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Chronic testicular pain is long-term pain of the testes. [ 2 ] [ 3 ] It is considered chronic if it has persisted for more than three months. [ 1 ] Chronic testicular pain may be caused by injury , infection , surgery , cancer , varicocele , or testicular torsion , and is a possible complication after vasectomy . [ 2 ]
Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. [5] Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. [5] Large varicoceles present as plexus of veins and may be described as a "bag of worms".
The differential diagnosis of testicular pain is broad and involves conditions from benign to life-threatening. The most common causes of pain in children presenting to the emergency room are testicular torsion (16%), torsion of a testicular appendage (46%), and epididymitis (35%). [4] In adults, the most common cause is epididymitis. [citation ...
Testicular torsion may also be caused by trauma to the scrotum or exercise (in particular, bicycle riding); [10] however, only about 4–8% of cases are the result of trauma. [1] [2] There is thought to be a possible genetic basis for predisposition to torsion, based on multiple published reports of familial testicular torsion. [10]
Varicoceles and testicular torsion are conditions in which direct damage to the testicles can potentially lead to testicular atrophy. [6] [7] Varicoceles are pooling of blood in the veins that deliver blood away from the testicles and are relatively common, occurring in approximately 15% of adolescent and adults with testicles. [7]
Spermatocele is a fluid-filled cyst that develops in the epididymis. [3] The fluid is usually a clear or milky white color and may contain sperm. [4] Spermatoceles are typically filled with spermatozoa [5] and they can vary in size from several millimeters to many centimeters.
Differential diagnosis of hematocele includes testicular tumor, testicular torsion, and epididymitis. [8] In a blood test or urine test, serum levels of tumor markers such as ( alpha-fetoprotein , carcinoembryonic antigen , β-human chorionic gonadotropin ) can help to reveal if testicular cancer is present which can help with the differential ...
Diagnosis is typically based on symptoms. [1] Conditions that may result in similar symptoms include testicular torsion, inguinal hernia, and testicular cancer. [1] Ultrasound can be useful if the diagnosis is unclear. [1] Epididymitis usually has a gradual onset.