Testicular discomfort, particularly when localized to the left side and exacerbated by sitting, can be a concerning symptom. While it often stems from benign conditions, it is important to address such pain rather than disregarding it. This article explores various potential reasons for left testicle pain when sitting and outlines the appropriate steps for assessment and relief.
Potential Causes of Discomfort
Inflammation in the scrotal area can lead to discomfort, which may feel worse with pressure from sitting. Epididymitis, an inflammation of the epididymis (the coiled tube behind the testicle that stores and carries sperm), typically presents with pain that increases gradually, alongside a hot and swollen scrotum. This condition can result from bacterial infections, including sexually transmitted infections or urinary tract infections. Similarly, orchitis involves inflammation of the testicle itself, sometimes caused by bacterial or viral infections like mumps, and can manifest with pain, swelling, fever, and nausea.
Fluid accumulation around the testicle can also be a source of pain. A hydrocele, a fluid-filled sac surrounding the testicle, is usually painless, but a large accumulation can cause discomfort when sitting or walking. Another fluid-filled sac, a spermatocele, is a cyst in the epididymis that may cause pain if it grows large.
Abnormalities in scrotal veins frequently contribute to pain. A varicocele, characterized by enlarged veins within the scrotum, occurs more commonly on the left side. This condition often causes a dull ache or a sensation of heaviness, which tends to worsen with prolonged sitting or standing due to increased pressure on the veins, often improving when lying down.
Pain originating from other parts of the body can also be perceived in the testicle, a phenomenon known as referred pain. Kidney stones, for instance, can cause sharp, cramping pain that radiates to the testicles due to shared nerve pathways. An inguinal hernia, where a portion of the intestine protrudes through a weak spot in the abdominal wall, can descend into the scrotum, leading to pressure, aching, or a burning sensation, particularly when sitting or straining. Additionally, inflammation of the prostate gland, known as prostatitis, can cause pain in the testicles, perineum (area between the scrotum and anus), or lower back, sometimes aggravated by prolonged sitting.
When to Seek Immediate Care
Certain symptoms accompanying testicular pain signal a need for immediate medical attention. Sudden and severe pain in the testicle, especially if it appears without a clear cause, warrants urgent evaluation. This urgency increases if the pain is accompanied by other symptoms like swelling, redness, fever, or chills. Nausea and vomiting are also significant indicators that immediate care is necessary.
Pain that develops after an injury to the scrotal area, or any pain that rapidly worsens, should prompt an immediate medical visit. These symptoms could indicate testicular torsion, a medical emergency where the spermatic cord twists, cutting off blood supply to the testicle. Testicular torsion occurs more frequently in the left testicle and requires immediate surgery, ideally within six hours of onset, to preserve the testicle.
Medical Assessment and Diagnosis
When seeking medical help for testicular pain, a healthcare provider will typically begin with a detailed medical history. This includes questions about when the pain started, its specific characteristics, any associated symptoms, and factors that aggravate or relieve it, such as sitting. A thorough physical examination of the scrotum and abdomen will follow to identify any visible signs of inflammation, swelling, or tenderness.
To pinpoint the cause of the pain, various diagnostic tests may be ordered. A urinalysis can check for signs of infection, which might indicate epididymitis or orchitis. Blood tests may also be performed to look for markers of inflammation or infection. Ultrasound, particularly a Doppler ultrasound, is a primary imaging tool used to assess blood flow to the testicles, aiding in distinguishing conditions like testicular torsion from inflammatory conditions such as epididymitis.
Approaches to Relief
Managing testicular pain involves both self-care measures and medical interventions, depending on the underlying cause. For general discomfort, resting the affected area and applying cold packs or ice to the scrotum for 10 to 20 minutes at a time can help reduce swelling and pain. Wearing supportive underwear, such as briefs or a jockstrap, can also provide comfort by elevating and stabilizing the testicles. Over-the-counter pain relievers like ibuprofen or acetaminophen may help alleviate mild to moderate pain.
Making lifestyle adjustments can also contribute to relief, especially if sitting aggravates the pain. This might involve adjusting sitting posture, using a cushion to reduce pressure, or taking frequent breaks to stand and move around, particularly during prolonged periods of sitting. For medically diagnosed conditions, treatment often includes antibiotics for infections like epididymitis, orchitis, or prostatitis. Anti-inflammatory medications may also be prescribed. Surgical interventions are sometimes necessary for conditions such as varicoceles, hydroceles, hernias, or in emergency cases like testicular torsion.