular torsion severe pain conditions occur. Also one acute inflammation or the Entrapment of a hernia can cause extreme pain. On the other hand, there is an inflammation of the prostate or bladder mostly in a light one Drawing in the testicle.

All types of testicular pain can also be expressed by a rather diffuse pain in the lower abdominal area. If treatment is absent or not responding, testicular pain can also occur chronic become.One speaks of chronic testicular pain when the pain is over at least 3 months stop or return regularly.

Frequencies and prognosis

The frequency peak for testicular pain is beyond the 45 years of age. It is believed that up to 50% of men will experience testicular pain problems during their lifetime. The risk is increased in men who took one as a child Undescended testicles (maldescensus testis) had. Testicular pain should always be done as soon as possible medically clarified become. With adequate treatment, a transition to a chronic problem can usually be avoided.

causes

Inflammation of the testicle or epididymis

The isolated testicular inflammation (Orchitis) is like inflammation of the epididymis (Epididymitis) a rather rare disease. It occurs when viruses or bacteria reach the testes either through the bloodstream, through lymph vessels or directly through the vas deferens.

Read more about this in our main article: What are the causes of testicular inflammation?

More often, however, the inflammation of the testes occurs on the basis of systemic infections. These infections mainly include mumps, but also chickenpox, Pfeiffer's glandular fever or malaria. However, especially after the introduction of the vaccination against mumps, the incidence of testicular inflammation and the infertility that often results from it have decreased significantly.

If the testicular inflammation is caused by an ascending urinary tract infection, the epididymis is usually also affected. The inflammation manifests itself in addition to the testicular pain itself, through swelling, reddening and overheating of the affected testicle.

Read more on this topic at: These are the symptoms I can tell if there is an inflammation of the epididymis

However, similar symptoms can also occur with testicular torsion, which is why you should see a urologist quickly should imagine. The diagnosis can then usually be made using ultrasound and urinalysis. The testicle should then be immobilized and elevated; cooling can relieve the pain. In the case of bacterial infections, the treating doctor will also prescribe an antibiotic. Painkillers and anti-inflammatory drugs that inhibit the inflammatory reaction can be taken as support.

Inguinal hernias and hernias

In the case of an inguinal hernia, abdominal organs, i.e. mainly parts of the intestine, enter the so-called inguinal canal. Normally blood vessels, nerves, muscles and also the spermatic duct pull through this to the testicles. If parts of the intestine enter this narrow canal or press on the structures in it, this causes testicular pain, among other things. It can even happen that parts of the intestine in the inguinal canal sink into the testicles.

The inguinal hernia is caused by a disproportion between the muscle and connective tissue that stabilize the inguinal canal and the pressure in the abdomen. Therefore, inguinal hernias often arise after physical exertion, such as heavy lifting, but also heavy sneezing or coughing. Inguinal hernias can also be congenital. The inguinal hernia usually has to be treated surgically.

Testicular torsion

With testicular torsion, the testicular pain is usually very strong and sudden. This is because, in testicular torsion, the so-called vascular pedicle, which supplies the testicles and epididymis with blood, is twisted in such a way that the blood supply to the testicle is cut off. The testicle is no longer supplied with blood and oxygen. In addition, the blood that has reached the testicle can no longer drain, which leads to severe swelling and congestion in the testicle.

If the testicular torsion is not recognized and treated at an early stage, the entire testicle can die off after approx. 4-6 hours. The testicular pain is accordingly usually much more severe than with testicular inflammation. In addition, the pain of testicular torsion does not improve when the testicle is lifted.

In this case, the emergency room of a hospital with a urological department should be visited immediately. The testicular torsion then usually has to be treated surgically. The torsion itself is eliminated in the operating room or, if the testicle has already died, it is removed. In addition, the other, not twisted testicle is usually fixed in such a way that there is no risk of torsion. The fertility is normally fully preserved even with only one testicle.

Read more on the topic: Testicular torsion

Testicular tumors and testicular cancer

Testicular cancer starts from the different cells of the testicle. Sometimes one speaks in this context of a germ cell tumor. A malignant tumor of the testicle leads to death if left untreated. If detected early, however, it can usually be treated well. Testicular cancer usually occurs between the ages of 20-40 years.

In the beginning, the testicular pain usually manifests itself as a slight pulling in the testicle or a pulling in the groin. You can sometimes feel an enlargement or swelling of the testicle. In the advanced stage, back pain can also occur due to the lymph nodes in the abdominal cavity.

To detect testicular cancer early, you should regularly palpate the testicles in a relaxed state. If you have palpable nodules or the pulling pain described above, you should consult a urologist. A precise clarification of the malignancy of the tumor can often only take place after removal by a pathological examination. Even after removing one testicle, the other testicle can usually take over the functions without any problems. Overall, if detected early, testicular cancer has a good prognosis.
Read more on this topic at: Testicular cancer

Testicular pain from back problems

Since the spine, or the spinal cord running in it, represents the neural connection between the body and the brain, damage to the spine can also cause testicular pain. If the nerve is damaged within its course, the pain is assigned to the organ to be supplied and not necessarily to the damaged area. This means that nerves supplying the testicles trigger testicular pain even if the real cause is elsewhere.

It is possible that a herniated disc in the lumbar spine or degenerative changes in the spine can lead to pain in other parts of the body, as in this case on the testicles. In addition, the so-called Ilioinguinal nerve many of the muscles that hold the testicles in place. This emerges in the lower back area and can therefore also be the cause of testicular pain when there is tension in the lumbar region.

