Testicle pain When to see a doctor

Sudden, severe testicle pain can be a sign of testicular torsion — a twisted testicle that can quickly lose its blood supply. This condition requires immediate medical treatment to prevent loss of the testicle. Testicular torsion can occur in males of any age, although it is more common in adolescents.

Seek immediate medical attention if you have:

• Sudden, severe testicle pain
• Testicle pain accompanied by nausea, fever, chills or blood in your urine

Schedule a doctor’s visit if you have:

• Mild testicle pain lasting longer than a few days
• A lump or swelling in or around a testicle

Self-care

These measures might help relieve mild testicle pain:

• Take an over-the-counter pain reliever such as aspirin, ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others), unless your doctor has given you other instructions. Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.
• Support the scrotum with an athletic supporter. Use a folded towel for support and elevation when you’re lying down.

Nov. 23, 2019

Show references

1. Eyre RC. Evaluation of acute scrotal pain in adults. https://www.uptodate.com/contents/search. Accessed Sept. 24, 2019.
2. Scrotal pain. Merck Manual Professional Version. https://www.merckmanuals.com/professional/genitourinary-disorders/symptoms-of-genitourinary-disorders/scrotal-pain. Accessed Sept. 24, 2019.
3. Belanger GV, et al. Diagnosis and surgical management of male pelvic, inguinal, and testicular pain. The Surgical Clinics of North America. 2016; doi: 10.1016/j.suc.2016.02.014
4. Rottenstreich M, et al. The clinical findings in young adults with acute scrotal pain. The American Journal of Emergency Medicine. 2016; doi:10.1016/j.ajem.2016.06.066.
5. AskMayoExpert. Scrotal pain (child). Mayo Clinic; 2019.
6. AAP Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2018-2019. Pediatrics. 2018; doi:10.1542/peds.2018-2367.
7. Sullivan JE, et al. Fever and antipyretic use in children. Pediatrics. 2011; doi:10.1542/peds.2010-3852.
8. 201.314 labeling of drug preparations containing salicylates. Electronic Code of Federal Regulations. https://www.ecfr.gov/cgi-bin/text-idx?SID=76be002fc0488562bf61609b21a6b11e&mc=true&node=se21.4.201_1314&rgn=div8. Accessed Sept. 24, 2019.

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Testicular Pain | University of Miami Health System

The testicles are a very sensitive part of the male body, and there are a number of potential causes of testicular pain. You can experience testicular pain after sustaining an injury to your genitals, or it may be caused by an internal problem, such as in the abdomen or groin. 

Causes can include:

• Diabetic neuropathy (nerve condition caused by diabetes)
• Epididymitis (inflammation of the testicles)
• Gangrene (tissue death due to insufficient blood supply)
• Henoch-Schonlein purpura (inflammation of the blood vessels)
• Hydrocele (build-up of fluid in the scrotum)
• Inguinal hernia 
• Kidney stones 
• Mumps (viral infection that affects the glands)
• Orchitis (inflammation of the testicles)
• Prostatitis 
• Scrotal masses
• Side effect of some medications, including antibiotics or chemotherapy drugs
• Spermatocele (build-up of fluid in the testicle)
• Injury to the testicles
• Testicular cancer 
• Testicular torsion
• Undescended testicle (a testicle that hasn’t moved into the scrotum prior to birth)
• Urinary tract infection (UTI)
• Varicocele (enlarged veins in the scrotum)
• Vasectomy

In some cases, the cause of testicular pain cannot be determined. This is known as idiopathic testicular pain. The urologic experts at the University of Miami Health System are highly experienced in identifying and treating all types of testicular pain, and are here to help you find relief.

Treatments

Antibiotics
If the testicular pain was caused by a bacterial infection, your doctor will prescribe an antibiotic medicine to treat the underlying infection.

Other Medicines
Your doctor may prescribe medicines to relieve the pain you are experiencing.

Surgery
Some causes of testicular pain may warrant a surgical procedure. For example, your urologist can remove kidney stones using minimally invasive surgery, which requires only a small incision in your back.

Surgery is nearly always the first treatment for testicular cancer. However, removal of the testicle (inguinal orchiectomy) and some of the lymph nodes in the lower abdomen may occur during diagnosis and staging. Stage I patients are cured with removal of the testicle 85 percent of the time, without chemotherapy.

Tests

Urine Tests
Your doctor may take a sample of your urine to run tests and help determine the underlying cause of your testicular pain.

Blood Tests
Your doctor may take a sample of your blood to run tests and help determine the underlying cause of your testicular pain.

Ultrasound
Your doctor may use ultrasound to help determine the cause of your testicular pain. Ultrasound uses sound waves to create pictures of your internal organs.

X-rays
Your doctor may take an X-ray of your testicles and surrounding area to help pinpoint the cause of your pain.

Physical Exam
Your urologist will perform a comprehensive physical exam – including gathering a medical history – in order to determine what is causing your testicular pain.

Why Choose UHealth?

Innovative, expert urology care. Our team of urology experts delivers advanced care for all urologic conditions. We use the latest research and the least invasive procedures to help you feel better and recover more quickly. Our experienced urologists design a personalized treatment plan to give you the best possible results. 

Advanced research in men’s health. Our urologists are dedicated to men’s health and conduct innovative research into many conditions. Our expert team has helped develop new minimally invasive and robotic surgical procedures to treat cancers, incontinence, and more. We give you access to leading-edge treatments and clinical trials that aren’t widely available. In addition, we have established the eighth fellowship program in the nation dedicated solely to teaching physicians how to care for men’s health. 

Leaders in robotic surgery treatment. We have some of the world’s most experienced robotic surgeons for urologic procedures. In fact, doctors come from all over the world to learn at our Urology Robotic Program — the #1 ranked program in South Florida. The University of Miami Health System was the first academic medical center in the world to get the da Vinci Xi robotic surgery system and has completed more than 5,000 robotic surgeries — procedures that offer less pain and scarring and a faster recovery.

Testicular Pain Treatment Chattanooga, TN

Treat Testicular Pain Through Medicine & Surgery

Testicular pain is pain or discomfort in one or both testicles that can spread into the groin. There are various conditions that cause testicular pain. Some are medical emergencies but most are not. Contrary to popular belief, there are excellent treatments available for testicular pain through medicine and surgery. You do not have to live with pain, and your first step to getting pain-free should involve a urology consultation.

There are two types of testicular pain, acute and chronic. Acute testicular pain occurs immediately and it is something you will definitely notice. All medical emergencies related to the testicles are considered acute.

Chronic testicular pain refers to pain lasting over three months. Pain is either dull or sharp, can come and go, and can significantly impact your lifestyle. Contact Dr. Shrid for treatment for you testicular pain at our Chattanooga, TN office, we often treat patients from Knoxville, Northern Georgia & Huntsville, AL too.

Contact Us Today For A Consultation

What is spermatic cord denervation?

This is a minimally invasive surgical procedure performed by Dr. Shridharani. Also known as cord stripping, spermatic cord denervation is used to resolve or reduce chronic testicular pain in men who have not responded to conservative treatment approaches. The goal of these surgeries is to remove the small nerves in the spermatic cord. This eliminates or reduces the nerves causing the chronic pain messages.

What causes testicular pain?

Even a minor injury can cause pain because the testicles are very sensitive. Common causes are injury, infection, swelling of the sperm ducts or testicles, and a twisting of the testicles called testicular torsion, which can cut off the blood supply.

Testicular torsion affects young men between the ages of 10 and 20. Torsion is a medical emergency that requires immediate treatment. Untreated testicular torsion can result in the loss of the affected testicle. If surgery is performed within 6 hours, most testicles can be saved.

