About all

Vas deferens pain treatment: What is Epididymitis? – Urology Care Foundation

Содержание

Epididymitis: Causes, symptoms, and treatment

In the back of the testicles, there is a coiled tube called the epididymis. This tube stores and carries sperm and is linked to the ejaculatory duct by another tube called the vas deferens.

Epididymitis is when this tube becomes painful, swollen, and inflamed.

There are two types of epididymitis. Acute epididymitis comes on suddenly, and pain and inflammation develop quickly. This kind of epididymitis lasts less than 6 weeks.

Chronic epididymitis develops slowly and has a duller pain. It is a long-term problem that lasts for longer than 6 weeks. Males of any age can be affected by the condition.

If the testicles also become inflamed and painful, then this is known as epididymo-orchitis.

Share on PinterestThe epididymis stores and carries sperm, and may become swollen and inflamed due to a bacterial infection.

The spread of a bacterial infection usually causes epididymitis. This infection will often start in the urethra, prostate, or bladder.

Two main types of infection cause epididymitis:

Sexually transmitted infection (STI)

Epididymitis caused by an STI, such as gonorrhea or chlamydia, is most common in young, heterosexual men; particularly those who have sex with multiple partners and do not use a condom.

Cases of epididymitis that are not caused by an STI are less common.

Urinary tract infection (UTI)

Epididymitis caused by a UTI occurs in children, older men, and men who have sex with men. The following factors often cause UTIs in men:

  • enlarged prostate pressing on the bladder
  • insertion of a catheter into the penis
  • surgery on the groin, bladder, or prostate gland

Children

While cases of epididymitis in children are rare, they do occur. Often the bacterial infection will spread from the urethra or bladder.

Inflammation will usually develop due to one of the following:

  • direct injury to the area
  • twisting of the epididymis
  • urine flowing back into the epididymis

Other causes

There are also some more unusual causes of epididymitis:

  • mumps
  • tuberculosis
  • high doses of a medication called amiodarone, usually taken for heart rhythm problems
  • groin injury
  • structural problems in the urinary tract
  • Behcet’s disease
  • congenital kidney and bladder problems

Epididymitis will cause pain in one or both testicles. The affected area will also be red, swollen, and warm to touch. If it is left untreated, it will worsen over time.

Other symptoms include:

  • fever
  • chills
  • heaviness in the affected testicle
  • enlarged testicle
  • affected testicle sensitive to touch
  • pain in the abdomen or pelvis
  • frequent urge to urinate
  • burning sensation when urinating
  • discharge from the end of the penis
  • blood in urine
  • pain when ejaculating or having sex
  • fluid buildup around the testicle which may feel like a lump

Symptoms will usually depend on the cause of the epididymitis. For example, discharge from the penis is likely to be due to an STI, while the urge to urinate probably results from a UTI.

Symptoms of epididymitis can also be similar to those of testicular torsion, a condition that sees the testicle twist and cut off the blood supply and which requires emergency surgical treatment.

As a result, if a person experiences any of these symptoms they should see a doctor straight away.

In children, the most common symptoms are:

  • discomfort in lower abdomen or pelvis
  • a red and tender area on the side of the scrotum
  • pain or burning when urinating
  • discharge from the urethra
  • fever

It can often be hard to tell the difference between epididymitis and testicular torsion, particularly in younger men.

Sometimes epididymitis and testicular torsion can occur at the same time.

Doctors may perform some other tests to find the cause. These include:

  • rectal exam, where a doctor inserts a finger into the anus to check for an enlarged prostate
  • urine and blood tests
  • urine samples to test for gonorrhea and chlamydia
  • ultrasound scans, to identify testicular torsion
  • medical history

Treatment will be provided based on what is causing the epididymitis. If it is a bacterial infection, the doctor will probably prescribe a course of antibiotics.

If the infection was caused by an STI, the man must tell their sexual partners. They will also need to abstain from having sex until the treatment is completed.

As well as this, doctors will probably also recommend painkillers and anti-inflammatory drugs, such as ibuprofen, to reduce pain and swelling.

There are also some basic things that a person can do to reduce discomfort:

  • resting lying down with the scrotum elevated
  • applying an ice pack to the painful area
  • wearing a scrotal support

In general, once treatment has started the pain associated with epididymitis will go within 1 to 3 days. However, some of the symptoms can take months to disappear.

In more severe cases, a person may have to stay in the hospital and may require some surgical procedures.

Follow-up exams with the doctor will also be necessary to make sure the infection has cleared up.

In most cases, epididymitis clears up with antibiotics and bed rest, and there are no long-term sexual or reproductive problems.

However, the condition can return, and some complications can occur:

  • abscess in the scrotum, which may require draining
  • chronic epididymitis
  • opening on the skin of the scrotum
  • the death of testicular tissue due to a lack of blood, known as testicular infarction
  • infertility

Chronic epididymitis

In the case of chronic epididymitis, doctors will not prescribe antibiotics as inflammation occurs without an infection.

Treatment includes:

  • frequent warm baths
  • anti-inflammatory medication that does not contain steroids
  • medication to relax muscles and alter nerve messages
  • anesthetic of steroid injections into the scrotum
  • surgery to remove affected epididymis
  • stress management techniques

Epididymitis: Causes, symptoms, and treatment

In the back of the testicles, there is a coiled tube called the epididymis. This tube stores and carries sperm and is linked to the ejaculatory duct by another tube called the vas deferens.

Epididymitis is when this tube becomes painful, swollen, and inflamed.

There are two types of epididymitis. Acute epididymitis comes on suddenly, and pain and inflammation develop quickly. This kind of epididymitis lasts less than 6 weeks.

Chronic epididymitis develops slowly and has a duller pain. It is a long-term problem that lasts for longer than 6 weeks. Males of any age can be affected by the condition.

If the testicles also become inflamed and painful, then this is known as epididymo-orchitis.

Share on PinterestThe epididymis stores and carries sperm, and may become swollen and inflamed due to a bacterial infection.

The spread of a bacterial infection usually causes epididymitis. This infection will often start in the urethra, prostate, or bladder.

Two main types of infection cause epididymitis:

Sexually transmitted infection (STI)

Epididymitis caused by an STI, such as gonorrhea or chlamydia, is most common in young, heterosexual men; particularly those who have sex with multiple partners and do not use a condom.

Cases of epididymitis that are not caused by an STI are less common.

Urinary tract infection (UTI)

Epididymitis caused by a UTI occurs in children, older men, and men who have sex with men. The following factors often cause UTIs in men:

  • enlarged prostate pressing on the bladder
  • insertion of a catheter into the penis
  • surgery on the groin, bladder, or prostate gland

Children

While cases of epididymitis in children are rare, they do occur. Often the bacterial infection will spread from the urethra or bladder.

Inflammation will usually develop due to one of the following:

  • direct injury to the area
  • twisting of the epididymis
  • urine flowing back into the epididymis

Other causes

There are also some more unusual causes of epididymitis:

  • mumps
  • tuberculosis
  • high doses of a medication called amiodarone, usually taken for heart rhythm problems
  • groin injury
  • structural problems in the urinary tract
  • Behcet’s disease
  • congenital kidney and bladder problems

Epididymitis will cause pain in one or both testicles. The affected area will also be red, swollen, and warm to touch. If it is left untreated, it will worsen over time.

Other symptoms include:

  • fever
  • chills
  • heaviness in the affected testicle
  • enlarged testicle
  • affected testicle sensitive to touch
  • pain in the abdomen or pelvis
  • frequent urge to urinate
  • burning sensation when urinating
  • discharge from the end of the penis
  • blood in urine
  • pain when ejaculating or having sex
  • fluid buildup around the testicle which may feel like a lump

Symptoms will usually depend on the cause of the epididymitis. For example, discharge from the penis is likely to be due to an STI, while the urge to urinate probably results from a UTI.

Symptoms of epididymitis can also be similar to those of testicular torsion, a condition that sees the testicle twist and cut off the blood supply and which requires emergency surgical treatment.

As a result, if a person experiences any of these symptoms they should see a doctor straight away.

In children, the most common symptoms are:

  • discomfort in lower abdomen or pelvis
  • a red and tender area on the side of the scrotum
  • pain or burning when urinating
  • discharge from the urethra
  • fever

It can often be hard to tell the difference between epididymitis and testicular torsion, particularly in younger men.

Sometimes epididymitis and testicular torsion can occur at the same time.

Doctors may perform some other tests to find the cause. These include:

  • rectal exam, where a doctor inserts a finger into the anus to check for an enlarged prostate
  • urine and blood tests
  • urine samples to test for gonorrhea and chlamydia
  • ultrasound scans, to identify testicular torsion
  • medical history

Treatment will be provided based on what is causing the epididymitis. If it is a bacterial infection, the doctor will probably prescribe a course of antibiotics.

If the infection was caused by an STI, the man must tell their sexual partners. They will also need to abstain from having sex until the treatment is completed.

As well as this, doctors will probably also recommend painkillers and anti-inflammatory drugs, such as ibuprofen, to reduce pain and swelling.

There are also some basic things that a person can do to reduce discomfort:

  • resting lying down with the scrotum elevated
  • applying an ice pack to the painful area
  • wearing a scrotal support

In general, once treatment has started the pain associated with epididymitis will go within 1 to 3 days. However, some of the symptoms can take months to disappear.

In more severe cases, a person may have to stay in the hospital and may require some surgical procedures.

