What causes pain in one testicle?

Pain in one testicle may be related to factors such as testicular torsion, epididymitis, varicocele, testicular trauma, or urinary tract stones. Testicular pain usually manifests as swelling and tenderness in the scrotum on the affected side, which may be accompanied by symptoms such as fever and abnormal urination. It is recommended to seek medical treatment promptly for a clear diagnosis to avoid delays in treatment.

1. Testicular torsion

Testicular torsion is more common in adolescents and causes severe pain due to obstruction of blood flow due to rotation of the spermatic cord. The typical manifestation is sudden, persistent unilateral testicular cramping, which may be accompanied by nausea and vomiting. Physical examination showed that the testicles were elevated and the cremasteric reflex disappeared. Emergency surgical reduction and fixation is required, and a delay of more than 6 hours may cause testicular necrosis. Scrotal color Doppler ultrasound is commonly used in clinical diagnosis, and the contralateral testicle needs to be preventively fixed after surgery.

2. Epididymitis

Epididymitis is often caused by retrograde bacterial infection and manifests as progressive testicular swelling and pain accompanied by redness of the scrotal skin. Routine urine examination showed elevated white blood cells, and the pathogens were mostly Escherichia coli or gonococcus. Treatment requires antibiotics such as levofloxacin tablets and cefixime dispersible tablets, combined with scrotal support to reduce swelling. Chronic epididymitis may form induration, which needs to be differentiated from tumors.

3. Varicocele

Varicocele causes a feeling of swelling in the scrotum due to poor venous return, and the pain worsens after standing for a long time. Physical examination revealed vermiform varicose veins in the scrotum, and color ultrasound showed that the internal diameter of the veins exceeded 2 mm. For mild cases, special underwear can be worn to hold up the scrotum, but for severe cases, laparoscopic high spermatic vein ligation is required. This disease may affect sperm quality, and men of childbearing age should review their semen regularly.

4. Testicular trauma

Testicular trauma is mostly caused by impact and straddle injuries, and manifests as local ecchymosis accompanied by severe pain. In severe cases, the tunica albuginea of ​​the testicle may rupture, requiring emergency surgery to remove the hematoma and repair the tear. For minor bruises, apply cold compresses to relieve swelling, and take ibuprofen extended-release capsules for pain relief. It is necessary to be alert to delayed testicular atrophy after trauma, and it is recommended to review the testicular volume 3 months after the injury.

5. Urinary system stones

Stones in the lower end of the ureter may radiate to the testicular area, causing referred pain, often accompanied by hematuria and waist and abdominal cramps. CT urography can identify the location of stones. For stones smaller than 6 mm, tamsulosin sustained-release capsules can be taken to promote elimination. Patients with repeated attacks need to be checked for metabolic diseases such as hyperparathyroidism, and should maintain a daily drinking volume of 2000 ml of water.

When testicular pain occurs, strenuous exercise should be stopped immediately and hot water sitz baths should be avoided to aggravate congestion. You can temporarily wrap an ice pack in a towel to apply cold compress to the affected area, but you are not allowed to take powerful analgesics to mask symptoms. You need to choose breathable underwear for daily use to avoid pressure on the perineum from long-term cycling. It is recommended to perform testicular self-examination every year to detect lumps with abnormal texture in time. If the pain lasts for more than 2 hours or is accompanied by high fever, hematuria and other symptoms, you must immediately go to the urology department for emergency treatment.