Acute testicular pain can be due to:

• Epididymis cysts containing dead sperm cells (spermatocele). The epididymis is the tube that collects and transports sperm.
• Inflammation of the epididymis usually due to an infection or inflammation.
• A hydrocele is a fluid-filled sac in the scrotum.
• Inflammation of the testicles that causes painful swelling often due to mumps or infection from bacteria, viruses and certain STDs.
• An inguinal hernia or kidney stone.
• Testicular cancer will cause pain in about 10% of men.
• Direct trauma to the testicles can cause a hematocele ( a collection of blood around the testicles).
• The testicular rupture caused by external trauma can result in blood leaking into your scrotum.

Chronic testicular pain can be due to:

• A varicocele (Varicose veins of the scrotum)
• Inflammation of the epididymis usually due to an infection or inflammation
• Orchitis
• Prostatitis
• Back/Spinal nerve injury
• Inguinal hernia repair with mesh can cause nerve entrapment leading to chronic pain
• Hydrocele

When should you call a doctor?

• When you have sudden, severe testicular pain you should seek immediate medical care. If you go to the emergency room, call your doctor.
• When you have had an injury or trauma to the scrotum, and you still have pain one hour later.
• When your pain is accompanied by nausea or vomiting.
• When you feel a lump in your scrotum.
• When you have a fever with testicular pain.
• When your scrotum is warm, tender, swollen and red.
• When you have been in contact with someone who has the mumps.
• When you have chronic testicular pain that affects your daily activities or lifestyle.

How is testicular pain diagnosed?

Your doctor will conduct an exam of your groin, testicles, and abdomen. You will be asked about the circumstances surrounding your pain, whether you have suffered an injury, how long you have had this pain, how it started, where the pain is located, how severe and constant the pain is, whether your pain goes into your abdomen or back, and any other symptoms. The cause of your pain can be diagnosed using blood tests, urinalysis, urine culture and imaging studies such as an ultrasound.

Testicular pain should not be ignored. It may be directly related to your testicles or may lead to the discovery of another health condition.

What treatment is available for testicular pain?

Treatment depends on the cause of the pain. You must be examined by a doctor to determine the course of treatment. The objective of treatment is to restore healthy function, avoid complications and prevent permanent damage that can result in infertility.

Chronic testicular pain can be extremely difficult to manage by healthcare providers and individuals. Luckily, advances in our understanding of testicular anatomy have improved our ability to treat testicular pain. Dr. Shridharani is one of the few microsurgeons in the U.S. offering microsurgical spermatic cord denervation. Through 2 cm groin incisions, the tissue that inflamed nerves travel through can be cut, preventing the pain signals from traveling from the testis. This procedure is minimally invasive, does not compromise blood flow to the testicles and therefore fertility, and erections are not impaired. Initially, numbing medication is given in the urology clinic to see if the procedure will be successful. If the response to the numbing medication is good, then the procedure has an 80% chance of helping your pain go away permanently.

If you suffer from chronic testicular pain, seeking specialist help is the first step in improving the quality of your life. Dr. Shridharani has taken a keen interest in managing urologic conditions that affect the quality of men’s lives. He has excellent outcomes treating testicular pain and works within a network of medical specialists and physical therapists to get you pain-free as soon as possible.

How is spermatic cord denervation performed?

Dr. Shridharani performs these microsurgeries as outpatient procedures. The procedure takes approximately 45 minutes. Dr. Shridharani uses initial numbing in our urology clinic to see if the nerves can be targeted. If this numbing is successful, he’s found the surgery to be highly successful.

The chronic pain is usually originating in the patient’s spermatic cord, which contains blood vessels and tiny nerves and is connected to the abdomen. Dr. Shridharani starts by making a small two-inch incision in the groin to access the spermatic cord. Working through an operating microscope, he separates all the structures in the spermatic cord, including the veins, nerves, and vas deferens. The arteries to the testicle and the lymph glands are left untouched. He then removes the small nerves in the spermatic cord, removing the source of the pain signals. He then closes the incision and the procedure is complete.

How does spermatic cord denervation help with chronic testicular pain?

These surgeries remove the small nerves in the spermatic cord. Doing so removes the source of the patient’s chronic pain.

How successful is spermatic cord denervation?

Studies on these surgeries have shown a high success rate without any impact on the physiological function of the testes. According to the studies, approximately 75 percent of patients receive complete pain relief, and another 9 percent have partial pain relief. The results are immediate.

For men who have suffered from chronic testicular pain that has not responded to conservative treatments, these new surgeries with Dr. Shridharani can be life-changing.

Does spermatic cord denervation surgery impact fertility and other functions?

No, these are minimally invasive surgeries. They do not compromise blood flow to the testicles, so both fertility and erections are not impaired.

What is recovery like after these surgeries?

Patients simply have to take it easy at home for between 2 and 5 days. You need to avoid strenuous activities. From there, you can play it by ear as to when you can return to work and other normal activities.

Schedule a Consultation Today!

Dr. Shridharani proudly serves Chattanooga and Knoxville TN, Northern Georgia, Huntsville AL and the surrounding areas with advanced treatments for testicular pain. Call (423) 778-4MEN (4636) to schedule an appointment today!

Albany NY Urologist Doctors – Testicular Pain Causes, Symptoms, Relief & Treatment

Type of Physician: Urologist

What is a Urologist? A certification by the Board of Urology; practitioners are competent to manage medical and surgical disorders of the adrenal gland and of the genitourinary system. Urologists have comprehensive knowledge of, and skills in, various surgical techniques for innate and acquired conditions of the reproductive and urinary systems and their related structures.

Specialty: Urology

Common Name:

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Testicular Pain Treatment in Austin, TX

Testicular pain can occur in or around one or both testicles, and the pain may actually originate from somewhere else in the body, like the groin or abdomen (this in known as referred pain). Testicular pain is not uncommon and can have a number of different causes. The testicles are a very sensitive region in the body and even a minor injury can cause discomfort or pain to develop here.

Typical signs and symptoms often include:

• Pain
• Swelling
• Tenderness
• Redness

Physical pain in the scrotum may be accompanied by other symptoms such as:

What Causes Testicular Pain?

There are a number of different causes for testicular pain, ranging from harmless to serious. Direct trauma or injury to the testicles can obviously cause pain, and depending on the severity, may require medical attention. However, if you are experiencing testicular pain in the absence of injury, it is important to have your symptoms evaluated to ensure there is not an underlying health condition.

Pain in the scrotum can be the result of serious conditions like sexually transmitted infection or testicular torsion. Ignoring these symptoms can lead to irreversible damage to the testicles and scrotum.

Some common underlying causes of testicular pain are outlined below.

Testicular Torsion – Torsion of the testes can occur if the spermatic cord becomes twisted. This causes restriction in blood flow to the testes, resulting in severe pain and potentially permanent damage. This condition is a medical emergency situation and should be addressed quickly. Pain and swelling of the scrotal sac are the major indicators that testicular torsion has occurred. The onset of pain can also be quite sudden.

Orchitis – Orchitis refers to the inflammation of the testicles, which can be caused by either bacterial or viral infection. While both testicles can be affected by orchitis at the same time, symptoms are restricted to just one testicle. The most common cause of orchitis is the mumps. Urinary tract infections and sexually transmitted infections can also lead to orchitis.

Epididymitis – The epididymis is the tube that stores and carries semen, located at the back of the testicles. Inflammation of this tube is referred to as epididymitis. While this inflammation can be caused by nonsexual infection, like a urinary tract infection or prostate infection, the most common source is sexually transmitted infection such as chlamydia or gonorrhea.