Follow-up exams with the doctor will also be necessary to make sure the infection has cleared up.

In most cases, epididymitis clears up with antibiotics and bed rest, and there are no long-term sexual or reproductive problems.

However, the condition can return, and some complications can occur:

  • abscess in the scrotum, which may require draining
  • chronic epididymitis
  • opening on the skin of the scrotum
  • the death of testicular tissue due to a lack of blood, known as testicular infarction
  • infertility

Chronic epididymitis

In the case of chronic epididymitis, doctors will not prescribe antibiotics as inflammation occurs without an infection.

Treatment includes:

  • frequent warm baths
  • anti-inflammatory medication that does not contain steroids
  • medication to relax muscles and alter nerve messages
  • anesthetic of steroid injections into the scrotum
  • surgery to remove affected epididymis
  • stress management techniques

Epididymitis: Causes, symptoms, and treatment

In the back of the testicles, there is a coiled tube called the epididymis. This tube stores and carries sperm and is linked to the ejaculatory duct by another tube called the vas deferens.

Epididymitis is when this tube becomes painful, swollen, and inflamed.

There are two types of epididymitis. Acute epididymitis comes on suddenly, and pain and inflammation develop quickly. This kind of epididymitis lasts less than 6 weeks.

Chronic epididymitis develops slowly and has a duller pain. It is a long-term problem that lasts for longer than 6 weeks. Males of any age can be affected by the condition.

If the testicles also become inflamed and painful, then this is known as epididymo-orchitis.

Share on PinterestThe epididymis stores and carries sperm, and may become swollen and inflamed due to a bacterial infection.

The spread of a bacterial infection usually causes epididymitis. This infection will often start in the urethra, prostate, or bladder.

Two main types of infection cause epididymitis:

Sexually transmitted infection (STI)

Epididymitis caused by an STI, such as gonorrhea or chlamydia, is most common in young, heterosexual men; particularly those who have sex with multiple partners and do not use a condom.

Cases of epididymitis that are not caused by an STI are less common.

Urinary tract infection (UTI)

Epididymitis caused by a UTI occurs in children, older men, and men who have sex with men. The following factors often cause UTIs in men:

  • enlarged prostate pressing on the bladder
  • insertion of a catheter into the penis
  • surgery on the groin, bladder, or prostate gland

Children

While cases of epididymitis in children are rare, they do occur. Often the bacterial infection will spread from the urethra or bladder.

Inflammation will usually develop due to one of the following:

  • direct injury to the area
  • twisting of the epididymis
  • urine flowing back into the epididymis

Other causes

There are also some more unusual causes of epididymitis:

  • mumps
  • tuberculosis
  • high doses of a medication called amiodarone, usually taken for heart rhythm problems
  • groin injury
  • structural problems in the urinary tract
  • Behcet’s disease
  • congenital kidney and bladder problems

Epididymitis will cause pain in one or both testicles. The affected area will also be red, swollen, and warm to touch. If it is left untreated, it will worsen over time.

Other symptoms include:

  • fever
  • chills
  • heaviness in the affected testicle
  • enlarged testicle
  • affected testicle sensitive to touch
  • pain in the abdomen or pelvis
  • frequent urge to urinate
  • burning sensation when urinating
  • discharge from the end of the penis
  • blood in urine
  • pain when ejaculating or having sex
  • fluid buildup around the testicle which may feel like a lump

Symptoms will usually depend on the cause of the epididymitis. For example, discharge from the penis is likely to be due to an STI, while the urge to urinate probably results from a UTI.

Symptoms of epididymitis can also be similar to those of testicular torsion, a condition that sees the testicle twist and cut off the blood supply and which requires emergency surgical treatment.

As a result, if a person experiences any of these symptoms they should see a doctor straight away.

In children, the most common symptoms are:

  • discomfort in lower abdomen or pelvis
  • a red and tender area on the side of the scrotum
  • pain or burning when urinating
  • discharge from the urethra
  • fever

It can often be hard to tell the difference between epididymitis and testicular torsion, particularly in younger men.

Sometimes epididymitis and testicular torsion can occur at the same time.

Doctors may perform some other tests to find the cause. These include:

  • rectal exam, where a doctor inserts a finger into the anus to check for an enlarged prostate
  • urine and blood tests
  • urine samples to test for gonorrhea and chlamydia
  • ultrasound scans, to identify testicular torsion
  • medical history

Treatment will be provided based on what is causing the epididymitis. If it is a bacterial infection, the doctor will probably prescribe a course of antibiotics.

If the infection was caused by an STI, the man must tell their sexual partners. They will also need to abstain from having sex until the treatment is completed.

As well as this, doctors will probably also recommend painkillers and anti-inflammatory drugs, such as ibuprofen, to reduce pain and swelling.

There are also some basic things that a person can do to reduce discomfort:

  • resting lying down with the scrotum elevated
  • applying an ice pack to the painful area
  • wearing a scrotal support

In general, once treatment has started the pain associated with epididymitis will go within 1 to 3 days. However, some of the symptoms can take months to disappear.

In more severe cases, a person may have to stay in the hospital and may require some surgical procedures.

Follow-up exams with the doctor will also be necessary to make sure the infection has cleared up.

In most cases, epididymitis clears up with antibiotics and bed rest, and there are no long-term sexual or reproductive problems.

However, the condition can return, and some complications can occur:

  • abscess in the scrotum, which may require draining
  • chronic epididymitis
  • opening on the skin of the scrotum
  • the death of testicular tissue due to a lack of blood, known as testicular infarction
  • infertility

Chronic epididymitis

In the case of chronic epididymitis, doctors will not prescribe antibiotics as inflammation occurs without an infection.

Treatment includes:

  • frequent warm baths
  • anti-inflammatory medication that does not contain steroids
  • medication to relax muscles and alter nerve messages
  • anesthetic of steroid injections into the scrotum
  • surgery to remove affected epididymis
  • stress management techniques

Epididymitis: Causes, symptoms, and treatment

In the back of the testicles, there is a coiled tube called the epididymis. This tube stores and carries sperm and is linked to the ejaculatory duct by another tube called the vas deferens.

Epididymitis is when this tube becomes painful, swollen, and inflamed.

There are two types of epididymitis. Acute epididymitis comes on suddenly, and pain and inflammation develop quickly. This kind of epididymitis lasts less than 6 weeks.

Chronic epididymitis develops slowly and has a duller pain. It is a long-term problem that lasts for longer than 6 weeks. Males of any age can be affected by the condition.

If the testicles also become inflamed and painful, then this is known as epididymo-orchitis.

Share on PinterestThe epididymis stores and carries sperm, and may become swollen and inflamed due to a bacterial infection.

The spread of a bacterial infection usually causes epididymitis. This infection will often start in the urethra, prostate, or bladder.

Two main types of infection cause epididymitis:

Sexually transmitted infection (STI)

Epididymitis caused by an STI, such as gonorrhea or chlamydia, is most common in young, heterosexual men; particularly those who have sex with multiple partners and do not use a condom.

Cases of epididymitis that are not caused by an STI are less common.

Urinary tract infection (UTI)

Epididymitis caused by a UTI occurs in children, older men, and men who have sex with men. The following factors often cause UTIs in men:

  • enlarged prostate pressing on the bladder
  • insertion of a catheter into the penis
  • surgery on the groin, bladder, or prostate gland

Children

While cases of epididymitis in children are rare, they do occur. Often the bacterial infection will spread from the urethra or bladder.

Inflammation will usually develop due to one of the following:

  • direct injury to the area
  • twisting of the epididymis
  • urine flowing back into the epididymis

Other causes

There are also some more unusual causes of epididymitis:

  • mumps
  • tuberculosis
  • high doses of a medication called amiodarone, usually taken for heart rhythm problems
  • groin injury
  • structural problems in the urinary tract
  • Behcet’s disease
  • congenital kidney and bladder problems

Epididymitis will cause pain in one or both testicles. The affected area will also be red, swollen, and warm to touch. If it is left untreated, it will worsen over time.

Other symptoms include:

  • fever
  • chills
  • heaviness in the affected testicle
  • enlarged testicle
  • affected testicle sensitive to touch
  • pain in the abdomen or pelvis
  • frequent urge to urinate
  • burning sensation when urinating
  • discharge from the end of the penis
  • blood in urine
  • pain when ejaculating or having sex
  • fluid buildup around the testicle which may feel like a lump

Symptoms will usually depend on the cause of the epididymitis. For example, discharge from the penis is likely to be due to an STI, while the urge to urinate probably results from a UTI.

Symptoms of epididymitis can also be similar to those of testicular torsion, a condition that sees the testicle twist and cut off the blood supply and which requires emergency surgical treatment.

As a result, if a person experiences any of these symptoms they should see a doctor straight away.

In children, the most common symptoms are:

  • discomfort in lower abdomen or pelvis
  • a red and tender area on the side of the scrotum
  • pain or burning when urinating
  • discharge from the urethra
  • fever

It can often be hard to tell the difference between epididymitis and testicular torsion, particularly in younger men.

Sometimes epididymitis and testicular torsion can occur at the same time.

Doctors may perform some other tests to find the cause. These include:

  • rectal exam, where a doctor inserts a finger into the anus to check for an enlarged prostate
  • urine and blood tests
  • urine samples to test for gonorrhea and chlamydia
  • ultrasound scans, to identify testicular torsion
  • medical history

Treatment will be provided based on what is causing the epididymitis. If it is a bacterial infection, the doctor will probably prescribe a course of antibiotics.

