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Unusual irregular pain in testicle
Discussion in 'All Categories' started by Vikas Vaidya - Dec 14th, 2011 4:56 pm.
Vikas Vaidya
Vikas Vaidya
I have been sufferred by unusual irregular pain in my Testicle since 2-3 months. Initially 2 months back I got a unbearable severe pain in testicle and got admitted in some nearby private hospital which instead of confirmed after MRI that there is a swelling nerve in upper part of my abdominal. After their treatment I got almost relaxed. But, after 2-3 weeks the problem got started and I have been suffering with mild to moderate pain in testicle.

Due to my exams and few other family responsibilities I couldn't undergone any treatment with some specialist.

I hope you can help me out.

Thanks.
re: Unusual irregular pain in testicle by Dr M.K. Gupta - Dec 15th, 2011 1:13 am
#1
Dr M.K. Gupta
Dr M.K. Gupta
Dear Mr Vikash

In order to diagnose the underlying cause of testicular pain, the care practitioner will conduct a complete history and physical exam on the patient. The physical exam will concentrate on examining the next areas:
abdomen/groin,
penis,
testicles, and
scrotum.
Laboratory tests which may be beneficial in helping result in the diagnosis include:
blood tests
urinalysis
a urethral swab to check for std's if the patient has penile discharge
In many cases, in order to help determine the reason for the testicular pain, an imaging study may also be ordered in the discretion of the healthcare practitioner.

Testicular ultrasound: This non-invasive test can assess the blood flow towards the testicle (if testicular torsion is suspected), along with helping diagnose other anatomical abnormalities inside the scrotum that induce testicular pain, including the following:
testicular rupture,
hematocele (an accumulation of blood),
abscess (a collection of pus)
testicular tumor, and
inguinal hernia.

In cases of epididymitis, testicular ultrasound may reveal an inflamed epididymis with an increase of blood flow to this structure.
Nuclear scan: Some hospitals may perform this test to help evaluate the reason for testicular pain. It is non-invasive, although it does require injection of radioactive dye through an IV line.

A nuclear scan will diagnose testicular torsion by showing decreased accumulation of dye within the affected testicle when compared to normal testicle.
In many hospitals, time required to prepare the types of materials and execute a nuclear scan is really lengthy that it's improper when testicular torsion is suspected.
Finally, in some cases after examining the individual, the health care practitioner may have this type of high amount of suspicion that testicular torsion is present, that no imaging tests is going to be ordered and also the individual will be taken right to the operating room.
After careful evaluation, if no serious underlying testicular injury happen to be identified, many instances of testicular trauma could be managed and treated in your own home. Treatment includes the next measures:
pain medications, including anti-inflammatory agents;
scrotal support and elevation;
ice packs; and
rest.
More severe cases of testicular trauma involve testicular rupture, blunt trauma with an associated hematocele (a collection of blood) and penetrating traumatic injuries requiring surgical intervention.
Testicular torsion: This condition requires immediate surgery with a urologist (specialist in genital and urinary organs). Just before surgery, a doctor may make an effort to untwist the testicle manually to relieve the issue temporarily, though definitive surgery will ultimately be required. Surgery will consist of untwisting the affected testicle, assessing its viability, and lastly securing the testicle to the scrotal wall (orchiopexy) to prevent subsequent episodes of torsion.
Epididymitis: The treatment with this condition is usually managed with an outpatient basis, although patients with severe cases of epididymitis combined with complications may require hospitalization. In most cases, treatment consists of the next:
antibiotics for 10-14 days using the choice of antibiotic prescribed varying with respect to the age and sexual good reputation for the person;
pain medications, including anti-inflammatory drugs;
scrotal support and elevation;
ice packs; and
rest.
Rarely, individuals with epididymitis may develop a complication requiring surgical management, like a scrotal abscess. Also, some cases of chronic epididymitis refractory to the above measures may need the administration of nerve blocks for pain control, or rarely surgical removal from the epididymis (epididymectomy). Patient's should work with their urologists in regard to their particular medical situation.
Men become very concerned and anxious once they feel pain in their testicles. To better understand the various causes of this symptom, an awareness of basic anatomy and also the development of a mans testicles is essential. Before birth, the testicles are located in the abdomen (belly). Eventually, a mans testicles migrate down through the abdomen in to the scrotum (the exterior pouch which has a mans testicles). However, they remain attached to the abdomen through the spermatic cord, containing vital blood vessels, nerves, lymphatic vessels, and the vas deferens. The spermatic cord also functions to suspend a mans testicles within the scrotum. Around the upper, outer, back position from the testicle lies a connected but separate structure called the epididymis, which serves to keep and transport sperm. Normally, the epididymis has a direct connection to the wall of the scrotum.
Testicular pain has many causes, most of which constitute surgical emergencies that need immediate medical assistance to be able to salvage the affected testicle.
Trauma: Trauma towards the testicles often produces extreme pain. An immediate blow towards the scrotum, while very painful, usually causes only temporary pain. Most cases of testicular injuries (85%) are caused by blunt trauma (sports injuries, a direct kick or punch, car accidents, or straddle injuries).

It may result in a bruise or swelling from the scrotum and testicles.
Occasionally, trauma towards the testicles could cause a far more significant injury that could require emergency surgery.
Testicular torsion: Testicular torsion is really a surgical emergency. It happens when the testicle twists within the scrotum, either spontaneously or less commonly, due to direct trauma. When the testicle twists, the blood vessels contained within the spermatic cord also twist resulting in an interruption of blood circulation to the affected testicle.

Because blood contains oxygen, and testicles require oxygen to remain functional and viable, the twisting may lead to the "death" of a testicle.

Torsion may occur at any age, but it is most typical within the first few months of life (newborns) and in boys between 12-18 years.

Torsion often occurs in men who come with an anomaly affecting the normal attachment of the testicle towards the wall from the scrotum (referred to as the bell-clapper deformity). A number of these guys have the same abnormality contained in both testicles.

Epididymitis: Epididymitis (inflammation from the epididymis) is most often due to contamination. It is the most typical cause of testicular pain in males over the age of 18 years old, though it also occurs in prepubertal individuals and also the elderly.

In sexually active men, the most common cause of epididymitis is a sexually transmitted disease (STD) such as gonorrhea or chlamydia.

Older and younger men will also have epididymitis, often due to an abnormality within the genitourinary system. In older men, enlargement from the prostate gland is a common cause.

Torsion of a testicular appendage: This is a common cause of testicular pain in younger boys, with most cases occurring between 7 and 14 years.

The testicular appendage and also the epididymal appendage are basically functionless tissue remaining from human embryonic development. As in testicular torsion, the twisting of those structures can lead to an interruption of blood circulation, resulting in varying levels of testicular pain.

Other, less frequent reasons for testicular pain range from the following:
Inguinal hernia: This problem is the place part of the intestine protrudes via a muscular defect within the groin area and slides in to the scrotum. This may cause scrotal swelling and testicular discomfort.

Orchitis (inflammation from the testicle): This inflammatory condition from the testicle generally occurs because of a contagious process. It is sometimes found together with epididymitis (epididymo-orchitis), especially when epididymitis went untreated for a few days. Many instances of orchitis are caused by a viral mumps infection, though other viruses and bacterial organisms may also cause it.

Testicular tumor: A tumor rarely causes testicular pain. It is important to conduct regular self-examinations from the testicles to locate any lumps or masses, as early detection improves the prognosis for testicular cancer.

Kidney stone: The pain from kidney stones may sometimes radiate into the testicular area.

Infections or bleeding within the abdomen: This rarely causes testicular pain.

With regards
M.K Gupta
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