Prostatitis – Prostatitis refers to inflammation of the prostate gland. This gland is located under the bladder and produces a fluid found in semen. The most common form of the condition is chronic prostatitis, of which the cause is unknown. Acute bacterial prostatitis, on the other hand, develops as a result of bacterial infection.

Kidney Stones – While kidney stones originate from the kidney, these solid masses made of crystals can be found at any point in the urinary tract. A kidney stone on the move commonly refers pain downward into the testicle region.

Treatment for Testicular Pain

Specific treatment for testicular pain will largely depend on the underlying cause. As noted above, some underlying causes are medical emergencies that require immediate attention. Testicular torsion, for instance, will more than likely require surgical repair by a urologist.

Other less severe conditions may be treated using a combination of approaches, including:

• Antibiotics
• Pain medication
• Anti-inflammatory agents
• Rest and ice packs
• Scrotal support and elevation

If you are experiencing testicular pain, please call our office at (512) 981-7246 to schedule an evaluation with an Austin pain management physician, Dr. Robert S. Marks or Dr. Sauman A. Rafii.  You may also request an appointment online by clicking the button below.

Request An Appointment Now →

Testicle injuries and conditions – Better Health Channel

There are various non-cancerous conditions that can affect the testicles. The testicles are also prone to injury because they are not protected by muscle or bone. It is important to seek prompt medical attention for any testicular complaint.

Testicle anatomy

Testicles are also known as testes (one is a testis) or ‘balls’. They are two small, oval-shaped male sex glands that produce sex hormones and sperm. Each testicle is housed in a fibrous outer covering called the tunica albuginea, which is contained within a sac of skin called the scrotum. 

Sperm production needs a temperature that is around 2°C lower than the body, which is why the testicles are located outside the body in the scrotum.

Testicular torsion

The spermatic cord attaches the testicle to the body. Testicular torsion occurs when the spermatic cord twists and cuts off the blood supply to the testicle. This condition can occur at any age, but tends to be more common between the onset of puberty and the mid-20s. It requires urgent medical attention.

Hard physical activity can cause this twisting of the cord. In most cases, however, it is caused by abnormalities in a male’s anatomy (body structure and organs) that make it easier for the testicle to twist or rotate around the cord.

Symptoms of testicular torsion

Symptoms of testicular torsion include:

• severe pain
• scrotal swelling
• nausea and vomiting.

These symptoms can often be confused with an infection of the testicles. An infection should not be considered until torsion has been ruled out.

Urgent medical attention is needed to save the testicle when torsion is diagnosed. Surgery must untwist the spermatic cord and restore blood flow to the testicle. A doctor uses physical examination and ultrasound scans to make the diagnosis. Sometimes, a doctor can only make a conclusive diagnosis at the time of surgical exploration.

The survival rate of the affected testicle is poor unless surgery is performed within four to six hours of the injury. Unnecessary investigations should not take place if torsion is suspected, as delays to surgery can affect the viability of the testis. If the blood supply has been disrupted for too long, the testis may not be viable or salvageable, and may need to be removed.

In many cases, the surgeon will also secure the spermatic cord on the unaffected side, to prevent future torsion of the other testicle. If the torted (twisted) testicle has to be removed, then a surgeon can put a prosthesis or silicone testis into the scrotum for cosmetic reasons (usually at a later date).

Torsion of the appendix testicle

The appendix testicle is a small tissue structure located at the upper third of the testicle. It doesn’t appear to have any particular function. Torsion of the appendix testicle means that the structure has twisted and cut off its blood supply.

This condition is easily confused with testicular torsion because the symptoms are so similar. However, the onset of pain is slower and the condition often presents with a noticeable blue dot on the surface of the scrotum. This blue dot is the darkened appendix testicle. Surgery is needed to correct the problem, but the testicle is not at risk.

Testicular cancer

Testicular cancer is an abnormal growth or tumour that appears as a hard and usually painless lump in either testicle. In most cases, testicular cancer can be cured if the person seeks medical treatment early. Surgical removal of the affected testicle (orchidectomy) is usually the first treatment for all testicular cancer.

Other testicular conditions

Other conditions that can affect the testicles include:

• epididymitis – the epididymis is a collection of small tubes located at the back of each testicle. It collects and stores sperm. Epididymitis is infection and inflammation of these tubes. Causes include urinary tract infections and sexually transmissible infections (STIs). Treatment is usually antibiotics
• epididymo-orchitis – this is infection of the epididymis, testicle or both, causing inflammation and pain. Treatment is usually antibiotics
• varicocele or varicose veins – 10 to 15 per cent of men have a varicocele, occurring where veins draw blood from the testicle. When a man stands up, blood in the veins has to move against gravity to return to the heart. Valves in the veins help this process. If the valves don’t work, blood pools in the veins. This swells the veins and gives the appearance of ‘varicose veins’. Varicoceles usually don’t need treatment, unless the varicocele is severe enough to cause discomfort or impair fertility. The links between varicocele and infertility are not fully understood and research is ongoing. Treatment may include surgery or radiological techniques that can block the affected testicular veins, and redirect the blood flow into unaffected veins
• haematocele – this is a blood clot caused by trauma or injury to the testicles or scrotum. In some cases, the body is able to reabsorb the blood. If not, the person will need surgery to remove the clot
• hydrocele – this is an abnormal build-up of fluid that causes the affected testicle to swell. In some cases, the body can reabsorb the fluid. Even though the condition is painless, the hydrocele may become so large that the person will need surgery to remove it
• spermatocele – this is an abnormal build-up of sperm-filled fluid next to the epididymis, which feels like a separate lump on the testicle. This is harmless, but can be removed surgically if it becomes large or bothersome. It is more common after a vasectomy
• undescended testicles – either one or both testicles are missing from the scrotum and are lodged inside the lower abdomen. Premature and low-weight newborn boys are most prone to undescended testicles. This condition is a known risk factor for testicular cancer and strongly related to infertility. Unless the testicle is brought down into the scrotum by 12 months of age, there is a high risk of damage to sperm production in later life.

Trauma to the testicles

Testicles are easily injured because they are not protected by muscle or bone. The main types of possible injuries include:

• penetrating (for example, a bite or stab wound)
• impact from a moving object (for example, a kick to the testicles)
• impact from hitting an immovable object (for example, a fall onto a hard surface).

The result of such trauma could be ruptured blood vessels or tearing of the testicle. 

A doctor can assess injuries to the testicles by physical examination and ultrasound. If the testicles seem normal, the doctor may prescribe pain-relieving medication. Even without an ultrasound, a surgeon may choose to explore the testicle, particularly in cases of possible testicular torsion.

Surgery is usually performed under a general anaesthetic. Significant injury to the testicles may require surgical exploration and repair or, potentially, removal of the affected testis. A man’s fertility is not affected if he still has one functioning testicle.

Reducing the risk of testicular problems

Suggestions on how to reduce the risk of testicular problems include:

• Take all reasonable precautions to prevent accidents. For example, drive safely and always wear a seatbelt.
• Protect yourself from sexually transmissible infections (STIs) by wearing a condom.
• Always use protective equipment such as a jockstrap or hard cup while playing sports.
• If you injure your testicles, always seek urgent medical advice.
• Perform testicular self-examination (TSE) regularly to become familiar with the look, feel and shape of your testicles so you will notice any abnormalities. See your doctor for further information on how to perform TSE.
• Always see your doctor if you experience any scrotal or testicular pain or unusual symptoms, or if you find a lump or swelling.

Where to get help

Symptoms boys and men shouldn’t ignore

A shy and quiet teenager came to the emergency department around 5 a.m. with his mother complaining of abdominal pain. His mom had a large cup of coffee in her hand and looked like she hadn’t gotten much sleep. The triage nurse took the teen to the bathroom to get a urine sample and brought him to his room. When I went to see him, he was watching a moving on his phone and seemed to be fairly comfortable. 

