Common Causes
Although titled testicular examination it involves the examination of the penis, scrotum and testes. As this is an intimate examination it is pertinent to gain a good rapport with your patient, maintain good communication and ensure the patient’s dignity at all times. Remember to offer a chaperone for this skill.
Related Conditions
The testicles are very sensitive, and even a minor injury can cause testicle pain or discomfort. Testicle pain might arise from within the testicle itself or from the coiled tube and supporting tissue behind the testicle (epididymis).
What is a testicular examination?
Testicular pain can have several causes, from infections to traumatic injuries. Sometimes, testicular pain can be a medical emergency. Testicular pain may be due to an injury or condition that has started in the testicles or groin, but in many cases, it has causes elsewhere in the body.
What causes pain in the testicles?
Patients presenting with testicular pain should be rapidly assessed and assumed to have testicular torsion until proven otherwise. Torsion occurs in 1/4000 under 25 year olds, is a surgical emergency and if not assessed and operated on within 6 hours can result in irreversible damage can develop (1).
Is testicular pain a medical emergency?
Should I be assessed for testicular torsion?
How do you check for testicular pain?
The cremasteric reflex should always be assessed. This reflex is elicited by stroking or gently pinching the skin of the upper inner thigh while observing the scrotum. A normal response is contraction of the cremasteric muscles on the ipsilateral side with unilateral elevation of the testis.
How do I know if testicular pain is serious?
Sudden, severe testicle pain needs immediate medical care. Contact your provider right away or go to an emergency room if: Your pain is severe or sudden. You have had an injury or trauma to the scrotum, and you still have pain or swelling after 1 hour.
How do you check for testicular torsion?
How Is Testicular Torsion Diagnosed?Ultrasound. High-frequency (Doppler) waves are used to make an image of the testicle and check the blood flow.Urine tests or blood tests. These can find if the pain and symptoms are being caused by an infection instead of a torsion.
How do you diagnose testicular problems?
An ultrasound test can help your doctor determine the nature of any testicular lumps, such as whether the lumps are solid or fluid-filled. An ultrasound also tells your doctor whether lumps are inside or outside of the testicle. Blood tests.
Can you strain a testicle?
The tube that surrounds the blood vessels that run into your scrotum, called the spermatic cord, can get twisted during an injury or simply without warning. This can cut off blood flow to your scrotum, resulting in bruising and discoloration. This injury needs immediate treatment.
Can stress and anxiety cause testicle pain?
Anxiety affects every part of the body, including the genitals. On men, this may result in conditions such as testicular pain and a smaller penis. In women, this could result in yeast infections, dryness, and other health conditions. Anxiety may also lead to issues with libido and sexual desire.
How can you tell the difference between testicular torsion and epididymitis?
Prehn's sign is a clinical finding that helps clinicians determine whether testicular pain is caused by epididymitis or testicular torsion. A positive Prehn's sign, characterized by pain relief from the maneuver, is indicative of epididymitis, or the inflammation of the epididymis (a duct running behind the testes).
Does testicular torsion hurt to touch?
You will definitely feel pain if your testicles are struck or kicked. You might also feel nauseated for a short time. If the testicular injury is minor, the pain should gradually subside in less than an hour, and any other symptoms should go away as well.
When should you suspect testicular torsion?
Acute scrotal pain in all prepubertal and young adult males should be managed as testicular torsion until proven otherwise. The most common symptoms include severe pain in one testis, sometimes accompanied by lower abdominal pain, nausea and vomiting.
Should I see a urologist for testicular pain?
Testicular pain, lump or masses: When testicular pain is persistent and does not go away within two weeks, it is time to see a Urologist. Any masses, firmness or nodules on the testicles should be examined by a urologic specialist, due to the chance of testicular cancer.
Do urologists treat testicular pain?
Any man with testicular pain should visit a urologist to identity the cause, rule out other possible conditions and begin a treatment plan. Symptoms of testicular pain will help guide a diagnosis and subsequent treatment.
Does Covid make your balls hurt?