If the infection was caused by an STI, the man must tell their sexual partners. They will also need to abstain from having sex until the treatment is completed.

As well as this, doctors will probably also recommend painkillers and anti-inflammatory drugs, such as ibuprofen, to reduce pain and swelling.

There are also some basic things that a person can do to reduce discomfort:

  • resting lying down with the scrotum elevated
  • applying an ice pack to the painful area
  • wearing a scrotal support

In general, once treatment has started the pain associated with epididymitis will go within 1 to 3 days. However, some of the symptoms can take months to disappear.

In more severe cases, a person may have to stay in the hospital and may require some surgical procedures.

Follow-up exams with the doctor will also be necessary to make sure the infection has cleared up.

In most cases, epididymitis clears up with antibiotics and bed rest, and there are no long-term sexual or reproductive problems.

However, the condition can return, and some complications can occur:

  • abscess in the scrotum, which may require draining
  • chronic epididymitis
  • opening on the skin of the scrotum
  • the death of testicular tissue due to a lack of blood, known as testicular infarction
  • infertility

Chronic epididymitis

In the case of chronic epididymitis, doctors will not prescribe antibiotics as inflammation occurs without an infection.

Treatment includes:

  • frequent warm baths
  • anti-inflammatory medication that does not contain steroids
  • medication to relax muscles and alter nerve messages
  • anesthetic of steroid injections into the scrotum
  • surgery to remove affected epididymis
  • stress management techniques

Epididymitis – Diagnosis and treatment

Diagnosis

Your doctor will check for enlarged lymph nodes in your groin and an enlarged testicle on the affected side. Your doctor might also do a rectal examination to check for prostate enlargement or tenderness.

Tests your doctor might recommend include:

  • STI screening. A narrow swab is inserted into the end of your penis to obtain a sample of discharge from your urethra. The sample is checked in the laboratory for gonorrhea and chlamydia.
  • Urine and blood tests. Samples of your urine and blood are analyzed for abnormalities.
  • Ultrasound. This imaging test might be used to rule out testicular torsion. Ultrasound with color Doppler can determine if the blood flow to your testicles is lower than normal — indicating torsion — or higher than normal, which helps confirm the diagnosis of epididymitis.

Treatment

Antibiotics are needed to treat bacterial epididymitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. Take the entire course of antibiotics prescribed by your doctor, even if your symptoms clear up sooner, to ensure that the infection is gone.

You should start to feel better within 48 to 72 hours of starting an antibiotic. Resting, supporting the scrotum with an athletic supporter, applying ice packs and taking pain medication can help relieve discomfort.

Your doctor is likely to recommend a follow-up visit to check that the infection has cleared.

Surgery

If an abscess has formed, you might need surgery to drain it. Sometimes, all or part of the epididymis needs to be removed surgically (epididymectomy). Surgery might also be considered if epididymitis is due to underlying physical abnormalities.

Lifestyle and home remedies

Epididymitis usually causes considerable pain. To ease your discomfort:

  • Rest in bed
  • Lie down so that your scrotum is elevated
  • Apply cold packs to your scrotum as tolerated
  • Wear an athletic supporter
  • Avoid lifting heavy objects
  • Avoid sexual intercourse until your infection has cleared

Preparing for your appointment

You might be referred to a doctor who specializes in urinary issues (urologist).

What you can do

Make a list of:

  • Your symptoms and when they began
  • Key medical information, including previous STIs
  • All medications, vitamins or supplements you take, including doses
  • Questions to ask your doctor

Some questions to ask your doctor include:

  • What’s the most likely cause of my symptoms? Are there other possible causes?
  • What tests do I need?
  • What treatments are available?
  • How long will it take for me to feel better?
  • Should my partner be tested for an STI?
  • Should I restrict sexual activity?
  • I have other medical problems. How can I best treat them together?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • How severe are your symptoms? Are they constant or occasional?
  • What, if anything, seems to improve or worsen your symptoms?
  • Do you have discharge from your penis or blood in your semen?
  • Do you have pain when you urinate or a frequent or urgent need to urinate?
  • Do you have pain during intercourse or when you ejaculate?
  • Have you or your partner had or been tested for an STI?
  • Do you do heavy lifting?
  • Have you been diagnosed with a prostate condition or urinary tract infection?
  • Have you had surgery in or near your urinary tract, or surgery that required the insertion of a catheter?
  • Have you had a groin injury?

What you can do in the meantime

While you wait for your appointment, avoid sexual contact that could put your partner at risk of contracting an STI, including sexual intercourse, oral sex and any skin-to-skin contact with your genitals. Let your sex partner or partners know about your signs and symptoms so that they can also seek testing.


Jan. 23, 2021

Testicular Pain, Left Testicle Pain, Pain in Right Testicle

For this procedure, we dissect the nerve inside the spermatic cord because it supplies the testicle with nerves. Cutting this nerve can successfully reduce the pain by 50 percent or greater. In fact, more than 90 percent of our patients have seen a 70 to 100 percent reduction in their pain.

Most insurance plans will cover this procedure. However, check with your insurance company before scheduling the surgery.

Preparation for Surgery 

Make sure you follow these rules before undergoing surgery:

  • Eat like you normally would the evening before your surgery.
  • Do NOT eat or drink anything after midnight, including the morning of surgery.
  • If you have medication you need to take the morning before your surgery, only take them with a small sip of water.
  • Wear loose, comfortable clothing.

Procedure 

We perform this surgery in the operating room and make a small incision in the groin, similar to where a hernia repair is done. If a hernia repair was already done, we go through the previous scar. You can opt for local or general anesthesia before the surgery.

The spermatic cord contains arteries, nerves, the vas deferens, and lymphatic vessels. We cut the nerves under an operating microscope and keep the testicular arteries, lymphatics, and vas deferens intact. This method preserves the testicle’s blood supply and blocks the nerve transmission from the testicle. We finish up by using dissolvable stitches and tissue glue to close the incision.

The entire surgery takes only one hour, which means you can go home the same day. 

As with any procedure, there are risks to a spermatic cord denervation, such as:

  • no pain relief,
  • hydrocele formation (fluid accumulation in the testicles),
  • loss or compromise of the testis, and
  • numbness of the scrotum and inner thigh on the operated side.

After-Surgery Care & Recovery

For the first 24 hours after your surgery, do not:

  • drive,
  • use machinery,
  • eat any heavy or large meals,
  • drink alcohol, or
  • make important decisions because the anesthesia can make it hard to think clearly.

Expect bruising, swelling, tenderness, inflammation, and pain after surgery. Many men report an immediate change in the type of pain, from deep neuropathic pain to superficial inflammatory pain. This postoperative pain will fade over time.

Make sure you take the following steps for a speedy recovery:

  • For the first three days, take 800mg of Ibuprofen every eight hours and 650mg of Tylenol every six hours around the clock. Use narcotic pain medication only if needed.
  • Ice the area for 20 minutes out of every hour to relieve pain.
  • No sex, masturbation, or lifting heavy objects more than 25 pounds for a week.
  • You may shower the day after surgery, but baths are not allowed for one week.

Testicular Pain: Possible Causes & Treatments



Overview

What is testicular pain?

Testicular pain is a condition that can affect males at any age. The testicles (testes) are small egg-shaped reproductive (sex) organs inside a thin pouch of skin called the scrotum.

If you have testicular pain, you may feel it in one or both testicles. However, the pain may not actually be coming from your testicles themselves. The pain may be coming from another part of your body such as the stomach or groin. This type of pain is called referred pain.

Testicular pain can be either acute (sudden and short) or chronic (gradual and long-lasting). Aside from the sharp pain of sudden injury, your first symptom might be a dull ache that increases with time or with activity. Testicular pain can be severe because the testicles have many sensitive nerves.

You should get medical care if your pain lasts longer than an hour or if it’s unusually intense, as this could be a sign of an emergency condition called testicular torsion.

Who’s most at risk?

Boys and men of any age can get testicular pain. You may be at a higher risk for testicular pain if you do heavy physical work or if you play full-contact sports.

Is testicular pain a warning sign of testicular cancer?

Testicular pain can be a possible sign of testicular cancer, so if you don’t know why you have testicular pain be sure to seek medical attention.

Can testicular pain be caused by a sexually transmitted infection?

Sexually transmitted infections (like gonorrhea, syphilis and chlamydia) can affect multiple body parts, including the testicles. This can cause the testicles to become swollen or inflamed (a painful, burning feeling).



Possible Causes

What causes testicular pain?

The source of the testicular pain may be obvious if you have had a recent injury or an accident, but in other cases it may not be clear why you have pain.