His mother said that he had been complaining of vague abdominal pain the night before but ate dinner and seemed fine when he went to bed. He woke up a couple of times overnight, but the pain would subside enough that he could get back to sleep, she said. But around 4 a.m. he woke up with more severe pain and vomited, which is when she decided to bring him in.

He didn’t have a fever or chills and had a normal bowel movement the day before, but his mom noticed that he was going to the bathroom to urinate a lot throughout the night.

I asked him where he hurt and he vaguely pointed to his mid-abdomen. He seemed to be tender across his lower abdomen and I asked about his surgical history to ensure he had not had his appendix removed. I asked him if he had any pain in his genital area and he shook his head yes, becoming visibly embarrassed. 

I had his male nurse come into the room and asked his mother to step out so I could do a genital exam. He seemed more at ease without his mother there and I was able to ask him a few more questions. He was not nor had ever been sexually active, which eliminated several diagnoses that I was considering. He said his pain was really bad in his right testicle but he was too embarrassed to tell his mother.

I immediately noticed that his right testicle seemed swollen and was extremely tender. I didn’t see any other abnormalities in his genital area or left testicle. I had the nurse give him some pain medication and I called our urologist. I was concerned he was suffering from a testicular torsion, which is reduced blood flow to the scrotum caused by the testicle twisting the spermatic cord that brings blood to the scrotum. It is critical to get blood flow restored as soon as possible because if the testicle goes without blood for too long, it can become irreparably damaged and may require surgical removal.

The urologist was on his way to the emergency department to see another patient and said he’d come see mine right away. He reexamined the teenager and agreed with my concerns. He explained to the teen and his mother that he needed to immediately manually untwist the young man’s testicle. Matt held his breath during the brief procedure (after more pain medication) and then let out a huge sigh of relief. His pain improved drastically over the next several minutes. 

He was hospitalized afterward to have surgery called orchiopexy. In this procedure, done under general anesthesia, the testicle is surgically secured to the scrotal wall to prevent it from twisting on itself again. This is done to both testicles because the defect is usually present on both sides.  

Testicular torsion is more common in young infants and boys just past puberty than adults but can occur at any time. Torsion can occur with a specific inciting event like direct trauma to the testicle or vigorous physical activity as well as happen spontaneously. Patients frequently have lower abdominal pain, nausea and vomiting. But they may not have pain in the testicle, especially when their symptoms first start. 

It is important to seek a prompt medical evaluation. A testicular ultrasound is usually done to evaluate blood flow to the testicle and identify other abnormalities of the testicles or scrotum that could be causing symptoms. Since my patient had been having pain for several hours and his exam was consistent with torsion, we didn’t want to wait for him to have an ultrasound done to confirm the diagnosis, which is why he underwent detorsion so quickly. 

I applauded the young man for being so stoic and allowing us to quickly determine what was going so he could get the treatment that he needed. The urologist said his surgery went well and he was expected to have a full and uneventful recovery.

Dr. Erika Kube is an emergency physician who works for Mid-Ohio Emergency Services and OhioHealth.

[email protected]

Treatment of orchitis (testicular inflammation) in men in Kazan

Symptoms of acute orchitis

The disease begins suddenly, and the state of health deteriorates so much that you cannot fail to notice them:

• Increased body temperature (up to 38-39 degrees).
• Acute pain in the testicle and / or scrotum – with pressure, with movement and / or at rest.
• Sharp pain radiating to the lumbosacral region, groin or lower abdomen.
• Significant increase in testicular size.
• Smooth (glossy), taut, reddened skin of the scrotum.
• Signs of general intoxication of the body (headache, dizziness, nausea, weakness, malaise).

Treatment of acute orchitis in “Alan Clinic” Kazan

In the Department of Urology and Sexology of our clinic, treatment is carried out in 3 stages.

Treatment is carried out without surgery and hospitalization, on the job . If necessary, a sick leave can be issued.

1st stage – acute pain relief

This is necessary to improve the patient’s quality of life.At this stage, drug therapy is prescribed, which may include anti-inflammatory and analgesic injections and intravenous droppers, tablets, ointments, suppositories.

2nd stage – treatment of the causes of orchitis

These include three main groups of diseases:

1. inflammatory – prostatitis, urethritis, cystitis, epididymitis, etc.
2. infectious – bacteria, viruses, STDs (sexually transmitted diseases) and others
3. vascular – varicose veins, complete or partial disturbance of blood flow in the vessels, congestion in the vas deferens (with frequent masturbation, interrupted sexual intercourse).

For treatment, drug therapy (antibiotics, antiviral, antibacterial and anti-inflammatory drugs) and a complex of physiotherapeutic procedures are prescribed:

• magnetotherapy,
• laser therapy,
• electrical stimulation,
• neurostimulation.

To track changes in the state throughout the entire course of treatment, ultrasound and control examinations and consultations of the attending physician are systematically carried out (free of charge).

3rd stage – dispensary observation after treatment

Includes:

• follow-up examinations and consultations of your urologist;
• Ultrasound diagnostics;
• development of individual recommendations to consolidate the effect obtained after treatment, as well as recommendations for prevention.

Symptoms of chronic orchitis

Signs of acute and chronic orchitis are very similar. The main difference is that in chronic orchitis, all symptoms are intermittent and less intense:

• Aching pains in the testicle – usually appear during hypothermia, during physical exertion or after them.
• Feeling of discomfort or slight pain when pressing on the testicle.
• A slight increase in the size of the testicle.
• On palpation, you can feel that the inflamed testicle is denser and harder than the healthy one.

Since patients with chronic orchitis do not experience severe pain, they can ignore their feelings and not go to the doctor.

This is a serious mistake that will result in infertility or impotence.

Treatment of chronic orchitis at Alan Clinic Kazan

Before starting to treat chronic orchitis, a much more thorough diagnosis is required than in acute orchitis.It is necessary to identify all concomitant diseases and complications that have arisen as a result of a long absence of treatment for inflammation.

Treatment should be long and complex. It is imperative to treat all concomitant diseases of the genital area. Separate treatment of only testicular inflammation will not bring the desired result.

A complete course of treatment, including physiotherapy, shock wave therapy, hormone (or hormone replacement) therapy, can restore or significantly improve testicular function.This means – to improve potency and restore the reproductive function of a man.

In especially difficult (neglected) cases, when the doctor sees that conservative therapy will be useless, he can recommend a surgical operation.

Do not bring to the operation – see a doctor in time!

Orchitis

Determination of orchitis

Orchitis – inflammation of one or both testicles, usually caused by a virus that causes mumps.At least one third of men who have had mumps develop orchitis after puberty.

Other causes of orchitis are bacterial, including sexually transmitted diseases (STDs) such as gonorrhea and chlamydia. Bacterial orchitis often results from epididymitis (inflammation of the epididymis), in which sperm are produced and stored. In this case, the condition is called epididymo-orchitis.

In this case, swelling and pain are the most common symptoms of orchitis.

Orchitis symptoms:

• testicular swelling on one or both sides
• minor to severe pain
• Soreness in one or both testicles, which may persist for weeks.
• nausea
• fever
• discharge from the penis
• blood in ejaculate

The terms “testicular pain” or “groin pain” are used. Groin pain is localized in the fold of the skin between the thigh and abdomen, not in the testicles.

If you experience pain or swelling of the scrotum, especially if the pain intensifies suddenly, you should immediately consult a doctor. Specialists of “Garant Clinic” will conduct a comprehensive examination of your body.