Testicular pain as the first symptom of COVID-19 may suggest orchitis as possible in men patients with SARS-CoV- infection. Further studies are necessary on the pathological effect of SARS-CoV-2 in the male reproductive system and to ensure a proper andrological follow-up for male patients.
Can testicle pain go away on its own?
Sometimes, chronic testicular pain goes away on its own, but there is no way to predict if it will go away, or when it may return. Sudden testicular pain can signal an emergency and may be a dangerous condition. For sudden testicular pain, seek medical help immediately.
How long does pain from testicular torsion last?
The swelling usually goes down within 2 to 4 weeks. You should be able to do most of your normal activities after 1 to 2 weeks, except for those that require a lot of effort. It's important to avoid straining with bowel movements and doing heavy lifting while you recover.
Why do I have a painful testicle?
Primarily, it is most important to distinguish if the presenting complaint is actually acute testicular pain (which is potentially a surgical emergency) or scrotal swelling (which should be relatively painless) The most common cause of acute testicular pain are: Testicular Torsion.
Why does my testicle hurt?
The most common cause of acute testicular pain are: Testicular Torsion. Definition: Twisting of the spermatic cord, cutting of the blood supply to the testicle, leading to ischaemia (5). This requires urgent detorsion and fixation (orchiopexy) before the testicle becomes ischaemic and needs removal (orchidectomy).
What does it mean when you twist your testicle?
Definition: Twisting of the vestigial appendages of the testis or epididymis. This can lead to pain and may mimic testicular torsion but does not cause damage to the testis and can be managed conservatively. Learning Bite.
What are the testicular appendages?
The testicular appendages (the appendix testis and appendix epididymis) are embryological remnants that serve no purpose but may twist and cause pain. This is common in pre-pubescent boys and doesnt require surgical intervention if the diagnosis is certain. Blood Supply to the Testes.
What is epididymo orchitis?
Epididymo-orchitis. Definition: Inflammation of the epididymis +/- testes, leading to acute pain or swelling. It may be caused by a sexually transmitted infection or other urinary tract infection spreading along the urinary tract and should improve with antibiotics (7). Torted appendages.
Where do testicular arteries travel?
The testicular arteries travel in the spermatic cord with the cremasteric and differential artery, where they anastomose with the vasa deferentia that branch off the internal iliac artery. Blood from the testes drain into a network of veins within the scrotum called the pampiniform plexus.
Where does the testis go during development?
During embryological development, the testis descends from the posterior abdominal wall, through the inguinal canal to the scrotum. The nervous and arterial supply and the venous and lymphatic drainage travel the same route in the spermatic cord. The testis is suspended in the scrotum by the spermatic cord (3).
What is a testicular self exam?
A testicular self-exam is an inspection of the appearance and feel of your testicles. You can do a testicular exam yourself, typically standing in front of a mirror. Routine testicular self-exams can give you a greater awareness of the condition of your testicles and help you detect changes. Self-exams can also alert you to potential testicular ...
What to do if you have a lump in your testicles?
Make an appointment with your doctor if you find a lump or other change during a testicular self-exam. Depending on the circumstances, your doctor might do a testicular exam followed by a blood test, ultrasound or biopsy. Most changes in your testicles aren't caused by testicular cancer.
What causes fluid to accumulate around testicles?
A number of noncancerous conditions can cause changes in your testicles, such as a cyst, injury, infection, hernia and collection of fluid around the testicles (hydrocele). By Mayo Clinic Staff.
What causes bumps on the testicles?
While you're doing the testicular self-exam, you might notice a few things about your testicles, such as bumps on the skin of your scrotum, that seem unusual but aren't signs of cancer. Ingrown hairs, a rash or other skin problems can cause bumps on the skin.
Can testicular cancer be detected early?
Though often promoted as a way to detect testicular cancer, testicular self-exams aren't proved to reduce the risk of dying of the disease. Testicular cancer is a relatively uncommon type of cancer. It's also highly treatable at all stages, so finding testicular cancer early doesn't make a cure more likely.