Causes of testicular pain might include:

  • ·Injury or trauma: An injury to your testicles may happen during sports, exercise or an accident.
  • Orchitis: Inflammation (swelling and a burning sensation) in one or both testicles (orchitis) may be caused by a bacterial or a viral infection. In children, the mumps virus is also a possible cause of orchitis. In the case of mumps the swelling usually starts four to six days after the start of the mumps.
  • Inguinal (groin) hernia: An inguinal hernia occurs when part of your intestine pushes through a weak part of your abdominal muscles near the groin. It’s usually not dangerous but it can be painful. If it is painful, you should seek immediate medical attention as you may require urgent surgery.
  • Epididymitis: This condition is due to inflammation of the epididymis. The epididymis is a tightly coiled group of thin tubes carrying sperm from the testicles to the sperm duct and out of the body. Epididymitis symptoms include pain and inflammation. The scrotum may be swollen and hot to the touch. This can last for days to weeks. Chronic epididymitis lasts longer than six weeks.
  • Spermatocele: A spermatocele is a space filled with fluid that can form inside the epididymis near the testicle. These cysts aren’t cancerous and are usually not painful, but at times they can grow to a large size and become uncomfortable.
  • Hydrocele: A hydrocele forms when fluid builds up around the testicles. Hydroceles are common, and sometimes they can cause pain or become infected.
  • Hematocele: A hematocele occurs when blood surrounds the testicle. This is usually the result of an injury.
  • Varicocele: A varicocele is a group of abnormally large veins near the testicles. These large veins may cause a dull discomfort in the affected testicle during daily activities. The testicle pain usually improves when lying down. Varicoceles may sometimes affect the ability to have children, and are sometimes surgically treated.
  • Testicular torsion: Torsion is the twisting of the blood supply to the testicle. This cuts off the blood supply to the testicle and results in a severe, sharp pain. Torsion can occur at any time. This condition needs immediate surgery to save the testicle.
  • Kidney stones: Kidney stones happen more commonly when you are dehydrated. Stones can get stuck in the ureters (tubes draining urine from the kidney into the bladder), causing pain in the back, groin or scrotum. Small stones may pass if fluids are increased. Larger stones may need surgery.
  • Post-vasectomy pain syndrome: Men who have had a vasectomy sometimes get testicular pain afterwards. This pain can be caused by higher pressure in the vas deferens (tubes carrying sperm) or epididymis and can result in a post-vasectomy pain syndrome.
  • Testicular cancer: Testicular cancer is the most common cancer in men aged 15-35. It can sometimes present with a dull ache or pain in the groin or testicles, testicular swelling or heaviness and aching in the lower abdomen or scrotum. Imaging methods can be used to examine the testicles for signs of testicular cancer.

What are some other symptoms that may occur?

Symptoms may include:

  • Pain: Testicular pain can feel different depending on the cause. A sudden injury results in sharp, sudden pain, followed by a dull ache. The pain of epididymitis can worsen with time. Kidney stones can cause sharp pains in the back that spread to the testicles and to the tip of the penis.
  • Bruising: There may be bruising on the scrotum if the testicles were injured.
  • Nausea and vomiting: Feeling sick to your stomach and vomiting can be a symptom of many conditions. These include testicular injury, orchitis or kidney stones.
  • Swelling: There may be a lump in the scrotum. The scrotum may appear red or shiny. These can signs of injury, orchitis, epididymitis or a testicular tumor.
  • Fever: Fever together with testicular pain is a sign of orchitis or epididymitis.
  • Urination problems: Some kidney stones can cause frequent urination. There may also be a burning sensation on urination, or blood may be seen in the urine.

Who treats testicular pain?

If you have testicular pain or if you have recently had high-risk sexual activity, you should seek medical help. High-risk sexual activity includes having more than one partner or having a partner who has had more than one partner. You can get diagnosed by specialists including:

  • Urologist: If you have signs of testicular cancer or kidney stones, you may be referred to an urologist (a surgical specialist who treats urinary problems).
  • Nephrologist: If you have kidney infections or poorly functioning kidneys, you may be referred to a nephrologist (a medical specialist who treats urinary problems).

How is testicular pain diagnosed?

Your doctor will exam you standing up and lying down. You’ll be asked questions about when the pain started, how long you have had it, how much it hurts and exactly where you hurt. You’ll also be asked about your sexual, medical and surgical history. Tell your doctor if any activities make your pain better or worse, like going to the bathroom, exercise, sex or sitting.

Blood or urine tests can help to rule out infections as a possible cause. If there’s a lump in your testicle, an ultrasound will be ordered to check for testicular cancer. If the ultrasound scan shows signs of cancer, you’ll be referred to an urologist to have the cancer removed.

If you get diagnosed and treated early, testicular cancer has a very high cure rate.

###

###



Care and Treatment

How is testicular pain treated?

You may be able to ease your testicular pain at home. Some remedies to try:

  • Apply ice to the area.
  • Place a rolled up towel under your scrotum if you’re lying down.
  • Wear a cup or athletic supporter.
  • Take warm baths.
  • Try non-prescription pain relievers.

If home remedies don’t work, testicular pain can be treated medically. Pain can usually be reduced with medications. These may include:

  • Pain relievers: Acetaminophen (Tylenol®) or non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen and naproxen, can help relieve pain. They’re often prescribed in cases of injury, trauma or orchitis.
  • Antibiotics or anti-infective medications: Orchitis or epididymitis caused by a bacterial infection should be treated with a course of antibiotics.
  • Tricyclic antidepressants: Medications such as amitriptyline can be used to treat nerve pain.

Is surgery needed for testicular pain?

Surgery isn’t usually needed for testicular pain, but if you have an emergency condition like testicular torsion or testicular cancer you may need surgery.

Types of surgery for testicular pain depending on the cause include:

  • Testicular de-torsion: This operation is done to untwist the spermatic cord and restore blood flow to the testicle(s). Your surgeon sews stitches around your testicle to prevent the twisting happening again. The opposite side of the testicle is also stitched to prevent future torsion.
  • Hernia repair surgery: This corrective procedure is done if your hernia can’t be pushed back into your abdomen or otherwise made smaller.
  • Epididymectomy: The epididymis is a tightly coiled group of thin tubes that carry sperm from the testicles to the sperm ducts. Surgeons may remove your epididymis if you have chronic pain. This is not commonly done, and medical treatments will be tried first.
  • Vasovasostomy: Vasovasostomy is the reversal of a vasectomy in men who suffer from testicular pain after having a vasectomy. Vasectomies can cause testicular pain that can be cured by reversing the vasectomy. This is rarely needed and is done as outpatient surgery.
  • Shockwave lithotripsy: This minimally invasive procedure uses shockwaves (force moving through air) to break up kidney stones.
  • Microdenervation of the spermatic cord (MDSC): This operations is performed under anesthesia. The surgeon uses an operating microscope to dissect and cut the nerves passing through the spermatic cord, which often cures or relieves testicular pain.
  • Orchiectomy: Rarely, if your testicle pain is not helped by medications or less invasive procedures, you may need to have the testicle removed (orchiectomy). This is an operation of last resort.
  • Testicular cancer: In this case your doctor does an operation to remove your testicle. After the surgery, the testicle is examined under a microscope and the type of testicular cancer can be identified. This determines if you need any further treatment.

Remember whenever you have surgery, it’s important to take regular care of your wound to prevent infection. Follow your doctor’s advice on how to clean your wound. You’ll also be given warning signs to watch out for in case it becomes infected. Your wound will be checked at your follow-up appointment.

How long does it take for testicular pain to go away?

Testicular pain may or may not last, depending on whether it is acute or chronic. If your pain is caused by a simple injury like a sudden hit or a fall, it should only hurt for about an hour. If your pain lasts longer than that or if it gets worse, immediately seek medical attention.

Can I still have children after losing a testicle?

In the majority of cases, one healthy testicle can make enough sperm for you to have children. You should still be able to have and maintain erections normally. Your testosterone (hormone) levels should stay the same too. Men who have had surgery for testicular torsion sometimes have a lower sperm count. They might also have antibodies in their system affecting the sperm’s movement. If you have had testicular torsion when you were young, you might have a lower sperm count. In that case, you may need to have a sperm count checked if you have any difficulties having children.

How do I prevent testicular pain?

Remember to have regular checkups, and always wear an athletic cup before playing full-contact sports. You should also wear protective clothing before doing dangerous work to avoid injury.

###



When to Call the Doctor

When do I need to see a doctor?

You should immediately call your doctor if you have testicular pain or swelling, especially if the pain gets worse or if you feel sick. If you have any symptoms of testicular torsion, make sure to seek immediate medical attention.

Treatment of inflammation of the vas deferens | Booking Health

Inflammation of the vas deferens (deferentitis) most often occurs against the background of inflammatory processes in other organs of the male reproductive system. This is the posterior part of the urethra, the epididymis and the testicle. Often the spermatic cord is involved in the pathological process.

The disease can have various etiologies. It can be caused by genital infections, specific or nonspecific bacteria.Sometimes it is the result of an autoimmune process. Depending on the cause of the inflammation of the vas deferens, different therapeutic tactics are used.

Principles of treatment

In most cases, the pathology is infectious. It can be caused by specific microorganisms (gonorrhea, chlamydia, tuberculosis, syphilis) or nonspecific bacterial flora. It includes all those bacteria that normally live in the urogenital tract, but with active reproduction or entering the vas deferens, they can cause inflammatory processes. These bacteria are brought in through medical instruments or from other foci of infection in the body.

In this case, etiotropic therapy is required. It is aimed at eliminating the main focus of infection. Antimicrobial drugs are used. The specific type of drug depends on the identified pathogen.

Before the etiotropic treatment of inflammation of the vas deferens is prescribed, an examination is carried out. Its task is to establish the type of pathogen of the pathological process.Only in this case it will be possible to count on a good treatment result, since different antibiotics have a different spectrum of action and destroy different bacteria.