Many causes can cause testicular pain, some of which require urgent treatment. One such condition involves testicular torsion, which can cause pain similar to orchitis. Doctor “Garant Clinic” will carry out research that will help determine what is the cause of your pain.

Causes of orchitis

Orchitis can be bacterial or viral.

Bacterial orchitis

Most often, bacterial orchitis is the result of epididymitis, an inflammation of the epididymis that connects the vas deferens and the testicle. The vas deferens removes sperm from the testicles. When inflammation spreads to the epididymis, the condition is called epididymo-orchitis.

Epididymitis usually occurs with infections of the urethra and bladder that spread to the epididymis.Sexually transmitted diseases (STDs), especially gonorrhea and chlamydia, are often the cause. Other causes of infections can be associated with abnormalities in the urinary tract, the presence of catheters or stents inserted transurethrally.

Viral orchitis

In most cases, viral orchitis occurs as a result of the transferred mumps (mumps). About one third of men who develop mumps after puberty develop orchitis during mumps, usually four to six days after the onset of the disease.

Risk factors for orchitis

Several factors can contribute to the development of orchitis. For orchitis, which is not sexually transmitted, these include:

• lack of vaccination against mumps
• over 45 years old
• recurrent urinary tract infections
• surgical operations, on the genitals or urinary tract, because there is a risk of infection
• congenital malformations of the urinary tract

Sexual activity with certain risks that can lead to STDs, this can cause sexually transmitted orchitis.

These risks in sexual activity include:

• multiple sexual partners
• Sex with a partner who has an STD
• bareback sex
• history of STDs

Complications of orchitis

Complications of orchitis may include:

• testicular atrophy. Orchitis can lead to atrophy.
• scrotal abscess. The affected tissue fills with pus.
• secondary epididymitis. Orchitis can lead to recurring episodes of epididymitis.
• infertility. In small amounts, orchitis can lead to infertility. If orchitis affects only one testicle, infertility is less likely.

Research and diagnostics of orchitis

The doctor conducts a physical examination, which may reveal enlarged lymph nodes in the groin or an enlarged testicle on the affected side, both of which can be painful on contact.A doctor may do a rectal exam to check for an enlarged prostate or tenderness, and check blood and urine tests to rule out infection and other complications.

Other tests, your doctor may need to determine STDs, to exclude possible testicular torsion, which requires immediate treatment.

These studies include:

• STD testing. This test is performed by taking a sample of discharge from the penis.The doctor will insert a probe into the glans of the penis to take a sample, which will then be examined under a microscope or culture method will be used to check for gonorrhea and chlamydia.
• urinalysis . A sample of the first morning urine sample, which must be collected at home in the morning or in the doctor’s office, is analyzed for appearance, concentration and the components it contains.
• ultrasound examination. This test uses high-frequency sound waves to provide an image of your body’s structures.In this case, torsion of the epididymis can be excluded. Doppler ultrasound can determine if blood flow in the testicle is decreased or increased, which helps to confirm the diagnosis of orchitis.
• nuclear magnetic resonance Also used to avoid testicular torsion. This causes a small amount of radioactive material to enter your bloodstream. In the testicle, areas that are poorly supplied with blood may be found, this may indicate torsion or increased blood flow, which confirms the diagnosis of orchitis.

Treatment

Treatment depends on the cause of the orchitis.

Treatment of viral orchitis

Treatment for mumps-associated viral orchitis aims to relieve symptoms. The doctor can prescribe pain relievers, non-steroidal anti-inflammatory drugs, recommend bed rest, take a position with an elevated scrotum, apply cold.

Treatment of bacterial orchitis

In addition to prescriptions that help relieve discomfort, bacterial orchitis and epididymo-orchitis require antibiotic treatment.If the cause of the infection is an STD, the sex partner also needs treatment.

Antibiotics. Make sure your doctor knows about all other medications you are taking or allergies you have. This information is just as important as whether your infection is sexually transmitted. This will help the doctor find the best treatment.

Be sure to take the entire course of antibiotics recommended by your doctor. Even if your symptoms go away sooner, you should take the entire course of antibiotics to ensure that the infection is cleared up.

Orchitis mode

To reduce discomfort, observe the following recommendations:

• rest in bed
• When you go to bed, your scrotum should be elevated.
• Apply cold compresses to the scrotum.

Prophylaxis for orchitis

Practicing safe sex, which includes having only one sexual partner and using a condom, will protect you from STDs, which means it will help prevent bacterial orchitis caused by STDs.

Mumps (mumps) immunization is the best way to protect against mumps viral orchitis.

Read more:

Testicular orchitis in men – causes, symptoms, treatment and diagnosis of orchitis – Clinic “Doctor near”

If you have more than 80% of the listed symptoms, we strongly recommend that you consult a doctor for advice.

A pathological condition such as orchitis is characterized by inflammation of the testicles due to bacterial or viral infection, traumatic injuries.The disease manifests itself in very unpleasant symptoms in the form of pain symptoms and edema, sometimes covering the epididymis. Orchitis affects men of any age, but most often it is detected in patients between the ages of 18 and 35 years (i.e., those who are at the peak of sexual activity).

This is due to the fact that they have a high risk of contracting sexually transmitted infections. Men over fifty years old who suffer from prostate adenoma are also at increased risk.This benign neoplasm is characterized by the growth of glandular tissue and provokes an increase in the organ. It should be noted that in the overwhelming majority of cases (about 85%) testicular orchitis proceeds together with the inflammatory processes of its epididymis. In 10% of all diagnosed cases, the lesion is bilateral.

Orchitis in men: etiology

Inflammatory processes of paired male gonads (testicles) develop for various reasons. Orchitis in children most often has a viral etiology, but it can be triggered by congenital anomalies or dysfunction of the bladder.The latter is accompanied by infection of the urethra and testicular tissue. Experts identify the following reasons that can lead to the development of the disease:

Orchitis in men: symptoms

Symptoms of orchitis depend on how severe the inflammation is and what pathogen caused it.Patients suffer from general clinical manifestations in the form of high fever, accompanied by chills, a feeling of weakness, muscle aches. Depending on the development and duration of the course, specialists distinguish acute and chronic orchitis:

In addition to the above, with testicular orchitis , such symptoms are possible, as discharge from the urinary tract of a whitish or greenish-yellowish tint with an unpleasant odor. In more than a third of cases, there are violations of the urinary function in the form of frequent urge to empty the bladder, severe cuts and a feeling of discomfort.

Complications of orchitis

Lack of timely treatment orchitis can lead to serious consequences:

• Dropsy of testicular membranes – hydrocele;
• Formation of pus in the membranes of the testicle – pyocele;
• Abscess;
• Transition into a chronic form, accompanied by pathological changes that can cause male infertility;
• Testicular atrophy.

Diagnosis of orchitis

Before how to treat orchitis , the doctor conducts complex diagnostic studies using laboratory and instrumental research methods. A preliminary diagnosis is made on the basis of:

• patient complaints;
• collection of anamnesis;
• physical examination;
• rectal palpation of the prostate.

Orchitis must be differentiated from testicular torsion and entrapment of a hernia located in the groin.To do this, it is enough to apply instrumental diagnostic methods.

Treatment of testicular orchitis

Testicular inflammation (orchitis) rarely requires hospitalization. They resort to it in cases where there are complications accompanied by the formation of pus. In this case, the patient is prescribed bed rest, wearing a suspensory and a diet that excludes the consumption of foods and products that irritate the mucous membranes. In order to eliminate intoxication, it is recommended to consume a large amount of liquid.Thanks to him, pathogens are quickly eliminated from the body along with urine.

