On Thursday March 19, 2009 I started to experience pain and tenderness in the area of my right testicle. About a week to week and a half before this I had experienced the same thing, but it had gone away within a couple of days. Anyway, I also noticed a slight heaviness to my scrotum and immediately checked it out. Upon inspection, I noticed that on the right side of my scrotum it was abnormally enlarged. With it being extremely tender and painful to touch, I was unable to feel around for any abnormalities. I was, however, to lightly touch and feel my scrotum and noticed that it was smooth to the touch and it felt like there was fluid inside.

I do plan on going to see a doctor, but have put it off for this long because I do not have a job nor do I have insurance. I was just wanting to seek out some advice/input on my issue before going to see a doctor just in case I might have doubts on the doctors official diagnosis.

Posted by: Maria/MD Health Forum.com Team

Testicular pain and swelling can have a number of causes. It may be related to infection, trauma, hernia, hydrocele or varicocele. You should talk to your doctor because health history and physical examination are very important in establishing the exact cause of those symptoms. Acute epididymitis- the inflammation of the epididymis, is the most common cause of acute scrotal pain. The epididymis is the coiled tube that stretches from the back of each testicle, it carries sperm from the testicle to the vas deferens. In younger patients, the infection can be caused by sexually transmitted diseases like chlamydia or gonorrhea. In men 40 years and above, epididymitis is associated with prostatitis and infections of the urinary tract. Sudden scrotal pain, unilateral scrotal swelling, painful ejaculation, lump on the testicle, lower abdominal pain and tenderness of the testicle are among the symptoms of acute epididymitis. Aside from health history and physical assessment, the doctor may also request for urinalysis and urine culture to confirm the diagnosis. Additional diagnostic procedures such as ultrasound and nuclear scan of the testicles may also be requested to rule out other disorders. The complications of epididymitis include: scrotal abscess, atrophy (shrinkage) of the testicle, chronic epididymitis and infertility. Acute epididymitis is treated with antibiotics. There are some cases when surgical intervention may be considered.

Testicular torsion may also manifest as acute scrotal pain and swelling. This condition is characterized by the twisting of the spermatic cord- the structure that supplies blood to the testicle. This consequently cuts the blood supply which may result to tissue death, removal of the affected testicle would be required if the torsion is not addressed immediately. Patients with testicular torsion may also experience abdominal pain, nausea and vomiting and fever. Some may also notice that the testicle appears higher than normal. Some men are suffer from testicular torsion due to inadequate connective tissue within the scrotum. Upon physical examination, the testicular region is very tender and enlarged. The physician may also request for additional tests like urinalysis tests or blood tests. Imaging procedures such as scrotal ultrasound may also be done to check on the blood flow, a result that reveals decreased blood flow to the testicle indicates testicular torsion. Nuclear scan of the testicles, is another way to visualize blood flow,in this procedure, radioactive substance will be injected into the blood stream. The blood flow is then detected with the use of special cameras. Generally, surgery is required to correct testicular torsion. Prolonged restriction of the blood supply may lead to complications, the testicle may shrink and would have to be removed surgically. Infection of the testicle and scrotum may also occur as a result of long-standing disturbance in the blood supply.

Passage of a kidney stone down through the urinary tract may also be experienced as scrotal pain.
I’ve read that there are factors that may affect the consistency and color of the semen. Sometimes changes in the appearance of the ejaculate is temporary and should not be cause for alarm, but there are cases when these changes actually indicate underlying health problems and would call for a doctor’s evaluation. It’s good to know that you plan to see a doctor, I hope you could do that at the soonest possible time. You can still find so many information from the internet but that should not substitute a visit to the health clinic.

This blog entry is for general information only. I recommend that you discuss your symptoms with your own doctor.

Reference:
Diagnosis and Treatment of the Acute Scrotum
American Family Physician
Gales,L et al.

http://www.urologychannel.com/testicular-pain/index.shtml

Tags: epididymitis, kidney stones, scrotal pain, testicular pain, testicular torsion, Urology