If a severe purulent inflammatory process in the vas deferens is detected, surgical treatment may be required. Otherwise, the abscess breaks out, pathological messages are formed between organs (fistulas), and the infection spreads to other anatomical zones.

Sometimes deferentitis is of an autoimmune nature. It occurs as a result of a violation of the blood-testicular barrier. Most often this occurs as a result of surgery, trauma, or severe inflammation. The sperm genotype differs from the genetic composition of the somatic cells of the male body. The immune system does not attack them only because of the protection of the blood-testicular barrier that separates the organs of the scrotum from the circulatory system of the human body. When the barrier is damaged, antisperm antibodies begin to be produced.A chronic inflammatory process develops. It may not be accompanied by severe symptoms, but it leads to infertility. In such a situation, treatment is carried out only if the man wishes to maintain fertility and have children in the future.

Antibacterial treatment for genital infections

Before antibiotics are prescribed, laboratory tests are carried out. Microscopy of the urogenital smear is performed. Urethral scraping is performed, followed by examination for common genital infections by PCR (polymerase chain reaction). The patient is examined for chlamydia, gonorrhea, trichomoniasis. It is also advisable to donate blood for syphilis.

In the course of these diagnostic tests, the very next day, the doctor will find out which pathogens of genital infections are present in the body, if any. Then the treatment is selected.

For gonococcal infection, cephalosporin antibiotics are prescribed. Most often it is ceftriaxone, since gonococci are highly sensitive to it. Accordingly, treatment almost always ends with recovery after the first course of therapy.

Gonorrhea with the development of inflammation of the vas deferens is considered complicated. On average, deferentitis begins 4 weeks after acute gonococcal urethritis. But there are times when the duct becomes inflamed only after a few months. Ceftriaxone treatment lasts 10-14 days. It is administered intramuscularly at 1 gram per day.

In case of inflammation of chlamydial etiology, treatment should be started as soon as possible, especially in the case of a bilateral process. Because chlamydiae often initiate pronounced cicatricial changes.As a result of inflammation of the vas deferens, a man may develop obstructive infertility. At the same time, fertility is not always restored even after the cure of chlamydia due to the formation of scars that impede the movement of sperm from the testicles into the urethra.

Chlamydial infection is treated with one of three groups of antibiotics. The most commonly used tetracyclines (doxycycline) or macrolides (josamycin). Less commonly used fluoroquinolones (levofloxacin).

Treatment for nonspecific deferentitis

It so happens that according to the results of the examination, genital infections are not detected.In men, inflammation of the vas deferens can be caused by nonspecific bacterial flora. It enters the ducts from:

  • Urethra
  • Prostate
  • Testicles
  • Distant purulent foci in the body (through the blood or lymphatic system)

In this case, flora is cultured. The type of bacteria that caused the inflammation is determined. The sensitivity of the isolated flora to antibiotics is assessed. Then the drug, to which the identified bacteria have the maximum sensitivity, is prescribed to treat the inflammatory process of the vas deferens.

In acute purulent inflammation, therapy is prescribed empirically (without an antibioticogram), already on the day of treatment. This is required to prevent complications. In the future, the antibiotic can be replaced in a few days, after receiving the bacterial culture data.

Significant purulent inflammation sometimes develops. Up to 200 ml of pus and more can accumulate in the vas deferens and surrounding tissues. In this case, a surgical operation is performed. The doctor will cut the duct and drain it.The pus is removed, the wound is washed with antiseptics. In parallel, antibiotic therapy continues.

Treatment in Germany

Booking Health offers treatment in the best clinics in Germany for inflammation of the vas deferens. In German medical institutions, both conservative and surgical methods of treatment are used to solve the problem of deferentitis as soon as possible.

You can undergo comprehensive treatment of benign and malignant pathologies of the urological spectrum at the Helios Clinic Berlin-Buch – the academic clinic of the Charite medical complex with more than a century of history.The Department of Urology under the leadership of Professor, Doctor of Medical Sciences Mark Schrader conducts drug, endourological and minimally invasive treatment of benign diseases of the genitourinary system in men (urethral stenosis, prostatic hyperplasia, urolithiasis), as well as therapy for malignant tumors of the kidneys and bladder, prostate, testicles, penis. The specialists of the department actively cooperate with colleagues from other departments of the clinic – for example, thanks to cooperation with the department of nuclear medicine, patients can undergo treatment with therapeutic radionuclides. The head physician of the department has a GCP certificate in the field of drug research, as well as additional qualifications in the field of drug therapy for oncological pathologies.

Advantages of contacting clinics in Germany:

  • Accurate diagnostics, allowing you to accurately determine the type of pathogen of the pathological process, to identify or exclude genital infections.
  • Etiotropic therapy with modern antibacterial drugs.
  • Surgical treatment is performed if necessary.The operations are carried out by world-renowned specialists.
  • Minimal risk of reduced fertility as a result of surgical treatment.
  • In case of development of obstructive infertility, it is possible to perform reconstructive operations on the vas deferens, which will restore the natural fertility of a man.

Booking Health staff will select the best clinic and treatment program for you. When choosing a medical facility, statistics on this disease and the cost of treatment will be taken into account. Thanks to Booking Health, you save on medical services and get medical care faster. In addition, the company solves all organizational issues for you. Therefore, you just have to focus on restoring your own health.

Choose treatment abroad and you will undoubtedly get an excellent result!


Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko

Read:

Why Booking Health – Questions and Answers

How not to make a mistake in choosing a clinic and a specialist

Types of prostate cancer treatment in Germany

Innovative treatment methods prostate gland

Send a request for treatment

90,000 Inflammation of the organs of the scrotum.Causes, effects, diagnostics, treatment

EPIDYDYMITIS, ORCHITIS, ORCHOEPIDYDYMITIS and DEFERENTITIS or INFLAMMATION OF THE ORGANS OF THE SCREW in questions and answers

What is it, how does it manifest itself and why does it happen?

Epididymitis is an inflammation of the epididymis. Orchitis – inflammation of the testicle itself, and orchiepididymitis – simultaneous inflammation of the testicle and its epididymis. The testicle, epididymis and spermatic cord are also called the organs of the scrotum.In practice, epididymitis is most often observed, less often orchiepididymitis, and even less often isolated orchitis. Also, isolated inflammation of the vas deferens, which is part of the spermatic cord, is quite rare – deferentitis . These inflammatory processes can be acute, chronic and recurrent.

Acute epididymitis, orchioepididymitis or orchitis is a sudden onset of inflammation, accompanied by an increase and hardening of the testicle and / or its epididymis, sharp and intense pain and a rise in body temperature.With proper treatment, these diseases disappear within 2 weeks.

Chronic inflammation of the testicle and / or its epididymis is characterized by a long (from several months to several years) course and resistance to treatment. The chronic course is most often characterized by tuberculous epididymitis. Recurrent inflammation of the scrotal organs is associated with inadequate treatment or repeated infection in the epididymis and testis. Chronic and recurrent epididymitis, orchiepididymitis and orchitis are manifested by less pronounced enlargement and more local compaction of the scrotal organs, the pain is less intense and paroxysmal, the body temperature is usually normal.

The causes of these inflammatory processes are most often infections that enter the epididymis through the vas deferens from the urethra (urethra). Moreover, in young men younger than 35 years old, these are most often sexually transmitted infections. In particular, chlamydia is the cause of acute epididymitis in young men with a frequency of more than 50%. At an older age (after 50 years), the leading cause of inflammation of the scrotum is intestinal microorganisms that cause urinary tract infections (cystitis, pyelonephritis). These include Escherichia coli, Klebsiella, enterococci, Pseudomonas, Proteus, etc. Less often, the cause of epididymitis and orchitis, as well as deferentitis, can be a tuberculosis or viral infection. So in boys under 15 years old, orchitis can often become a complication of viral mumps (mumps) or rubella. The development of epididymitis, orchitis and orchiepididymitis is largely promoted by sudden hypothermia, which leads to a deterioration in the blood supply to the scrotum. Inflammation of the scrotal organs can also be caused by injuries and operations on the testicle, its epididymis and the spermatic cord.In this regard, antibiotics and anti-inflammatory drugs are often prescribed after scrotal injuries and operations on its organs.

What is the danger of inflammation of the organs of the scrotum? Do I need to see a doctor urgently?

Inflammation of the testicle and / or its epididymis is dangerous, first of all, by the development of male infertility. If they are not treated promptly, they can lead to disruption of sperm formation, their normal development and transport from the testicle to the posterior urethra, where sperm are finally formed.If there is bilateral inflammation of the scrotal organs, the risk of infertility is much higher. In such cases, problems associated with insufficient production of the male sex hormone – testosterone (decreased libido, weakened erection, decreased performance, decreased muscle mass, etc.) may develop.

The second very important point dictating the necessity of urgent medical attention is the danger of a testicular tumor, which can begin to manifest itself in the same way as orchiepididymitis.As you know, testicular tumors in more than 90% under 45 years of age, we recommend testing for sexually transmitted infections, at this age can develop and malignant and can cause the death of a young person if he does not consult a doctor in a timely manner. At the same time, if a testicular tumor is detected in time and correctly treated, it is curable in almost 100% of cases. In the presence of painful enlargement, and especially testicular compaction, it is important to exclude its infarction, or necrosis associated with the cessation of the normal blood supply to the organ. Testicular infarction – an irreversible disease leading to organ necrosis and requiring removal of the testicle. It usually occurs as a result of torsion of the spermatic cord and clamping of the testicular artery. Torsion of the spermatic cord develops most often against a background of significant hypothermia or injury, when a spasm of the muscle that lifts the testicle (musculus cremaster) occurs. Thus, if the symptoms described above appear (enlargement and induration of the testicle and / or its epididymis, pain in the scrotum, increased body temperature), you should urgently consult a urologist and undergo proper diagnosis and treatment.