Is it necessary to do a testicular self exam?
No special preparation is necessary to do a testicular self-exam. You might find a testicular self-exam is easier during or after a warm bath or shower. Heat relaxes the scrotum, making it easier for you to check for anything unusual.
What is a testicular exam?
A testicular examination is mainly performed on male patients who present with testicular pathology e.g. pain, swelling, a lump. Although titled testicular examination it involves the examination of the penis, scrotum and testes.
Can you kneel down for a testicular exam?
Testicular examination is best performed with the patient stood up. You should kneel down in front of and to the side of the patient, NOT directly in front of the patient.
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Why does my scrotal area hurt?
The most common causes of acute scrotal pain and/or swelling are torsion of the testicular appendage (appendix testis), epididymitis and testicular torsion. Delays in surgical management of testicular torsion result in higher rates of testicular loss (>40%).
Is testicular torsion an emergency?
Testicular torsion is an emergency. It requires immediate referral to a surgeon. Surgical evaluation should be undertaken in all cases where testicular torsion cannot be confidently excluded. Ultrasound should only be considered in selected cases, after surgical assessment.
Introduction
Unpleasant or distressing feeling of one or both of the testicles.
Testicular pain is not always related to an underlying condition. It may be caused by:
- Certain exercises like cycling
- Trauma or injury
- Adverse effects of some drugs e.g. antibiotics or chemotherapy
Inspection
Assessment of The Scrotum Whilst The Patient Is Standing
to Complete The Examination…
Urology Conditions Overview
- Penis, groin and abdomen
Inspect the patient’s penis, groin and abdomenfor relevant clinical signs: 1. Skin changes: bruising, swelling, warts (human papillomavirus) and erythema. 2. Scars:note any scars on the penis (e.g. circumcision) or in the inguinal region (e.g. inguinal hernia repair, orchidopexy). 3. Masses:note … - Scrotum and perineum
Ask the patient tolift their penis out of the way to allow you to closely inspect the scrotum and perineumfor relevant clinical signs: 1. Skin changes: warts (human papillomavirus), erythema (e.g. cellulitis, fungal infection). 2. Scars:may indicate previous surgery (e.g. vasectomy, testicular fix…
References
- At the end of the examination, ask the patient to standto allow you to re-assess the scrotum. Inspect and palpate the posterior scrotum for evidence of varicocele (a palpable mass that feels like ‘a bag of worms’) or a hernia(a mass which you cannot get above).
Overview
- Explain to the patient that the examination is now finished and provide them with privacy to getdressed. Thank the patientfor their time. Dispose of PPE appropriately and wash your hands. Summarise your findings.
Why It's Done
- Hydrocele
Key points: 1. Hydrocele involves an accumulation of fluid in the tunica vaginalis which can be congenital or acquired. 2. The testicle should be palpable within the cyst and the mass should transilluminate. 3. If the hydrocele is large, the testicle may be difficult to palpate. - Epididymal cyst
Key points: 1. An epididymal cyst is a benign, smooth, extra-testicular, spherical cyst in the head of the epididymis. 2. Typical clinical findings include a fluctuant mass, separate from the testicle that transilluminates.
Risks
- Drvgaikwad. Adapted by Geeky Medics. Paraphimosis. Licence: CC BY.
- Pygmalion. Adapted by Geeky Medics. Chancre. Licence: CC BY.
- Fisch12. Adapted by Geeky Medics. Varicocele. Licence: CC BY.
How You Prepare
What You Can Expect
- Testicular self-exams help you learn how your testicles normally look and feel. Then you're more likely to notice subtle changes. Changes in your testicles could be a sign of a common benign condition, such as an infection or a cyst, or a less common condition, such as testicular cancer.
Results
- Performing a testicular self-exam doesn't pose any direct risks. However, if you notice something unusual that concerns you, the follow-up exams might lead to unnecessary worry and medical tests. For example, if you discover a suspicious lump, you might have tests to determine its cause. This could involve blood tests, ultrasound exams or a procedure to remove testicle tissu…