Prevention and prognosis of orchitis

Preventive measures eliminate promiscuous sexual activity and require the use of protective equipment when playing sports with a high risk of injury. In addition, they provide for regular preventive examinations by a urologist and timely treatment of diseases of the genitourinary system.

Timely treatment of testicular orchitis in men is the key to eliminating complications and a favorable prognosis.A network of clinics “Doctor near” invites you to take his course in Moscow. Our specialists will carry out a comprehensive diagnosis, which will reveal the cause of the disease and direct efforts to eliminate it. We employ highly qualified doctors with decades of practical experience. They know how to effectively treat orchitis and eliminate reproductive disorders.

You can sign up for a consultation with them by filling out and sending us the online form presented on the website or by contacting our operators: +7 (495) 154-92-31!

Testicular pain – causes, diseases, diagnosis, prevention and treatment – Likar24

Pain in the testicles – as a rule, begins abruptly, increasing gradually, sometimes developing into chronic.Many people just endure this kind of pain. It would be a mistake on your part if you ignore it. At first, it does not cause much discomfort and your daily life remains unchanged. That is why many men do not attach much importance to this. All men with suspicious symptoms or severe pain should see a doctor immediately, as some causes of pain can lead to testicular loss or other serious complications.

Pain in the testes in men is the first and main sign of problems with the genitourinary system.If you have pain, it can signal inflammation. Pain can also indicate other problems that may be associated with thermal, mechanical, functional trauma or injury. With such pain, you should be careful, as this may be a sign of the formation of a tumor. Therefore, go to a doctor’s consultation and do not postpone it.

The need for tests depends on the results of the survey that the doctor conducted and the physical examination of the patient.First, the doctor determines the nature of the problem by finding out if it requires immediate intervention. The onset and nature of the pain, as well as the age of the patient, can help to find out the cause. However, some routine tests are always done.

• Urinalysis and urine culture
• Tests for diseases that can be sexually transmitted
• Color echo if you suspect testicular distortion

In case of testicular distortion, timely diagnosis is very important.If necessary, an operation should be performed immediately instead of analyzes.

• Orchitis (testicular inflammation)
• Epididymitis (inflammation of the epididymis)
• Orchoepididymitis (occurs more often than the previous two separately)
• deferentitis (local inflammation of the vas deferens)
• Chlamydia
• Ureaplasmosis
• Trichomoniasis
• Gonorrhea
• Enterococci
• Pseudomonas
• Escherichia coli
• Mumps
• Rubella
• Testicular torsion
• Cyst
• Contusion
• Inguinal hernia
• Varicocele (expansion of the venous plexus of the spermatic cord as a result of intense physical exertion or impaired blood flow)
• Stagnation of blood in the testicles as a result of prolonged abstinence

First of all, you need to find out the cause of pain in this area, carry out the necessary medical research and consult a urologist and oncologist.

If any pain or other symptoms appear, first of all it is necessary to consult a doctor and eliminate the underlying cause of the pain.

90,000 Testicular cancer – symptoms and signs.

Testicular cancer is a complex and insidious oncological disease that manifests itself in men in the seminal gland, mainly. Treatment of this disease is possible through surgery and chemotherapy. The causes of this disease are few factorial, and the symptoms are expressed by painful sensations in the scrotum.

Causes of testicular cancer

The exact causes and development of testicular cancer have not been established. The main factor in the diagnosis of testicular cancer is genetic inheritance. Most often, this disease manifests itself in men by family relationship father-son, in blood brothers less often. The disease mainly affects white men.

Also, the manifestation of pathologies is the cause of the onset of the tumor process.Underdevelopment, cryptorchidism (undescended testicle into the scrotum) and hyperestrogenism that develops in the prenatal period.

Symptoms of testicular cancer

Testicular cancer is an insidious disease with severe symptoms already at the time of the appearance of metastases in the body. Since painful sensations by patients mainly appear already at the last stage, when the tumor grows into the tissue of the organ and noticeably squeezes the seminiferous tubules, it is difficult to recognize the disease in the early stages.Which complicates the possibility of full recovery.

Symptoms of the disease can manifest itself in the aggravation of the general condition of the body, loss of appetite, slightly elevated body temperature, as well as a visible sensation of the lymph nodes in the supraclavicular region. Symptoms as severe as back pain, chest pain and severe shortness of breath are a sign of a possible diagnosis of testicular cancer.

Stages of testicular cancer

Determination of the stages of testicular cancer depends on the spread of the tumor within the organ and its metastasis to the blood, lymph and other organs.Symptoms and stages of development of the disease are divided into groups using the international classification of stages of malignant diseases.

Stage 1 – detection of atypical cells within the testicle.

Stage 2 – tumor cells multiply inside the organ and the detection of tumor markers within or slightly above normal.

Stage 3 – the tumor can grow into the spermatic cords of the scrotum.Lymph node metastases are possible. Tumor markers are within the normal range or slightly higher.

Stage 4 – the cancer is also located within the testicle, the presence of metastases in the lymph nodes is high enough, but the spread is not so distant. In some cases, liver and bone damage occurs. Tumor markers are significantly higher than normal.

Testicular cancer diagnostics

Diagnosis of testicular cancer treatment begins with the consultation of a specialist.Collection of family history, palpation of the testicles and analysis of the collected data, allow you to determine the likelihood of cancer.

In men, when signs of the disease are manifested, fear is revealed, which has a detrimental effect on early diagnosis. Therefore, when the first signs appear, it is necessary to be examined by a urologist-oncologist.

Then an ultrasound examination is prescribed, which allows you to most accurately determine the presence of a tumor.

Detection of cases of metastasis is possible by computed tomography.

A blood test for the presence of tumor markers allows assessing the prognosis of testicular cancer treatment. Correct therapy should show how effective the recovery program is. An increase in blood counts after medical manipulations indicates a relapse of the disease, therefore it is important to monitor blood counts.

A biopsy may also be ordered by your doctor. In this case, the procedure takes place by open surgery or puncture. Each case is considered individually.But the indications for biopsy are: bilateral testicular tumor, tumor of lymphoid tissue and the presence of a tumor with a normal value of tumor markers.

Testicular cancer treatment

For a possible favorable outcome, three types of treatment are used:

• chemotherapy;
• radiation therapy;
• surgical treatment.

Testicular cancer, despite the hidden symptoms, responds well to chemotherapy.While maintaining the level of drugs and full courses of treatment, there is a positive tendency to suppress abnormal cells and resist their development.

In case of residual manifestation on computed tomography of a tumor in the retroperitoneal part after chemotherapy, removal of the retroperitoneal lymph nodes is prescribed, since the manifestation of the development of a tumor process is possible.

Testicular cancer suggests the possible removal of an organ and spermatic cord. This technique is prescribed when chemotherapy cannot be used and when symptoms of the disease persist.

Prevention of testicular cancer

To achieve complete remission, it is important to keep all the recommendations of the attending physician and go through a full recovery after treatment. Testicular cancer is an insidious disease that manifests its symptoms after the onset of metastasis, so it is very important to monitor your health. In men, professional activity is most often physically difficult, but an ardent return to the work process can adversely affect the recovery of the body.

After treatment, it is necessary to undergo an examination by a specialist, conduct laboratory blood tests to track the level of tumor markers.

Branches and departments where testicular cancer is treated

MNIOI named after P.A. Herzen is a branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” of the Ministry of Health of Russia.

Research Institute of Urology and Interventional Radiology named after V.I.ON THE. Lopatkin, a branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” of the Ministry of Health of Russia.

ultrasound of the scrotum

Ultrasound examination of the scrotum is a diagnostic procedure in which sound waves penetrate the tissues and allow the doctor to find out information about the state of each organ. Such an examination is comfortable for the patient, and therefore doctors often prescribe it for “male” problems – after all, most men refuse painful manipulations.Ultrasound does not cause any discomfort. In addition, it is recognized as one of the most informative diagnostic methods. Note that this procedure makes it possible to identify pathological processes and developmental anomalies not only in adult men, but also in children.

