Testicular pain and swelling have countless causes, from viral or bacterial infections to trauma. It is important to know the etiology because it determines the treatment; the pain is usually triggered by torsion due to trauma, from mumps (a viral infection) that spreads to the testicles to trigger orchitis, or from bacterial infection with epididymitis or epididymitis-orchitis. Cancer is unlikely, as this condition is usually painless. When you experience these disorders, there are a few things you can do to treat them.
Steps
Method 1 of 3: Find Relief Quickly
Step 1. Take over-the-counter pain relievers
Pain relievers such as acetaminophen, aspirin, or ibuprofen are helpful in managing pain and, in some cases, swelling. These drugs work by inhibiting the production of chemicals called prostaglandins that trigger the inflammatory response; however, paracetamol has a very weak anti-inflammatory effect. Here is the recommended dosage:
- Ibuprofen (or similar active ingredient): 200-400 mg tablets to be taken up to three times a day with food or in any case on a full stomach;
- Aspirin: 300 mg tablets to be taken up to four times a day;
- Paracetamol: 500 mg tablets to be taken up to three times a day;
- Don't mix them, as overdosing can cause serious side effects.
Step 2. Lie on your back
Until you can see a doctor, lie on your back trying to support your testicles in the way you find most comfortable to relieve physical stress and discomfort.
You can improve scrotal support by using a jockstrap; this garment relieves pain by protecting the area from friction between the legs, movement and external contact, which can make irritation worse
Step 3. Apply an ice pack
In case the swelling and pain come on suddenly, gently place an ice pack or bag of frozen vegetables on your testicles to relieve these symptoms.
- Cold therapy is an important remedy because it extends the survival time of the organ in case the edema is severe and prevents the blood supply to the testicles.
- To protect the skin from chilblains, wrap the compress or bag of frozen vegetables in a dry cloth before using it.
Step 4. Rest and avoid strenuous activities
Give your testicles time to heal naturally by avoiding straining yourself into demanding jobs that could exacerbate the situation. do not lift weights, do not run, and do not perform other vigorous exercises.
If you can't rest completely, wear a jockstrap and / or underwear that offers support
Method 2 of 3: Look for Symptoms
Step 1. Identify your risk factors
There are some common circumstances that predispose to both viral and bacterial pain infections. Here are some examples:
- Sexual activity;
- Very strenuous physical activity, such as frequently riding a bicycle or motorbike
- Sitting for a long time, for example driving a truck or traveling very often
- Previous prostatitis or urinary infections;
- Benign prostatic hypertrophy or having undergone prostate surgery, which is quite common in men of a certain age;
- Anatomical abnormalities, such as hypospadias (deformation of the urethra), which may be present in prepubertal young people.
Step 2. Watch out for trauma
In this case, we speak of testicular torsion which manifests itself with pain in the gonads and epididymis, the small tube that stretches along the lower part of the testicles. A very thorough physical examination is required to assess this situation. If you have suffered any trauma to the genitals, especially if the testicle has twisted on itself, get a medical check-up, as there is a risk of losing the organ.
- The doctor might check for the cremasteric reflex, which is absent in trauma. It is observed by gently rubbing a medical hammer along the inside of the thigh; this stimulation triggers a physiological protective reaction whereby the testicle retracts into the scrotal sac.
- Testicular torsion usually manifests as sudden, intense pain.
Step 3. Consider the possibility of an infection
In this case, age plays an important role; infections that cause pain in the gonads can be bacterial in nature and affect the epididymis and testes. In patients over the age of 35 or under the age of 14, these are usually bacteria that originate from the anal area. For individuals aged 15 to 35, the most likely infection is venereal, such as chlamydia or gonorrhea. You feel painful to the touch as you go for your visit, and your doctor may look for Prehn's sign, a reduction in pain when the testicles are lifted.
- Treating the infection can reduce pain, counteract the progression of bacterial proliferation and prevent possible septicemia.
- The cremasteric reflex is also present with infections.
Step 4. Look for orchitis
It is a viral infection that suddenly triggers intense pain and swelling of the testicles. It is an acute symptomatology that can be caused by an epidemic mumps, a viral infection that is becoming more frequent due to the lack of vaccination with MMR of children around 11 months of age; about 20-30% of children with mumps also get sick with orchitis. This second infection typically occurs a week after the development of swelling in the parotids, the glands located under the jaw.
There is no cure for this form of orchitis, which can also lead to infertility; the only possible intervention is to manage symptoms with pain medication and ice packs
Step 5. Consider the possibility of a sexually transmitted infection
In this case, the symptoms are often swelling and pain in the testicles accompanied by burning when urinating; the discomfort begins gradually and takes weeks to manifest. Pain may be associated with nausea and vomiting, as well as abdominal discomfort; the cremasteric reflex is also present.
- Ultrasound allows for greater visibility of blood vessels and can show pockets of infection or abscesses.
- You may also complain of other symptoms, such as discharge or blood in the urine.
Step 6. Check for signs of epididymitis-orchitis
Pain caused by a bacterial infection develops quickly, within a day. The testicles and epididymis swell rapidly, become large, red and painful to the touch; this situation causes severe pain.
You may also have a different infection, such as the urinary tract or urethra
Step 7. Undergo lab tests
These tests are useful in identifying the infection; Your doctor may request a urinalysis to check for bacteria, such as E. Coli. If you are young and sexually active, your doctor may suggest a Multiplex polymerase chain reaction test to determine if you have chlamydia or gonorrhea.
In all cases of scrotal pain and swelling, a routine ultrasound is done to identify possible complications
Method 3 of 3: Treating Prolonged Pain
Step 1. Treat bacterial infections
Men of any age can get infections that cause pain in the gonads, such as those from E. Coli or other pathogens. Benign prostatic hypertrophy plays an important role in elderly individuals. Bacteria accumulate in the urinary tract, as the bladder does not empty completely due to an enlarged prostate; as a result, E. coli or other gastrointestinal bacteria travel up the urinary tract triggering an infection.
- Generally, antibiotics such as Bactrim or quinolone are given; the treatment cycle lasts about 10 days, unless there is a prostate problem that requires longer treatments.
- Prehn's sign is often present, so you can lift your testicles and apply ice to find relief.
- In the first few days, you can get the pain under control by taking acetaminophen, ibuprofen, or stronger narcotic pain relievers.
Step 2. Cure STDs
In this case, antibiotics are prescribed, for example ceftriaxone, followed by a course of azithromycin or doxycycline; you should notice improvement in pain 24-48 hours after starting therapy. Apply cold packs and lift your testicles to find some relief while you wait for the antibiotics to take effect; you can also take an over-the-counter pain reliever, especially during the first few days.
Step 3. Manage Testicular Trauma
In this circumstance, the twisted testicle does not receive enough blood due to different types of accidents, such as slipping off the bike seat hitting the groin area; in severe cases, there is a torsion of the spermatic cord which requires surgery. Each year, out of 100,000 males under 18 years of age, this disorder affects 3.8%.
- Early detection of a highly elevated testicle and the absence of the cremasteric reflex are sufficient to justify surgical exploration; in this way, it is possible to avoid orchiectomy, the removal of the testicle.
- Even mild trauma can cause swelling, pain, high fever, frequent and urgent need to urinate.
- The useful time for surgery is about eight hours after the accident; in this way, extensive damage to the spermatic cord is avoided, which can be quickly returned to its natural position without having to remove it. Despite this promptness of intervention, the orchiectomy is performed in 42% of cases; late diagnosis leads to the necessary removal of the testicle and possible infertility.
