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Testicular Pain

These conditions are unique to men and cause much anxiety.

Am I losing control of my bladder?

Pain urology originates from the kidney, bladder, prostate and/or testes. In the testes, acute onset of pain in one testes can be an EMERGENCY! Torsion of the testes if left untreated may result in the loss of the testes. Pain from the torsion of the testes is usually spontaneous, acute in onset, with no relief from a change in posture and unfortunately more common in boys and young men. Diagnosis of torsion must be made promptly as torsion of the testes causes the testes to twist on its own spermatic cord, thus blocking the flow of blood into the testes. When this blockage is complete and not reversed within 6 hours, the testes is at high risk of irreversible damage and will need to be surgically removed.

Just recently, I had to sadly remove a testes from a 15 years old boy as he has had torsion for over one week. The affected testes was dead and that was the reason that the boy's pain subsided after a few days.

Other causes of pain in the testes can be from trauma, infection cancerand varicoceles. Viral infection of the testes can be from a spread from a mumps infection, which is an infection of the salivary gland.

In 20% of mumps, the virus also infect the testes causing orchitis, resulting in painful enlarged testes. Mumps are more common in the young. Unfortunately, the possible long term effect of this infection is poor sperm production in adulthood.

In the adult men, sexually transmitted infection such as chlamydia and gonorrhea can cause pain with other symptoms such as urethral discharge. Prompt treatment is important for both the male and female partners as, left untreated, it may cause infertility in both.

Chronic, dull and intermittent pain in the testes can be caused by varicoceles. Large testicular veins cause a pooling of blood surrounding the testes and raise the surrounding temperature as well. This raised temperature causes discomfit, such as a dull heaviness in the genital area with prolonged standing, marching or sitting. Prolonged exposure to the raised temperature may affect the function of the testes, hence poor sperm numbers, poor sperm quality and a low hormone testosterone may occur if varicoceles are left untreated. Please seek the advice of your urologist or kidney specialist who will examine you, order an ultrasound scan of the testes and veins and check your hormonal profle.

Dull pain with a hard solid mass in the testes may be the presenting symptoms of testicular cancer. A mass in the testes must never be discounted especially if you and your partner have problems with getting pregnant. Testicular cancer is more associated with men who have very poor sperm numbers/quality or azoospermia, zero sperms.

In conclusion, testicular pain is a significant symptom which needs your attention!

Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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