The testicles in men are the most vulnerable part of their body. They are protected only by a thin layer of scrotum and are very sensitive to any influences. The testicle, or testicle, testis (lat. Testis), is a paired male reproductive organ (gonad) that produces sperm and releases the main male hormone testosterone into the bloodstream.
Normally, the testes are located in the scrotum. They have an oval shape, dense texture. Nutrition is obtained from the inguinal artery. The testicles are separated by a septum. The scrotum is suspended on the spermatic cord. The upper pole is sharper and slightly tilted forward. The testicles are normally asymmetric - the left is lower. Some researchers consider this a feature of embryogenesis. When walking for this reason, the testes are not injured.
Testicular size normal
They have a length of 4-6 cm, a width of 25-35 mm. Weigh from 17 to 32 grams. There is an opinion that the larger the testes, the greater the fertility, but this is not always true.
Structure
The testicles are covered with peritoneum, under it there are 2 more membranes - protein and vaginal. In the protein (fibrous) membrane, an outgrowth of connective tissue (mediastinum) extends into the testis parenchyma from the inside. Connective tissue radially located septa fan out from it fan-shaped. They divide the parenchyma of the testicle into segments, there are 250-300 of them. They have a conical shape, they are located tubes (seminiferous tubules). The tops of the cones are directed toward the mediastinum, and the bases toward the fibrous membrane. Each lobule contains 2-3 convoluted seminiferous tubules lined with spermatogenic epithelium.
In the region of the tops of the cones, the convoluted tubules merge with each other and form direct seminiferous tubules that flow into the network of the testis in the parenchyma. From them originate the efferent tubules, going to the appendage and flowing into its duct.
In the tubules, sperm matures. In the epididymis (epididymis) there is a duct for the removal of the seed, which opens into the urethra. So the structure is not simple.
The scrotum is always cool to the touch, because the temperature here is a degree lower than that of the body. This is provided by nature so that the vital activity of sperm is not disturbed. Hot testicles are a sign of pathology.
What happens when the testicles hurt?
Pain is not a diagnosis, it is only a signal of trouble, it can be of various types, accompanied by cyanosis, swelling. If the right testicle or left is pulled, injury may result, followed by a hematoma. Possible dull bursting pain with a return to the leg, scrotum, pubis, even in the right hypochondrium. In this case, one can assume the presence of an inflammatory process, surgical intervention is likely to be required.
Pain of moderate intensity spilled throughout the scrotum? There is probably a process of inflammation in the kidney system. Severe stitching pain in the form of seizures with a return to the lumbar region most often becomes a consequence of urolithiasis.
Burning in the scrotum, pain at the end of urination give orchitis and cystitis. Pain in the testicles (single or double-sided), swelling of the scrotum may indicate an inguinal hernia.
A pain symptom in the testicles is often accompanied by a deterioration in the general condition of the patient:
- fever and chills;
- temperature increase to 38 and above;
- vomiting and nausea;
- weakness and lack of appetite;
- poor sleep and headaches.
Associated symptoms
The following manifestations may accompany pain:
- If you touch the scrotum, then you constantly feel discomfort.
- The testicle is enlarged, edematous.
- The very structure of the testicle changes, it can become tuberous, compacted, overly convex.
- Scrotum pain not only becomes aching, it can be acute and paroxysmal.
If the duration of any pain in the testicle exceeds 30-60 minutes, a doctor's consultation is required.
Causes of pain
It should be said right away that pain can relate to common causes. These include injuries, sexual overexcitation. But there are pathologies that are more characteristic of any one testicle.
For the left testicle are more characteristic:
- torsion;
- epididymitis;
- orchitis;
- varicocele;
- neoplasms.
This does not mean, of course, that there are no such diseases in the right testicle, but they are less common.
Right testicle
If the right testicle hurts and pulls in men, the cause may be in the following pathologies:
- urolithiasis disease;
- cystitis;
- inflammation of the appendages, the testicles themselves are not affected.
These pathologies are the most common for the right testicle. Other causes may be exogenous or endogenous, physiological and pathological. Pain can vary in time and intensity.
