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What are the causes for testicle pain and its treatment options

The testicles are a part of the male reproductive system. The testicles are two oval organs about the size of large olives. They are located inside the scrotum, the loose sac of skin that hangs behind the penis. The testicles make the male hormones and produces sperm.

Testicular pain is a fairly common condition experienced by men. Testicle pain is discomfort in one or both testicles. The pain sometimes radiates to the lower abdomen. Pain may also be caused by a hernia or an unsatisfied erection.

Causes of testicle pain
There may be a number of causes which lead to testicle pain in men. If not treated on time or properly this pain may become chronic.

Some common causes of testicle pain include:

Epididymitis
It is the inflammation of the ducts through which sperm leaves the testicle. An inflammation of the epididymis is usually due to an infection. It is the most common cause of testicular pain in men older than 18 years. In sexually active men, the most common cause of epididymis is a sexually transmitted disease such as gonorrhea or chlamydia. Older and younger men may also get epididymitis, often because of an abnormality in the genitourinary system such as enlargement of the prostate.

Orchitis
It refers to inflammation or infection of one or both testicles, which may be caused by bacteria or a virus like mumps. Orchitis can occur at the same time as epididymitis or prostatitis especially when epididymitis has been left untreated for days.

Fluid accumulation
Fluid in the testicles often causes swelling and mild discomfort and pain. There are several main types of fluid collection:
• Varicocele refers to enlarged veins in the scrotum that carry blood away from the testicles.
• Spermatocele is swelling and accumulation of fluid in the epididymis that forms a cyst and often contains dead sperm cells.
• Hydrocele is the disorder in which fluid accumulates in the area inside the scrotum, surrounding the testicle.

Trauma
A direct blow to the scrotum, while very painful, causes only temporary pain. It may result in a bruise. Trauma to the testicles often produces extreme pain. Trauma to the testicles can cause severe pain, bruising and swelling.

Testicle torsion
The testicles are secured at either end by a structure called the spermatic cord within the scortum. If this cord gets twisted around a testicle, it cuts off the testicle’s blood supply. Symptoms of testicular torsion include sudden and severe pain, enlargement of the affected testicle, tenderness and swelling.

The twisting may result in deadening of the testicle as blood contains oxygen and testicles need oxygen to function. Torsion often occurs in men who have an abnormal attachment of the epididymis to the wall of the scrotum.

Torsion of a testicular appendage
A testicular appendage is a basically functionless structure that sits in a groove between the testicle and the epididymis. It can cut blood flow due to twisting and lead to varying amounts of pain. This is a common cause of testicular pain in younger boys between 3 – 14 years.

Hernia
In such case, part of your intestine intrudes into the scrotum. This may cause pain if it threatens to affects the blood supply to the testicles.

Testicular tumor
It is a tumor which rarely causes pain but can cause swelling.

Treatment options for testicle pain

Surgery
New surgical techniques are being worked out to help men with chronic testicular pain that have not responded to conservative medical treatments. One of them is a procedure known as Microsurgical denervation of the spermatic cord or "cord stripping" entails making a small incision (2 inches) in the groin and under the operating microscope separating all the structures in the spermatic cord including the veins, nerves and vas deferens.

Torsion or hernia may require immediate surgery by an urologist (specialist in genital and urinary organs). Before surgery, a doctor may make an attempt at untwisting the testicle to relieve the problem temporarily.

Medicines and drugs
Antibiotics and other medicines like NSAIDs are prescribed to the people suffering from testicle pain. They may include:
• ceftriaxone (Ceftin)
• ciprofloxacin (Cipro)
• doxycycline (Doryx, Vibramycin)
• azithromycin (Zithromax)
• trimethoprim and sulfamethoxazole combined (Bactrim, Septra)

Make sure your doctor is aware of any other medications you are taking or any other allergies you have.

Other treatment options for testicular pain

The conservative treatment of post vasectomy pain syndrome is usually successful and includes
• Sitz baths
• Scrotal support
• Spermatic cord block
• Application of ice pack to relieve the pain

Testicles are important parts of male anatomy and if injured or damaged can affect a man’s sexual life. If any pain or swelling is experienced in testicles, a doctor should be consulted as it may need medical treatment.