How is the diagnosis of inflammatory diseases of the scrotum organs carried out?

The basis for the diagnosis of diseases of the testicle, its epididymis and the spermatic cord is a physical examination (primarily palpation or feeling). The leading auxiliary methods are diaphanoscopy and ultrasound examination (US) of the scrotum. All these methods are absolutely painless, and their correct use and proper interpretation make it possible to make an accurate diagnosis in the vast majority of cases.In recent years, ultrasound of the scrotum, as a much more informative and accurate method, has practically replaced diaphanoscopy.

To establish the causes of epididymitis, orchitis and orchiepididymitis, a general analysis and urine culture for microflora are required, sometimes semen (ejaculate) is analyzed for the presence of various infections in it. Tests for sexually transmitted diseases are performed. If suspected, an examination is carried out for the presence of Mycobacterium tuberculosis in the urine and / or ejaculate.If a testicular tumor is suspected, blood tests are performed for the appropriate tumor markers. Only a properly constructed complex of diagnostic measures allows you to establish an accurate diagnosis and carry out the most effective treatment. Be sure to contact your urologist!

What is the treatment of inflammatory diseases of the scrotum organs?

Treatment of epididymitis, orchitis, orchiepididymitis and deferentitis is carried out primarily with antibiotics, since their main cause is various infections.The choice of an antibiotic in an acute inflammatory process is carried out empirically, taking into account the known age characteristics of causative infections. Upon receipt of the results of microbiological studies and analysis of the sensitivity of the isolated microflora to antibiotics, it is possible to adjust antibiotic therapy, change its duration, dosages of drugs, and sometimes the drugs themselves and their combinations.

Along with antibiotics, non-steroidal anti-inflammatory drugs (indomethacin, diclofenac, celebrex, etc.) are prescribed.) in order to reduce inflammatory edema, pain and the fastest reverse development of inflammatory changes. In case of severe pain, blockade of the spermatic cord with a local anesthetic (lidocaine, prilocaine, marcaine) is used, which significantly reduces pain. All patients are advised to wear tight panties (swimming trunks) that tighten the scrotum during treatment. This promotes better blood and lymph flow in the scrotum, accelerates the reverse development of inflammation.

In the presence of abscesses or abscesses of the testicle and its epididymis, as well as in chronic recurrent epididymitis that is difficult to treat, in the case of testicular tuberculosis, surgical treatment is used.It can consist in opening and draining abscesses, partial or complete removal of the testicle and / or its epididymis. The use of various methods of physiotherapy for inflammatory diseases of the scrotal organs has not proven its effectiveness in correctly conducted scientific studies and is not included in the international standards for the treatment of epididymitis, orchitis and orchiepididymitis. In this regard, we do not use physiotherapeutic methods of treating these diseases in our practice.

What is the prevention of inflammatory diseases of the scrotum organs and their complications?

For the prevention of the diseases described above and their complications, one should, first of all, avoid infection with sexually transmitted infections and treat them in a timely manner, not be exposed to sudden hypothermia, and protect the scrotum from injury.You should give preference to tight-fitting panties, dress warmly enough in winter. If you have the signs of epididymitis, orchitis and orchiepididymitis described above, you should immediately consult a urologist!

Hello. Six months ago, there was a pulling pain in the scrotum. An ultrasound scan revealed a varicocele on the left, the veins dilated to 3.9mm and a fluid formation of the epididymis on the right, 4.2mm.The pain does not go away what should I do thanks in advance

See other questions or ask your own on the topic: Pain in the scrotum

Vasit: Funiculitis, Inflammation of the vaginal membrane of the testicle, Funiculitis | doc.ua

Funicular

Funiculitis – inflammation of the spermatic cord, which involves the vas deferens and surrounding tissues. It is a complication after epididymitis or testicular removal. It is characterized by severe pain in the groin area and specifically in the scrotum, compaction and sharp thickening of the spermatic cord.In the chronic form, the pain is more moderate, the thickening of the cord is insignificant.

Treatment of inflammation in the acute period consists in the use of anti-inflammatory drugs and the cessation of sexual intercourse during the period of therapy.

Inflammation of the vaginal membrane of the testicle

The inflammatory process is called periorchitis. It is extremely rare as an independent disease. In fact, it is a reaction to an inflammatory process, trauma or neoplasm of the visceral plate of the vaginal membrane.It proceeds in an acute and chronic form.

Acute inflammation has signs of acute orchitis with accumulations of purulent or serous-fibrinous substance between the plates of the vaginal membrane. With incomplete resorption of the exudate, a chronic form of inflammation develops, in which infiltrates of bone or cartilaginous consistency can be felt in the testicular membranes.

Treatment of acute inflammation of the vaginal membrane of the testicle is aimed at eliminating the process. Purulent inflammation is most often opened and the cavity is drained.Chronic periorchitis is treated by excision of the altered testicular membranes and measures to treat the underlying disease. With timely medical care, the prognosis is favorable.

Deferentite

Inflammation of the vas deferens, which occurs due to infection, most often together with epididymitis (inflammation of the epididymis). If treatment is not provided on time, inflammation affects all components of the spermatic cord and funiculitis is formed. The infection is caused by a specific (tuberculosis) and nonspecific flora (E. coli, streptococcus, staphylococcus).Sometimes inflammation can develop due to testicular injury, complications after surgery on the organs of the scrotum, to which an infectious component will join.

The symptoms of deferentitis are:

  • Pain in the groin area;
  • swelling and redness;
  • weakness;
  • increase in body temperature;
  • fatigue.

Symptoms are pronounced in acute form and milder in chronic.

Treatment of inflammation is conservative and consists in antibacterial therapy using anti-inflammatory and analgesic drugs, as well as physiotherapy.

An experienced urologist will be able to diagnose vazit and any of the diseases included in this concept. You can find such a specialist and make an appointment with him using the Doc.ua website.

Epididymitis and orchitis: price for treatment

If you feel intense pain in the scrotum, it may be a manifestation of an inflammatory process in the testicle (orchitis), or the epididymis (epididymitis), or it may be a combination of both – epididymo-orchitis.

The epididymis, located along the posterior edge of the testicle, collects sperm from the testicle and discharges it into the vas deferens.

There are two forms of this disease – acute and chronic.

Acute epididymitis begins suddenly, with severe symptoms and subsides with intensive treatment.

Chronic epididymitis is a long-term illness, usually the result of an acute epididymitis, and develops in 15 percent of patients after an acute process. Most cases of epididymitis occur in adults.

Orchitis is an acute or chronic inflammatory process in the testicle.

Testicles – paired male sex glands located in the scrotum. They simultaneously perform two functions: first, they secrete male sex hormones – androgens, the main representative of which is testosterone; secondly, male germ cells – sperm cells – are formed in the testes.

Orichitis, as a rule, is a complication of mumps, as an independent process is extremely rare.

Epididymo-orchitis – acute inflammation of the epididymis and testicle.

What are the causes of the disease?

Acute epididymitis is usually associated with a bacterial infection. In children who have not reached puberty, the infection usually starts in the bladder or kidney and then spreads to the testicle. It is often associated with congenital disorders that predispose to urinary tract infections. In sexually active men, the most common cause of epididymitis is bacterial infections, sexually transmitted diseases such as gonorrhea or chlamydial infection.These infections, entering the urethra, lead to urethritis and then enter the prostate gland or epididymis, causing epididymitis.

In men over 40, the most common cause is urinary tract bacteria. Bacterial prostatitis (infection of the prostate gland) or recent urethral catheterization can also lead to inflammation in the epididymis. In rare cases, bacterial epididymitis develops as a result of the spread of a bacterial infection from the bloodstream, most often this path is possible in the presence of tuberculosis.

Epididymitis is also possible as a result of hypothermia, trauma, surgery on the prostate gland. The drug amiodarone can also cause non-infectious epididymitis.

Chronic epididymitis may result from multiple episodes of acute epididymitis that persist, but may also occur without clinical manifestations of acute epididymitis or prior infection when the cause is unknown.

In most cases of acute orchitis, the testicle is inflamed due to the spread of bacterial infection from the epididymis, therefore “epididymo-orchitis” is the most correct term.Although orchitis without epididymitis can develop from a bacterial infection, it can also be the result of mumps (or other viral infections). Orchitis occurs in about a third of men who have mumps after puberty. Most of these patients develop testicular hypertrophy.

Acute epididymo-orchitis, usually bacterial in nature and, in rare cases, a consequence of a tuberculous infection of the epididymis that spreads to the testicle and involves both structures.It is extremely rare that the process can begin in the testicle and spread to the epididymis. Orchitis associated with mumps does not affect the epididymis.

Clinical manifestations and diagnostics

Acute epididymitis and acute epididymo-orchitis usually begins with an increase in body temperature to 39 C, severe pain in one half of the scrotum, in the groin, and in the lower abdomen. Enlargement, soreness, redness, and thickening of the skin of the scrotum may also accompany pain. Violations of urination are possible if there is an infection in the urethra or prostate gland: frequent urination, painful, burning, discharge from the urethra.

