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Testicular  Pain

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About Testicular Pain

The testes are two small organs located inside the scrotum and under the penis. Males of all ages can experience testicular pain. There are two types of testicular pain: acute (sudden and short) and chronic (gradual and long-lasting). Aside from the sharp pain of the sudden injury, the first sign might be a dull ache that worsens with activity or time. As the testicles have many sensitive nerves, testicular pain can be intense, severe and distressing.

What Causes Testicular Pain

Like other places of the body, testicular pain can be caused by a variety of factors. These conditions can be categorized into three broad categories, ischemic (poor blood supply), inflammatory or neuropathic (nerve type) pain of the testes. The most common types of conditions are epididymitis (inflammation of the testes), testicular torsion (twisted spermatic cord that brings blood to the scrotum) and inguinal hernia. Most causes of testicular pain are either because of one’s biological build (constitutional) or the pathogens from sexual intercourse and transmission.

What Causes Testicular Pain

Like other places of the body, testicular pain can be caused by a variety of factors. These conditions can be categorized into three broad categories, ischemic (poor blood supply), inflammatory or neuropathic (nerve type) pain of the testes. The most common types of conditions are epididymitis (inflammation of the testes), testicular torsion (twisted spermatic cord that brings blood to the scrotum) and inguinal hernia. Most causes of testicular pain are either because of one’s biological build (constitutional) or the pathogens from sexual intercourse and transmission.

Symptoms Of Testes Pain

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Pain
Pain in the testicles can vary depending on their underlying cause. It may be either a localised testes pain or a referred pain from another source. A sudden testicular injury may result in a localised sharp, immediate pain followed by a dull ache. Conversely, one may feel a referred pain as a sharp back pain spreading to the testicles and the penis if kidney stones are present.
Bruising and/or swelling
There may be bruising or a lump on the scrotum. The scrotum may also appear red or shiny which can be an indication of an injury, orchitis, epididymitis or testicular tumour.
Other Symptoms
Other symptoms may include fever, nausea, vomiting or urination problems (frequent urination, burning sensation while urinating, blood in the urine).

A Message About Testicular Pain

Many males may find talking about testicular pain embarrassing or awkward. Too often, one may dismiss the dull ache or testicular discomfort as normal, allowing it to fester and compound into something more sinister. Non-distressing testicular pain persisting for more than 1 month would require medical attention to exclude more serious pathology such as cancer or infection. Conversely, less serious problems such as Hydrocele (cyst-like formation behind the testes) can also present as persistent testicular pain.

Many testicular pain may result from post-infection or post-surgical pain. Prostate infection as well as some urinary tract infections, including post prostate surgery, may present as nerve-type pain. The pain is due to nerve irritation or hypersensitization of nerves affected by nerve “injury” from the preceding medical condition. This type of pain cannot be treated by treating the underlying condition. The focus is on the stabilization of the sensitized nerve.

Diagnosing Testicular Pain

Here at Singapore Paincare, our team of experienced primary care doctors and pain care specialists, together with Urologists, will conduct a thorough diagnosis. This includes a physical exam, questions about your symptoms and an evaluation of your medical history. Blood or urine tests may be performed to check for any infections. In case of a lump in the testicle, an ultrasound will be ordered to check for testicular cancer.

What Treatments Are Available for Testicular Pain?

In many instances, non-surgical treatment methods can provide excellent outcomes. At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our pain resolution approach focuses on removing pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments, and cognitive and physical rehabilitative therapies. We help patients to improve their functions and prevent pain from recurring.

Non-Surgical Treatments for Testicular Pain

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Anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs are effective in eliminating the pain caused by testicular pain. NSAIDs are often prescribed to patients suffering from injuries, trauma, and orchitis. These medications will target the organ inflammation, stop the swelling and allow for healing.
Pharmacotherapy
Apart from NSAIDS, our physicians and specialists may also prescribe antibiotics or anti-infective medications for testicular pain caused by bacterial infection. Anti-convulsant and anti-depressants can also be used to treat nerve pain.
Radiofrequency ablation of the sensitised painful nerve
In neuropathic testicular pain, medications may be inadequate to control the nerve pain. Patients may benefit from desensitisation of the surrounding nerve plexus supplying the testes. Specialised injections which apply micro-electrical current and heat to the sensitised painful nerves will provide improved pain relief, without causing further nerve sensitivity or damage.
Spinal Cord Stimulation
In refractory and difficult to control pain, Spinal Cord Stimulation may modulate the pain signals with proprioceptive stimulus, covering over and blocking the pain transmission. The stimulation of the relevant nerves is targeted within the tailbone by implantation of electrodes next to the affected nerve plexus.

Surgical Treatment for Testicular Pain

When it comes to testicular pain, surgery is usually not necessary unless it’s an emergency condition like testicular cancer or testicular torsion. Depending on the cause, surgery for testicular pain includes:

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Hernia Repair Surgery
You may need this procedure if you are not able to push your intestinal hernia back into your abdomen or if you need to make it smaller.
Testicular Detorsion
This surgery involves untwisting the spermatic cord to restore the blood flow to the testicles. To prevent the twisting from happening again, the surgeon will create stitches around the testicle.
Testicular Cancer Surgery
This surgery involves the removal of the testes which will be examined under a microscope to determine the type of testicular cancer and if the patient needs further treatment, such as chemotherapy or hormonal therapy.

How Can I Prevent Testicular Pain?

You can prevent yourself from having testicular pain by:

  • Doing regular check-ups
  • Wearing an athletic cup before playing full-contact sports
  • Wearing protective clothing for dangerous tasks/jobs

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