The main advantages of examining the scrotum by ultrasound

This technique allows you to examine in detail the state and structure of the various membranes of the scrotum, testicles and spermatic cord. If the study is done with a Doppler, the doctor may also assess blood flow and vascular health.After the manipulation, the doctor deciphers the results. Note that due to timely diagnosis, it is possible to identify a lot of pathological processes even before the first symptoms appear, which allows you to start treatment early and avoid serious problems and complications in the future.

Among the advantages, the following factors can be noted:

• The man does not feel any discomfort or pain during the procedure.
• Ultrasonic waves have no negative effect on the body.
• The research is highly informative.

Like any medical manipulation, ultrasound has one drawback – when a neoplasm is detected, it is impossible to know whether it is a malignant tumor or a benign one. For this purpose, after the procedure, other diagnostic tests are prescribed (usually a biopsy).

When is ultrasound of the scrotum indicated

Due to the complex anatomical structure of the scrotum, ultrasound is almost the only way to identify an accurate diagnosis.This procedure is prescribed if the patient has symptoms of urological diseases or a history of concomitant diagnoses.

Carrying out a study of the organs of the scrotum is assigned in the following situations:

• Impossibility of conceiving a child when all tests and studies on the part of the mother are normal;
• When probing the area of ​​the scrotum, a seal is found;
• Unstable erection;
• Pain in the testicles or other parts of the scrotum;
• Changes in the size of the testicles or scrotum in general;
• Injury to this area;
• Poor spermogram results.
• The appearance in this area of ​​a hematoma or a bright vascular network.

In addition, ultrasound of the scrotum is used for dynamic monitoring of the treatment process.

If you or your loved one are experiencing pain or discomfort in the scrotum, this is not the norm. According to statistics, most often painful sensations signal epididymitis – inflammation of the epididymis. With a timely visit to a doctor and early treatment, you can completely recover and forget about discomfort, while an advanced disease can lead to infertility.

Do I need special preparation for the study?

No special training is required for adult men. It is enough to thoroughly carry out hygienic manipulations in the morning before the procedure, and in case of abundant hair, remove hair from the studied area. When it comes to children, it is not recommended to give the baby a drink in 1.5 hours, so as not to interrupt the procedure to empty the bladder. It is also worth telling the child about the upcoming study, mentally preparing so that the child remains calm and immobile during the examination.

In the event that ultrasound diagnostics with Doppler is to be performed, inform the doctor about taking vasodilators. It may be necessary to discontinue the medication a couple of days before the proposed study.

How is scrotal ultrasound performed?

The procedure is carried out in the ultrasound diagnostic room. The patient removes all clothing below the waist and the doctor asks him to lie either on his back or on his side. The man should press the penis with his hands to his stomach.A special gel is applied to the scrotum area, which facilitates better contact of the sensor. On average, the manipulation does not exceed 15 minutes.

At the end of the ultrasound examination, the man is sent with the results of the procedure to the attending physician. The specialist determines the exact diagnosis and prescribes treatment if any pathology is detected.

Doppler ultrasound of the scrotum

Doppler ultrasound is sometimes prescribed to the patient.Most often this occurs when an erection is impaired, in order to assess the functioning of the blood flow in the intimate area, as well as the structure and functionality of the vessels located in this area. With the help of such manipulation, it is possible at an early stage to identify the existing atherosclerotic plaques or blood clots.

Interpretation of results

The diagnosis and interpretation of the data should be carried out by the attending physician who referred you to the examination of the organs of the scrotum. Don’t try to diagnose yourself on your own.

After performing the manipulation, the doctor can detect the following deviations from the norm:

• Cryptorchidism. This ailment is typical for boys under the age of 7 years. The essence of this pathological process is the absence of one testicle in the scrotum. The cause of the abnormality can be different. If such a nuisance is detected in a timely manner, the problem can be eliminated and infertility can be avoided in the future.
• Seals and tumors. Experts assure that oncological diseases or benign tumor-like formations in the area of ​​the scrotum organs occur infrequently, however, even at an early stage, this process will be clearly visible when performing an ultrasound examination.This is evidenced by fuzzy contours and lack of graininess.
• Calcifications and cysts. These pathologies can occur in both an elderly man and a newborn.
• Inflammatory process. It usually occurs due to traumatic damage to the scrotum or the introduction of pathogens with blood or lymph pathway. In this case, the patient usually understands that not everything is normal: there is a pronounced swelling of the scrotum, an increase in temperature in the groin area and soreness when touched.

Scrotum norm by ultrasound

If there are no pathological processes in the scrotum, then the length of the testicles should be about 5 centimeters, the thickness should not exceed three centimeters, the transverse size should be 1.5-2 cm; vertical size – 2.5-3 cm. Normally, the testicles have an oval shape, a homogeneous structure of increased echogenicity.

If, as a result of the study, pathological processes are revealed or your results do not coincide with the above-described norm, you should not be upset ahead of time.Each organism is individual and the size may vary slightly, and only a doctor can make a final diagnosis.

🧬 I’m embarrassed to ask: 10 important questions for a urologist

Taking care of your health is a useful thing, but even in it there is a lot of room for embarrassment and harmful delusions. We asked Konstantin Lokshin, Doctor of Medical Sciences and Head of the Center for Operative Urology, Oncourology and Andrology of the GMS Clinic Medical Center, about the problems with which one should go to the urologist, and what, on the contrary, should not be feared.

What symptoms should you go to a urologist with, and which shouldn’t you be afraid of?

One of the key signs with which you need to see a urologist is blood in the urine and blood in the ejaculate.

In no case should this moment be ignored. Especially smokers, because smoking is a risk factor for lung cancer, bladder cancer, and, to a lesser extent, prostate cancer.

Other signs are pain and discomfort in the testicles, pain in the perineum, unusual discharge from the urethra, lower back pain, especially if it manifests itself on one side.

If the testicles or one of them change in size, this is also a reason to see a doctor. But their different position just should not be alarming.

It is necessary to monitor how urine is excreted – there should be no pain, and trips to the toilet should be on average 6-8 times a day. If the stream is weak, urination is difficult, intermittent, incontinence appears, frequent nighttime urges – all these are reasons to consult a doctor, although not all of them definitely mean that the person is sick.

Prostate adenoma – is this a sentence and will only get worse?

No, absolutely not. In most men, after 40-50 years, an adenoma appears to one degree or another, and by the age of 90, all of them. But only in about a third of them it becomes a disease, for the rest it is, let’s say, the process of growing up.

Adenoma is not a sentence, most men do not even need treatment and observation is enough.

For most people who still need to be treated, there are solutions for conservative treatment of this disease.And only 25-30% of this third may ultimately need surgery.

What common fears associated with urological diseases are unfounded?

The fear of adenoma turning into cancer, for example, is unfounded – contrary to what unscrupulous advertising sometimes tries to impose. “Have you been tested for hidden infections? Otherwise, they will cause prostatitis, adenoma, and then cancer. ” Not only is this not so, it just becomes the cause of fears – a person decides not to go anywhere and not to be checked, they say, what will be, that cannot be avoided, and this is just harmful to health.

Yes, it is better not to get STDs, and yes, an adenoma occurs in almost all men in the end, but no, it does not degenerate into cancer. Men after 45-50 years do have a parallel risk of prostate cancer, but they are not related, they even grow from different parts of the prostate gland.