To make a diagnosis, it is necessary to study the general analysis of urine, urine culture to determine the microflora, taking a smear from the urethra, to exclude sexually transmitted infections. An ultrasound scan of the scrotum is necessary to rule out possible testicular torsion or epididymal tumors.

Chronic epididymitis: pain is localized only in the scrotum, less pronounced and more limited than with acute epididymitis. Moderate enlargement and induration of the epididymis is characteristic.In acute epididymitis, an infection in the urine is usually found, whereas in chronic epididymitis, this is usually not.

Acute orchitis. Symptoms of the acute phase of orchitis include a sharp pain in the testicle, an increase in body temperature to 39 C with severe weakness and possible chills. An increase in the testicle and scrotum on the affected side is possible, the skin of the scrotum above the testicle is swollen, hot. Mumps (inflammation of the salivary glands) usually precedes orchitis (an average of 3 to 7 days). The main diagnostic methods are examination and ultrasound examination of the scrotum organs.

Laboratory diagnostic methods: urine analysis for the determination of microflora with the determination of sensitivity to antibiotics. It is necessary to conduct a microscopic examination of a smear from the urethra, to exclude sexually transmitted infections.

How to treat epidymitis?

Acute epididymitis and acute epididymo-orchitis. Treatment, in cases of suspicion of a bacterial nature (most often), includes taking antibiotics for an average of 2 to 3 weeks. In most cases, antibiotics are given by mouth (in tablet form).It is necessary to take anti-inflammatory drugs, which not only reduce inflammation but also relieve pain. Treatment also includes bed rest for 2-3 days with the exception of hypothermia or overheating, wearing tight swimming trunks, preferably with an elevation of the scrotum. The goal is for the inflamed epididymis to be above the level of the heart. This improves blood flow from the testicle, which promotes quick healing and reduces swelling and discomfort.

In case of a venereal nature of the disease, treatment must also be carried out with the sexual partner.

Tuberculous epididymitis is treated with anti-tuberculosis drugs, although, unfortunately, in some cases, surgical intervention is necessary – removal of the testicle along with the epididymis. Cases of severe infection, with severe pain, vomiting, and very high body temperature may require hospitalization.

Acute orchitis: for bacterial infection, identical to treatment for acute epididymitis and acute epididymo-orchitis.

Frequently Asked Questions:

What if there is no improvement after the first three days of taking antibiotics?
Most cases of acute epididymitis or epididymo-orchitis are easily treatable with the right antibiotics, but in some cases they may not be effective.First of all, when it comes to tuberculous epididymitis. In some cases, with the development of an abscess (a pocket with pus), antibiotics alone cannot be dispensed with and surgical intervention is necessary to drain the abscess or remove part or all of the epididymis, and it may be necessary to remove the epididymis along with the testicle. Other complications that need surgery include testicular infarction (testicular death due to damage to blood vessels) and cutaneous fistula (infection that continues to pass through the skin).

Can I transmit the infection to my sexual partner?
If acute epididymitis or epididymo-orchitis develops as a result of a sexually transmitted infection (usually in sexually active men younger than 40), then the sexual partner should be treated with you, as the infection can easily return to you after treatment, from your partner through sexual contact …

Will I be able to have children after an inflammatory process in the testicle or epididymis?
Testicular atrophy, after suffering from mumps and tuberculous epididymitis, in some cases leads to abnormalities in the semen.After an episode of acute epididymitis or epididymo-orchitis, the duct of the epididymis, which carries sperm away from the testicle, may be damaged. In any of these cases, if the other testicle is not affected, most men are able to conceive a child.

Are hormonal disturbances possible after an illness?
The ability of a damaged testicle to secrete testosterone is lost in some men with atrophy. First of all, it is associated with mumps and tuberculous epididymitis.Possible blockage of the epididymis duct, which occurs after acute epididymitis or epididymo-orchitis, does not affect hormonal production.

Does epididymitis or epididymo-orchitis cause testicular cancer?
There is no connection between these diseases and cancer.

Inflammation of the testicles and their appendages (orchioepididymitis)

Inflammation of the testicles and their appendages (orchiepididymitis)

Orchitis is an inflammation of the testicle (s).The inflammation of the epididymis that develops along the way is called epididymitis. Since these diseases usually appear together, the inflammation of the testicles and their appendages is called orchiepididymitis.

Reasons

Orchitis can develop as a result of past infectious diseases – mumps (mumps), influenza, scarlet fever, chickenpox, pneumonia, brucellosis, typhoid fever. However, most often the cause is inflammatory diseases of the genitourinary system, such as urethritis, prostatitis, etc.
The disease develops as a result of the drift of infection into the testicle with blood flow. The cause of the development of epididymitis is the spread of infection along the vas deferens from the seminal vesicles, prostate and urethra. Orchitis can also be caused by testicular injury. Orchiepididymitis sometimes occurs after prostate surgery.

Allocate acute and chronic stages of development of orchiepididymitis.

Acute stage is characterized by acute pain in the testicle.The scrotum on the affected side noticeably increases, folds are smoothed, the skin on it becomes shiny, taut. Touching an inflamed testicle is extremely painful. A person’s temperature rises, general signs of inflammation are observed – headache, nausea, weakness.

This condition, if untreated, can last for about a couple of weeks, and then progress to chronic stage . The temperature decreases, the pain passes, however, when the testicle is felt, a compacted painful formation is determined – an inflamed epididymis.
In the worst case, a purulent form of testicular inflammation may develop, as a result of which there is a violation of the patency of its duct. With bilateral damage, it can lead to infertility.

Diagnostics and treatment

The diagnosis is made by an andrologist or urologist during a personal examination. Laboratory diagnostic methods are used, with the help of which the doctor determines the nature of the infection. In addition, ultrasound of the scrotum organs is performed.

The patient is prescribed bed rest, and the scrotum should be in an elevated state, for which, for example, a towel is placed.A diet is prescribed with the exception of spicy, fatty and fried foods, drinking plenty of fluids.

In addition, the infectious disease that caused the development of inflammation must be treated. Broad-spectrum antibiotics are usually prescribed.

At the end of the acute process, physiotherapy is carried out.

With the development of a purulent abscess, it is necessary to open and drain the testicle to remove pus. In the worst, neglected case, orchiectomy is performed – removal of the affected testicle.Therefore, you should not delay a visit to the doctor with symptoms of epididymitis epididymitis.

Branch

Causes of varicocele – Clinic Health 365, Yekaterinburg

Varicocele is a varicose vein of the plexus plexus of the testis and the internal spermatic vein. Varicocele is a fairly common cause of decreased testicular function and occurs in about 15-20% of all men. More often (in about 80-90%) varicocele of the left testicle develops.Severe expansion of the veins of the scrotum can subsequently lead to a decrease in the size of the testicle. It is important to note that with severe varicocele on one side, there is often a decrease in testicular function on the opposite side. The average testicular volume in men is normally 23 ± 3 cm 3 .

Both testicles must be the same size and density. A difference in size of more than 3 cm 3 is considered significant.

With long-term varicocele, sperm production is impaired and its quality decreases.In 40% of infertile men, the examination reveals varicocele. There are several theories to explain the negative effect of varicocele on sperm quality, including the effects of compression of the testicles by crowded veins, lack of oxygen, the effects of overheating of the testicles due to blood stasis, and the effects of toxins.

Despite careful research, none of the theories has been conclusively proven, although at present, the main damaging factor is considered to be an increase in temperature inside the testicle due to circulatory disorders.Regardless of the mechanism of action, the presence of varicocele is undoubtedly a significant factor in the decrease in testicular function and the occurrence of male infertility.

Testicles are male paired reproductive organs, which consist of spermatogonia cells that produce spermatozoa, Sertoli cells (which provide nutrition for germ cells during their development), and Leydig cells that produce the male sex hormone testosterone. The testicles are located in a leather sac called the scrotum.The epididymis is the small tubular tissue in which the sperm finally mature.

Sperm from the testicle exits through the vas deferens, which connects the epididymis and the prostate gland. The vas deferens runs through the scrotum and is part of a larger bundle called the spermatic cord. The spermatic cord contains the vas deferens, blood and lymphatic vessels, and nerves.

The lobate venous plexus consists of the veins of the spermatic cord.Through these veins, blood flows from the testes, epididymis and vas deferens, and when they merge, the spermatic vein is formed, which flows into the vein of the kidney on the left or into the vena cava on the right. The veins of the plexus plexus can expand and become tortuous, just like varicose veins in the legs.

Causes of varicocele

The causes of this disease are not fully known, but it is likely that the nature of its occurrence is multifactorial.Several theories have been proposed to explain the cause of varicocele in light of the fact that in 90% of all patients, varicocele occurs on only one side. Some of them are:

  • Congenital absence of internal valves of the left testicular vein, which usually prevent blood flow back down the veins when the person is in an upright position
  • Difference in the structure of the venous system in the right and left testicles. The vein of the right testicle flows directly into the inferior vena cava, and the vein of the left testicle flows into the left renal vein almost at right angles.This model predisposes to slowing blood flow through the vein of the left testicle
  • The left renal vein lies between the mesenteric artery and the aorta, so it can be compressed by them. This creates a higher pressure in the left testicular vein, which flows into the renal vein
  • Difference in the length of the veins: the length of the vein of the left testicle is 8-10 cm longer than the vein of the right testicle.

