Essay Example on Testicular Pain: Causes & Symptoms

Testicular pain is a type of pain that occurs around or in both or just one testicle. Testicles pain often originates from the abdomen or groin, and the patient experiences it in both or one of the testicles. There are numerous possible causes of testicle pain, the pain may originate from the epididymis, a coiled tube, and supporting tissue behind the testicle, or sometimes it may come from within the testicles themselves. Testicles are usually very sensitive to even slight injuries causing discomfort and pain. Some of the testicles pain originates from the groin, abdomen, or other parts of the body. For instance, hernias and kidney stones can prompt testicle pain. In the case of our patient, a sexually active 25-year-old male complaining of testicular pain, testicular torsion, epididymitis, and even urinary tract infections (UTI) may be possible causes of pain in the testicle or testicle pain. However, detailed and complete sexual history, age, and physical examination, besides laboratory tests must be done to establish the real cause of the pain.

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Testicular torsion can either be intravaginal or extravaginal torsion. Intravaginal torsion occurs due to free rotation of testicle within the tunica vaginalis as a result of bell clapper deformity, a congenital anomaly. Failure of the posterior harborage of epididymis, gubernaculum, and testis, causes the deformity, allowing free rotation of testis within the tunica vaginalis. On the other hand, extravaginal torsion happens due to rotation of testis within the scrotum as a result of deficient testicle fusion to the scrotal wall (Gordhan & Sadeghi-Nejad, 2015). When diagnosing testicular torsion, the examiner should consider whether the patient had classical presentations such as acute-onset, severe, one-sided scrotal pain. Besides, complaints of nausea and vomiting should also be considered and examined. Confirming the presence of cremasteric reflex and executing both urinalysis and scrotal ultrasound in the laboratory is imperative for examiners to validate the diagnosis (Mansori & Bagheri, 2016). Additionally, examiners need to use Doppler ultrasonography to examine testicular blood flow. Treatment option available for testicular torsion is a surgical intervention with detorsion, scrotal exploration, and orchidopexy.

Conclusion

In the case of the epididymis, discerning it from torsion is sometimes very strenuous. However, to effectively diagnose it, examiners should consider the prior sexual activity history and genitourinary tract system of the individual, all of which provide indications of epididymitis. During physical analysis, observing cremasteric reflex, swollen, and tender epididymis is very significant. Additionally, executing urinalysis, urethral cultures, and urine cultures is imperative to establish potential causative agents (Gordhan & Sadeghi-Nejad, 2015). Performing both nuclear scintigraphy and Color Doppler ultrasound is very significant to determine the flow of blood to the scrotum. The content of examinations plays a vital role in identifying whether it is epididymitis or severe testicular torsion. Empiric antibiotic treatment should be considered immediately for an individual clinically suspected to suffer from epididymitis (Gordhan & Sadeghi-Nejad, 2015). In the case of our sexually active male patient of 25 years of age, administration of empiric treatment such as ceftriaxone and ofloxacin or doxycycline is vital. However, if the patient experiences genitourinary abnormalities, surgery may be the only option to correct the situation.

References

Gordhan, C., & Sadeghi-Nejad, H. (2015). Scrotal pain: Evaluation and management. Retrieved 18 June 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294852/.

Mansori, M., & Bagheri, S. (2016). Sonographic Evaluation of Clinically Occult Inguinal Hernias in Patients With Scrotal Pain and Normal Scrotal Color Doppler Sonography. Biosciences, Biotechnology Research Asia, 13(3), 1611-1616. https://doi.org/10.13005/bbra/2307