Pain in the scrotum is noted with inflammatory and voluminous processes, fluid accumulation, trauma, some infectious and parasitic pathologies. In diseases of the kidneys, ureters, prostate, rectum due to irradiation. More often dull, pulling, aching, bursting, less often sharp, twitching, pulsating. The causes of pain in the scrotum are determined by the results of a survey, external examination, diaphanoscopy, ultrasound and laboratory tests. Sometimes a puncture is required. Prior to diagnosis, immobilization using a special bandage or suspensor is recommended.
Pain in the scrotum is the result of sexual arousal without subsequent discharge. This condition is more common in adolescence and youth, develops against the background of a combination of high libido and the absence of a sexual partner. In adults, it is observed when circumstances arise that prevent sexual relations, voluntary refusal of sex for religious reasons.
A similar condition is observed in men who practice protection by interrupting sexual intercourse, in patients suffering from orgasmic dysfunction. In all these cases, the cause of pain is the rush of blood to the genitals without the subsequent release of seminal fluid. The pain is dull, bursting, aching. May persist for several hours.
Pain in inflammatory diseases is combined with edema, hyperemia, hyperthermia. It is caused by nonspecific bacterial infections, develops after injuries, invasive medical procedures. In children and adolescents, it may be the result of a viral infection: mumps, measles, rubella. It is revealed in such pathologies as:
With impaired immunity, massive infection, the acute forms of the listed diseases can turn into purulent inflammation. There is a deterioration in the condition, an increase in symptoms of intoxication, an increase in pain, which becomes twitching, pulsating. Along with nonspecific microflora, inflammation of the testicle, spermatic cord and epididymis can be caused by the following sexually transmitted diseases:
Clinical manifestations of specific infections vary. A typical feature is the discharge from the urethra of a copious yellowish, greenish or whitish secret with an unpleasant odor.
Pain in the scrotum
Purulent inflammation can affect the organs or soft tissues of the scrotum, be local or widespread, occur primarily or develop as a result of the infection moving from nearby anatomical structures:
Dropsy is widespread or limited. The following pathologies are distinguished:
Pain occurs in stage 2 varicocele. The intensity of unpleasant sensations varies significantly, some patients report mild soreness or discomfort when walking, others complain of very sharp burning or shooting pains. Pain is associated with physical activity. Visually revealed varicose veins, sagging of the diseased half of the scrotum. At stage 3, the pain becomes constant, occurs at rest, disturbs at night. The asymmetry of the scrotum is progressing.
Sudden sharp pain in the scrotum, radiating to the perineum and groin, is the first symptom of testicular torsion. Due to unbearable pain, vomiting, collapse are possible. The scrotum is slightly enlarged, the affected testicle is located above the healthy one. The skin over the testicle is hyperemic, pale or cyanotic. There may be difficulty urinating, acute urinary retention.
The edematous scrotum syndrome develops acutely with the accumulation of a large amount of effusion. Complicates injuries, inflammatory and non-inflammatory diseases of the scrotum, tumors, allergic reactions. The scrotum rapidly increases in volume. The pains are so sharp and intense that they are accompanied by vomiting, a drop in blood pressure, and the appearance of cold sweat.
Segmental testicular infarction is manifested by pain that grows over several days. With a total heart attack, the symptoms resemble testicular torsion or acute epididymo-orchitis. The intensity of sensation reaches the degree of pain shock. Patients are pale, covered with cold clammy sweat. Tachycardia, hypotension are detected, confusion is possible.
With closed injuries of the scrotum, pain is also sharp, very intense, often accompanied by the development of pain shock. The scrotum is edematous, cyanotic with a purple or black tint, greatly enlarged in size. Hematocele, dislocation of the testis, sometimes with torsion, can be observed. With open injuries of the scrotum against the background of pain and bleeding, traumatic shock almost always develops.
Pain in the scrotum appears some time after the onset of compaction, sometimes combined with pain in the lower abdomen, is detected in every fourth patient with a malignant testicular tumor. Observed in germ and non-germinogenic neoplasia:
The neoplasm increases in size, the scrotum becomes edematous. Subsequent symptoms are largely due to metastasis. For benign tumors of the scrotum, the pain syndrome is uncharacteristic, it can appear with secondary infection due to the development of inflammation.
Parasitic diseases of the scrotum are typical for countries with a tropical and subtropical climate. Filariasis is caused by helminths, provokes the development of elephantiasis due to damage to the lymphatic system of the genital organs. Soreness of the scrotum occurs several years after infection, often combined with hydrocele, epididymitis, funiculitis. Pain is caused by dense swelling due to the accumulation of fluid in the tissues. Wuchereriosis is also accompanied by damage to the lymphatic vessels, elephantiasis. The weight of the scrotum in both diseases can reach 15-2 or more kilograms.
Sharp pains in the scrotum and inguinal region, nausea, vomiting, worsening of the general condition occur when the inguinal-scrotal hernia is infringed. Another possible cause of pain is irradiation in diseases of the rectum and organs of the genitourinary system. Radiating pain is observed in the following pathologies:
Urologist's consultation
The cause of pain in the scrotum is determined by the urologist-andrologist. During the conversation with the patient, the doctor establishes the circumstances and time of the onset of the symptom, monitors the dynamics of the development of the disease. To clarify the diagnosis, the following procedures are carried out:
Patients with injuries are shown fixation with a suspensor or a special bandage, cold on the scrotum. In other conditions, suspensions are often effective. With severe pain and the absence of urgent pathology, a single dose of painkillers is possible. Other methods of treatment before the diagnosis is not shown.
Medicines of the following groups are prescribed:
With many diseases of the scrotum, wearing a suspension is effective. With the secondary nature of the pathology, treatment of the underlying disease is necessary. In the case of non-tumor processes, it is possible to prescribe physiotherapeutic procedures.
Taking into account the nature of the pathology, the following can be performed:
In case of malignant tumors, severe damage to the testicle due to a heart attack, crushing, extensive necrosis against the background of Fournier's gangrene, purulent complications of inflammatory processes, an organ-removing operation is required - orchiectomy, epididymectomy, orchiepididymectomy. Subsequently, to eliminate the cosmetic defect, an artificial testicle is implanted.