So if no direct, urological causes of testicular pain can be found, one should also consider an orthopedic search for the cause. The symptoms then often improve under physiotherapy or after treatment of the back problems.

Testicular pain from sperm congestion

A sperm congestion (accumulation of seminal fluid in the testicles) does not exist physiologically. The idea behind this idea is that the testicle continues to produce sperm and, if they do not pass through them regularly ejaculation removed, accumulate in the testicle. However, it does not take into account that old sperm cells are absorbed and broken down by the body independently, or are expelled in the form of, sometimes at night, unnoticed ejaculations.

The exception to the above are men who have had a vasectomy, i.e. after surgical severing of the spermatic duct. With these, there may actually be a brief backlog of sperm in the testicles immediately after the operation. But here, too, these are reabsorbed and broken down after a short time, so that the congestion of the seeds has no disease value here either.

Read more on the topic: Sperm

Colloquially, the term testicular pain caused by sperm congestion, but also pain caused by sexual arousal or activity. It is quite possible that prolonged excitement, especially if it does not end in ejaculation, leads to an irritation of the testicles and the vas deferens.

Read our article on this: Inflammation of the vas deferens.

Short-term painful conditions of the testicles can also occur after sexual intercourse. Even if there is no build-up of seminal fluid in the testicles, there are certainly indications that good sexual hygiene, in the sense of regular sexual activity, has a positive effect on the course of e.g. Inflammation of the prostate.

Testicular pain when walking

Many of the causes of groin pain described above can be influenced by changes in the position of the testicles or general activities. With testicular inflammation, an improvement in pain when the testicle is raised is typical. Accordingly, the pain can increase from the constant up and down while running.

The nerves that supply the testicles can also be influenced in various places in their course to the spinal cord or the brain. An incipient hernia can put pressure on the nerves running in the inguinal canal. Under certain circumstances, this pressure is too low at rest to cause testicular pain. Only with the higher impact load when running can pain occur.

Something similar is possible with problems of the spine. A herniated disc of the lumbar spine can change its position as a result of the movement in such a way that it presses and irritates the nerve during the additional stress while running. The fact that testicular pain occurs or worsens when walking is completely normal for many diseases.

But it is also possible that testicular pain, e.g. caused by tension in the muscles in the back or pelvic floor, and even improved with light movement Whether running is suitable as a sport for the respective illness or whether it should be paused must always be discussed with the treating doctor.

Testicular pain during exercise

As with running, other exercise can affect the appearance or severity of testicular pain. Especially sports with mechanical stress on the testicles and pelvic floor area, such as cycling or horse riding, can cause problems here. Activities that require a lot of force, such as heavy lifting or weight training, can cause testicular pain by increasing the pressure in the lower abdomen.

In sports where there is a risk of traumatic testicular damage, such as In martial arts a jockstrap should be worn anyway. In addition to protecting against injury, the jockstrap can also help relieve testicular pain when moving, as the testicles are higher and more stable than normal.

Other causes

Any kind of direct injury can of course also be considered as a further cause. In these cases, however, the connection can usually be clearly established. But also tension in the area of ​​the pelvic floor or a so-called pelvic pain syndrome can cause testicular pain. Especially if the pain is perceived more diffusely throughout the lower abdomen, the actual cause can also be in the prostate area, as in the case of prostate inflammation or in the area of ​​the rectum or bladder. Kidney stones or bladder stones are also possible causes.

Typical diseases of the testicle

Abnormal changes in the testicle (Testis) include inflammation (Orchitis) and tumors, which are malignant in 95% of cases and cause severe testicular pain.

Please read our overview page: Diseases of the testicle

Location anomalies

Furthermore, there are positional anomalies, why Testicular retention and Testicular ectopy counting.

Under Testicular pain from testicular retention one understands that the Testicles in the embryonic development does not move to its definitive place in the scrotum, but "gets stuck" in between on its normal path. This can be in the abdomen or in the groin in the inguinal canal.

Testicular ectopy describes the position of the testicle outside the normal migration path.

The clinical picture of the very painful represents an acute emergency Testicular torsion The testicle and the spermatic cord twist and thus prevent normal blood flow to the testicle and cause pain in the testicle.

Furthermore, a Varicocele, Hydrocele or Spermatocele Trigger testicular pain. This is an expansion of the venous testicular vessels (Varicocele), a build-up of fluid in the tunica vaginalis (Hydrocele) or a semen-filled cyst (Spermatocele).

You can get all of these diseases through one Ultrasound of the testicle diagnose quickly.

Prophylaxis and treatment

There is no general prophylaxis against the occurrence of testicular pain. General therapy cannot be recommended either. The most important is always that Complaints serious to to take and as quickly as possible, specialist to be clarified. For many of the diseases described above, especially the Testicular torsion, is a quick treatment important to save the affected testicle. To detect the occurrence of testicular tumors at an early stage, one can, similar to that for women at Breast cancer screening it is recommended to palpate the testicle regularly. This is especially true when you know that you are under you in childhood Undescended testicles suffered because in this case the risk of both testicular cancer and the development of an inguinal hernia is increased. If in doubt, testicular pain should be clarified once too much rather than too late. Otherwise, irreparable damage to the testicle may already have occurred.