Testicular aching can range from a dull, persistent ache to sharp, sudden pain. Understanding its potential causes is important.
Common Causes of Right Testicular Aching
Aching in the right testicle can stem from inflammation, structural issues, or referred pain. One frequent cause is epididymitis, inflammation of the epididymis, the coiled tube behind the testicle storing and transporting sperm. It typically results from a bacterial infection, often STIs or UTIs, causing gradual pain, swelling, and tenderness.
Orchitis, inflammation of the testicle itself, can be caused by bacterial or viral infections like mumps. Symptoms include testicular pain, swelling, fever, and nausea, and it may occur alongside or follow epididymitis.
Varicocele, an enlargement of scrotal veins like varicose veins, commonly affects the left side but can occur on the right. It can cause a dull ache that worsens with standing or exertion, sometimes feeling like a “bag of worms” within the scrotum.
Hydroceles, fluid around the testicle, can cause aching or heaviness. Though often painless, large hydroceles may produce discomfort due to size and pressure.
Spermatoceles, or epididymal cysts, are fluid-filled sacs in the epididymis with sperm. Usually benign and painless, large cysts can cause a dull ache or fullness.
An inguinal hernia occurs when intestine or fatty tissue protrudes through a weak abdominal muscle spot, often into the groin or scrotum. This can cause pain or a bulging sensation extending to the testicle, especially during straining, coughing, or lifting.
Referred pain, originating elsewhere, can be felt in the testicle. Examples include kidney stones, with pain radiating from the abdomen or flank, or nerve compression in the back. Minor scrotal trauma can also cause persistent aching.
Less common but serious conditions like testicular torsion and testicular cancer require immediate attention. Testicular torsion is a medical emergency where the spermatic cord twists, cutting off blood flow. This causes sudden, severe pain, swelling, nausea, and vomiting, requiring urgent surgery. Testicular cancer, though rare, can manifest as a dull ache or heaviness, alongside a lump or change in size or shape.
When to Seek Medical Attention
Seek medical attention for testicular aching if you experience sudden, severe pain, possibly indicating testicular torsion. Urgent assessment is also needed for pain accompanied by fever, nausea, or vomiting.
Other concerning signs include scrotal swelling, redness, or tenderness. Consult a healthcare provider if pain develops after a groin injury, or if you discover a new lump or any change in testicle size or texture. Professional evaluation is also needed for persistent pain, pain not improving with self-care, difficulty urinating, blood in urine, or penile discharge.
Understanding the Diagnostic Process
For testicular aching, a healthcare provider will take a detailed medical history, inquiring about the pain’s onset, nature, and associated symptoms. A thorough physical examination follows, palpating the scrotum, testicles, and abdomen for tenderness, swelling, lumps, or hernias. This provides initial clues.
Diagnostic steps often involve laboratory tests. Urine tests check for infection signs like bacteria or white blood cells, indicating epididymitis or UTI. Blood tests may assess inflammation markers or other systemic issues.
Imaging studies visualize scrotal contents. A scrotal ultrasound is a primary diagnostic tool, differentiating conditions like epididymitis, hydrocele, varicocele, and testicular torsion by assessing blood flow and structural abnormalities. If referred pain from kidneys is suspected, a CT scan of the abdomen and pelvis might investigate for kidney stones or other abdominal pathologies.
General Treatment Approaches
Treatment for right testicular aching depends on the underlying diagnosis. For bacterial infections like epididymitis or orchitis, antibiotics eliminate the infection. Pain relievers, including over-the-counter options like ibuprofen or acetaminophen, and sometimes prescription medications, manage discomfort.
Anti-inflammatory medications reduce swelling and pain from inflammatory conditions. Supportive care, including rest, ice packs, and scrotal support, alleviates symptoms and promotes healing.
Surgical intervention is necessary for specific conditions. Testicular torsion requires emergency surgery to untwist the spermatic cord and restore blood flow. Varicoceles causing significant pain or infertility may be treated with a varicocelectomy, which ties off or blocks affected veins.
Hydroceles can be surgically repaired via hydrocelectomy, removing fluid and sac. Inguinal hernias are typically repaired surgically to prevent complications. For less severe conditions or those that may resolve spontaneously, watchful waiting and symptom monitoring may be the initial approach.