There is also the fear of operations. All normal people are afraid of operations, this is a natural fear. But an operation is not always a terrible serious intervention and a difficult recovery, sometimes a couple of days are enough for him.Here you always need to look for a middle ground in order not to succumb to the provocations of doctors and not to do unnecessary manipulations, but also not to miss the moment, not to let the problem become difficult to solve or insoluble, instead of doing a good, graceful operation, after which the person will forget about this problem … Now, for example, after adenoma surgery, a person is in the hospital for one day and returns to normal life.

Are there any harmful myths associated with STDs?

Of course, for example, oral sex without a condom is safe and no diseases are transmitted through it.They are transmitted, so protection should be taken care of in any case and checked regularly. According to international recommendations, if a person has two or more partners during the year, it is recommended to undergo annual screening for STDs.

Another is that you can only get infected during sex. Some diseases can be contracted from a towel, from a toilet seat and so on, that is, the sexual route cannot be called exclusive. Another thing is that the probability, of course, is lower, but it exists, especially if there are wounds, cracks, and so on.But there is no need to walk and be afraid – basic hygiene, care and accuracy are enough.

There is another side of such myths – for example, that any contact is a 100% risk of getting sick. This is wrong. My favorite example is with gonorrhea: with a one-time unprotected contact with a sick woman, the probability of infection is only 17%. This does not mean that it is worth the risk – it is always better to choose barrier methods of contraception if there is more than one partner.

Should I be afraid of prostate cancer and how often should I get tested?

We, urologists, oncologists and epidemiologists, are constantly fighting with each other on this issue.There is a blood test for PSA – this is a tumor marker for prostate cancer. Oncologists say that everyone should not do this all the time. Conducted a study that you need to look at the results of 1000 people in order to detect cancer in one. It turns out that the rest of the people passed the blood test in vain.

There is another side: there is clinically insignificant prostate cancer. For example, a person in 80 years old, with strokes, with heart attacks. We will find in him markers of a slowly growing prostate cancer, which will only become a disease in 15 years.And we will begin to “drive” him through a blood test, then a biopsy of the prostate, then prescribe a treatment – we will only harm him. Here is the question of patient selection – who needs it and who does not.

In Scandinavia, which has the highest rates of prostate cancer, it has been suggested that PSA screening be done between 40-45 years in men. If the indicators are low, then for the next few years you can forget about it. If they are high, then the survey is done annually. I like this selective position, as we avoid unnecessary diagnoses and do not miss significant diseases.

Does everyone need circumcision?

At one time in the United States, virtually everyone was circumcised to reduce the risk of STDs. It all started with sailors, when the men were going to serve in the navy, they were told: “If you do not cut yourself off, you will not enter.” Because, as they say, docks in ports – and treat them later. It is also believed that circumcision reduces the risk of penile cancer, although statistically speaking, these are very small numbers. This is, in general, a rare disease.

Nowadays such universal circumcision is being done less and less – and the fashion has passed, and other factors influence.In general, babies were often circumcised not even by urologists, but by obstetricians-gynecologists at birth. The decline in the popularity of circumcision is due to the fact that with any intervention there is a risk of complications. It is believed that it is small, and one in 100,000 is not much, but it is not much until you or your child become this one. Therefore, now there is a very restrained attitude towards preventive operations – they just cut something off less and less.

By the way, a similar situation is with varicocele – enlargement of the veins in the testicles, which is sometimes associated with infertility.Even now there are colleagues who, without exception, offer to everyone who has varicocele to be operated on. About 15% of men have this condition – this is a large number. But not all of them need surgery, some of them, on the contrary, are contraindicated.

A small penis is normal?

The fear of size is one of the most common. Recently, colleagues conducted a survey – according to its results, it turned out that the average penis size is 21 cm.When the participants were asked to try it on again and were taught exactly how, it turned out that the average length is still 13 cm. These are the average figures – 12-16 cm – and, moreover, one must measure not just “from the abdomen”, but from the pubic joint. Some have fat there – if you don’t measure it, then less can be counted. Many people are dissatisfied with their appearance, and dissatisfaction with this area is also common, but this does not mean that there is a real reason for alarm and some serious measures. I am not a supporter of penis enlargement without indications.

There are also pathological abnormalities – there is the concept of “micropenis”, there is a hidden penis. In the vast majority of situations, a person can be helped – modern medicine is not about despair at all. There is a whole subsection of genital surgery in urology, these are specialists who deal with complex operations for gender reassignment, reduction, extension, enlargement, compression. To the extent that you can make a new penis from the latissimus dorsi muscle. A man tensed a muscle – and he seemed to have an erection.I do not own this surgery, but I am familiar with such specialists. There is almost always a solution that allows a person to live a sex life, even if it seemed that there was no chance – for example, with a traumatic loss of the penis.

Male infertility – is it worth it to be afraid and what to do?

There is nothing to be afraid of. To begin with, it is necessary to determine whether it is infertility or a state of subfertility, that is, a reduced ability to conceive. There is statistics that it is worth starting to be examined in this area if a generally healthy couple does not conceive during the year with regular sexual activity – it is with regular, and not occasionally.If a woman in a couple is over 35 years old, then this period is reduced to six months. This is due to the fact that in many modern women, the ovarian reserve (the total number of eggs) is reduced, this is due to interventions and other factors.

Whatever the reason for male infertility, this is not a sentence. Even if we are talking about an extreme degree – azoospermia, in which there are no sperm in the ejaculate. Now there are techniques that allow, at least within the framework of IVF, to conceive a child.

One of the common reasons for difficulties with conception is a violation of the patency of the vas deferens, which in turn can occur as a result of many factors. Most often it is a chlamydial or myoplasmic infection, complications after gonorrhea. There are genetic forms in which critically few sperm are produced. We successfully overcome all this with the help of microsurgical operations that allow us to obtain sperm directly from the testicle or epididymis.

In any case, there is definitely no need to despair.

Can the risk of kidney stones be reduced?

The easiest way is to drink plenty of water, this is the most frequent recommendation at the reception. It prevents many health problems altogether. The kidneys secrete about 1.5-2 liters of urine per day, but at the same time they drive up to 100 liters of fluid through themselves, so the fear of “pouring the kidneys” is not entirely justified, this is also from the realm of myths – the kidneys have a gigantic working reserve.Moreover, if a person has one kidney removed, the other will take over all the work and will cope. We recommend drinking enough water to make your urine clear or almost clear.

How often should a urologist visit and should women visit him?

There is a misconception that a urologist is a male doctor, but this is not the case. It is better for women to consult a urologist, and not a gynecologist, when it comes to urinary tract infections – cystitis, pyelonephritis. These, by the way, are the most common bacterial infections; they occur more often than intestinal and pulmonary infections.With such problems, it is better not to go to a gynecologist – urinary infections are generally better treated by urologists. This is really our area.

Men should visit a urologist if there are alarming symptoms, discomfort. There are no clear uniform recommendations for preventive visits, but I advise you to regularly check after 45-50 years and periodically do ultrasound of the kidneys and other organs. At the same time, it is imperative to conduct self-examination – a man should regularly probe the scrotum for seals and other changes.Testicular tumors, for example, are practically asymptomatic for a very long time – even when they grow large, they still do not hurt. In general, most urological cancers are slow-growing, but testicular cancer is an exception, it can develop quickly and most often occurs at the age of 20-40, so feeling yourself is not only pleasant, but also useful.

But here I would like to convey one important thing. Today, in terms of oncourology, we have made great strides forward. When I started to study urology in 1994, it was mostly major mutilation surgery.Now, most of the patients whom we operate and conduct minimally invasive interventions are patients with a good prognosis, a complete cure can occur in 70-80% of them.