Right-sided varicocele can be observed in combination with left-sided (bilateral varicocele).In 35-40% of men with complaints of left-sided varicocele, a medical examination reveals dilated veins and the right testicle.

Isolated right-sided varicocele is very rare and raises certain concerns. In patients with unilateral varicocele on the right, thrombosis or occlusion (blockage) of the inferior vena cava should be excluded, especially when it comes to the elderly.

The severity of varicocele:

  • Severe – dilated scrotal veins are visible during normal examination
  • Medium – veins are detected by palpation (without Valsalva test)
  • Mild – detected only with movements that increase intra-abdominal pressure, which prevents the outflow of blood from the testicles and leads to swelling of the veins.(a special Valsalva test is performed, when the patient holds his breath and at the same time pushes)
  • Subclinical – slightly dilated veins are not detected during examination, but are visible on ultrasound or phlebography

Degree

varicocele

Testicular volume, ml

Vein diameter, mm

left

right

I

16.6 ± 1.4

16.2 ± 1.2

2.8 ± 0.02

II

15.3 ± 1.0

15.8 ± 0.9

4.1 ± 0.04

III

12.2 ± 0.7

15.9 ± 0.8

5.5 ± 0.06

Related articles:

Andrology

Ultrasound of the scrotum

Microsurgical testicular biopsy microTESE

Treatment of premature ejaculation

Treatment of obstructive azoospermia.Male infertility

Treatment for venous erectile dysfunction

Operations for curvature of the penis

Penile lengthening operation

Testicular prosthetics

Endofalloprosthetics with an inflatable prosthesis

Endophalloprosthetics with a plastic prosthesis

Pain when urinating

Symptoms of renal colic

Laser stone crushing for renal colic

Laparoscopic radical prostatectomy

Prostate biopsy

Transurethral resection of the prostate (TUR)

Cystoscopy

Prostatitis.Symptoms …

Ultrasound of the prostate

Ultrasound of kidneys and bladder

Ultrasound elastography

ultrasound of Scrotum organs

Ultrasound of the scrotum (ultrasound of the testicles) is performed according to the following indications:

  • Pain in the scrotum: trauma, inflammation, torsion
  • Tumors in the testicle and outside the testicle
  • Evaluation of possible hernias and the contents of the hernial sac
  • Search for possible malignant neoplasms in case of detection of enlarged lymph nodes of the mediastinum and retroperitoneal space
  • Monitoring of previously identified infections, tumors, lymphomas, leukemias
  • Decrease in the size of the testicles, atrophy
  • Search for localization of an undescended testicle
  • Infertility
  • Premature puberty
  • Diagnosis of varicocele
  • Control after surgical operations on the organs of the scrotum

Anatomical structures with ultrasound of the scrotum (ultrasound of the testicles)

The testicles of an adult male are 3 to 5 cm long and 2-3 cm wide and thick.During embryogenesis, the testes descend into the scrotum from the abdominal cavity. The scrotum is a connective tissue – muscle sheath for the testicles. It is divided into two parts by a central seam. There is normally only a small amount of fluid between the testicle and the scrotal wall. An appendage, which consists of a head, body and tail, departs from the upper lateral edge of each testicle. The tail of the epididymis passes into the vas deferens, which then, as part of the spermatic cord through the inguinal canal, enters the abdominal cavity, connects with the seminal vesicles and then, in the form of an ejaculatory duct, passes through the thickness of the prostate gland and opens in the prostatic part of the urethra in the region of the seminal tubercle.Normally, with ultrasound of the scrotum, it is possible to visualize well the structure of the testicle, the head of the epididymis (the body and tail are not normally detected by ultrasound) and the structure of the spermatic cord. The thickness of the walls of the scrotum, the size of which does not exceed 8 mm, is also assessed. When using duplex scanning, it is possible to distinguish arterial vessels that feed the testicle and the organs of the scrotum, as well as the veins of the spermatic cord. When conducting ultrasound of the scrotum (ultrasound of the testicles), it is imperative to compare the right and left sides of the scrotum and the right and left testicles. The testicle itself with ultrasound of the scrotum looks homogeneous, with a pronounced area of ​​dense tissue located closer to the posterior-outer surface of the mediastinum of the testicle.

Acute scrotal syndrome

Acute scrotal syndrome is painful swelling of the scrotum and its contents. Diagnosis of acute scrotal syndrome requires urgent scrotal ultrasound, since many of the causes of this syndrome require surgical treatment.

  • Epididymitis
  • Orchoepididymitis
  • Testicular torsion
  • Torsion of the egg pendant or torsion of the epididymis
  • Injury
  • Restrained inguinal-scrotal hernia
  • Rare: acute hydrocele (dropsy of the testicle), hemorrhage or necrosis within the tumor

Epididymitis with ultrasound of the scrotum is characterized by an increase in the head of the epididymis and changes in its structure; the body and tail of the epididymis can become visible during ultrasound of the scrotum.Fluid can collect in the scrotum – a reactive hydrocele. Ultrasound symptoms with epididymitis or orchiepididymitis may be similar to the changes that are recorded during ultrasound of the scrotum with testicular torsion. The use of duplex scanning of testicular vessels makes the diagnosis of torsion convincing. Acute epididymitis When the testicle is twisted, the testicular artery, which feeds it, is pinched, and in this condition, the pulsation of the testicular vessels will not be visible during duplex scanning. Testicular torsion is a very dangerous condition that can lead to organ loss, so surgical treatment is often urgently needed.Timely ultrasound diagnosis of acute epididymitis is also important. If ultrasound of the scrotum reveals an enlarged appendage with a violation of the structure, but it is impossible to visualize the body and tail, this is more inherent in the hematogenous or lymphogenous pathway of infection. Thus, this localization of the lesion is not typical for sexually transmitted diseases, which mainly infect the epididymis through the vas deferens and primarily affect the tail of the epididymis. Advanced cases of epidiidmitis and orchitis can lead to the formation of a pyocele, the appearance of a purulent cavity inside the scrotum, and the disease can also take the form of an abscess, testicular infarction, or even fulminant fasciitis (Fournier’s gangrene).Epididymitis can be caused not only by bacteria, but also by taking certain medications, such as cordarone (amiodarone), an antiarrhythmic cardiac drug that can cause epididymitis. Also, inflammation of the epididymis can be chemical – due to the throwing of urine through the ejaculatory and vas deferens into the tail of the epididymis.

Diagnosis of varicocele with ultrasound of the scrotum

Varicocele is an enlargement of the veins of the spermatic cord, which often leads to testicular atrophy. Typically, varicocele develops on the left testicles.This is due to the fact that the testicular vein (it is its tributaries that expand with varicocele) leaves the spermatic cord and flows retroperitoneally into the left renal vein at an acute angle. Doppler ultrasonography of the vessels of the spermatic cord As a result, prerequisites are created for an increase in pressure in the system of the left testicular vein – its lumen expands, the walls lose elasticity and the venous valves cease to perform their function. There are also cases when the pressure in the leftmost renal vein is increased with aorto-mesenteric forceps syndrome.It is characterized by the fact that the left renal vein, passing between the aorta and the superior mesenteric artery, can be compressed and blood outflow is disturbed in it, which leads to an increase in pressure in all tributaries, including in the left testicular vein. Diagnosis of aortomesenteric forceps syndrome is carried out during ultrasound of the kidneys by using duplex scanning of the renal vessels. With ultrasound of the scrotum, the Valsalva test is used to diagnose varicocele, it allows you to identify the reverse blood flow in the veins of the spermatic cord.Also, with ultrasound of the scrotum, changes in the testicle are assessed with varicocele. Long-term varicocele leads to testicular athophy and loss of testicular function.

Ultrasound of the scrotum in the diagnosis of malignant tumors

Ultrasound of the scrotum is widely used when a malignant process is suspected. Since the organs of the scrotum are easily accessible for ultrasound examination, the diagnosis of malignant diseases is performed with great accuracy. Basically, testicular tumors develop from spermatogenic epithelium cells responsible for the production of sperm in quantitative terms, this is 90% of all malignant testicular tumors.About 5% of cases of malignant testicular tumors are stromal cells (cells that provide a scaffold, a medium for the development of cells of spermatogenic epithelium) and 5% of testicular tumors are secondary tumors. A risk factor for developing testicular cancer is cryptorchidism, the undescendedness of one or two testicles from the abdominal cavity. According to statistics, testicular cancer occurs in 10% of cases of cryptorchidism. Even after surgical descent of the testicle into the scrotum, the risk of developing testicular cancer remains. With ultrasound of the scrotum (ultrasound of the testicles), it is impossible to reveal the cellular structure of the tumors, however, based on the totality of clinical and laboratory data, it can be assumed with a certain degree of accuracy what type of tumor the formation found with ultrasound of the scrotum belongs to.When diagnosing malignant tumors, duplex scanning is used, which helps to differentiate the affected areas.

Ultrasound of the scrotum (ultrasound of the testicles) with infertility

The main task of ultrasound of the scrotum in male infertility is to find the cause that causes a decrease in the sperm count. It is possible to conditionally separate the processes of maturation and reproduction of spermatozoa and the process of delivery of spermatozoa from the testicles. When conducting ultrasound of the scrotum, the size and structure of the testicles are assessed, a conclusion is made about possible violations of the structure of the testicles, leading to infertility.