Possible causes of pain on the right
If the right testicle hurts in men, it is impossible to say the reasons without thinking, since there are a lot of them. Physiological can include an increased level of libido, when an erection is frequent, and sex is not expected. When excited, capillaries begin to work 2 times stronger, organs are poured. In the absence of ejaculation, a sensation may occur in men that pulls the right testicle. This is pretty unpleasant. There is no harm to the body, there is only discomfort.
Another pathology is inflammation of the testicles. It can occur after infections: chickenpox, measles, mumps. Diabetes, hepatitis B, and HIV infection can play a role.
The process is not limited only to what hurts and pulls in the right testicle. In men, the general condition is disturbed. The testicle becomes swollen, swollen and red.
Tumors
The peak incidence occurs after 30 years. 99% of testicular tumors are malignant. Usually the lesion is unilateral. The cause is cryptorchidism, trauma or a hereditary predisposition.
Symptoms are pain in the scrotum, giving in the groin and perineum, and discomfort when walking. Metastasis causes symptoms from other organs.
Inguinal hernia
Also more commonly observed in the right testicle. In 85% of cases, it is acquired. Its provoking factors can be: urination disorders, constipation, weight lifting, high jumps, prolonged standing, increased fatness.
Types of pain from causes
Drawing pain is a sign of most often infections of the genitourinary sphere, prostatitis, orchitis. If temperature is added to it, the appeal to the doctor should become urgent.
Pulls the right testicle and in case of torsion of the testicle or inguinal hernia. Also, such pain is characteristic of a long absence of intimacy. Drawing injuries can also be provoked by minor injuries that occur during sports, cycling. In order to correctly determine the cause of weak pulling pain in the right testicle in a man, a comprehensive diagnosis is needed.
The causes of aching pain are the same, but testicular dropsy and epididymitis are added.
Acute pain may indicate a testicular torsion, or rather, its spermatic cord. In addition to pain, fever and vomiting may occur.
An acute symptom may also be a sign of epididymitis. Such pain will radiate to the buttocks, perineum and lower back, while pulling the right testicle and giving it to the groin.
Sharp pain is the result of injuries of the testicle, its appendage. It can cause pain shock, so contacting a doctor should be urgent.
Orchitis and epididymitis (inflammation of the testis and appendages)
The inflammatory process can be single or double-sided. The most common cause of inflammation is infection as a result of sexual contact or inflammation in neighboring organs.
In children and adolescents, orchitis develops after respiratory infections and measles, mumps, and herpes viruses. Often the primary becomes epididymitis.
In the acute form of pathology, body temperature rises, the testicle swells, and the inflammatory process is accompanied by severe pain. In this case, pain in the right testicle pulls and gives to the leg, lower back and groin. Upon transition to a chronic form, pain in the scrotum becomes constantly aching.
Hydrocele
This is dropsy of the testicles. Such a disease requires surgical intervention. Normally, the vaginal membrane of the testicle always contains a small amount of fluid. With its accumulation in large quantities for various reasons, a hydrocele develops.
A disease always arises on one side. The testicle is compacted, its dimensions increase and the shape becomes pear-shaped.
The cause may be infection (ureaplasma, chlamydia or mycoplasma), trauma, congenital pathology of the testicle. In the latter case, there is always an increase in testicle size in the evening, and in the morning it is normal. The acute form of dropsy also has signs of fever and severe pain. The chronic stage is marked by pain in the right testicle - pulling and constant.
Mechanical damage to the scrotum
They vary in degree of injury:
- A bruise is a slightly swollen and painful testicle. Treatment is usually not necessary, if the pain is too severe, a procaine blockade is done.
- Infringement is a disease of children under 3 years old. It develops as a complication of undescended testicle in the scrotum (cryptorchidism). It is characterized by acute pain, hyperemia and swelling of the tissues.
- Dislocation - the testicle takes an unusual position for him. It can get into the abdominal cavity, inguinal region, between the muscles of the thigh. There is a swelling and severe pain.
- Rupture - this is a rupture of the shells, an operation to restore them is required. Pain up to shock and death.
- Chipped testicular injury - damage to the testicle with a piercing or cutting tool. The pain is so intense that it can lead to shock and loss of consciousness.
Other pathologies
Torsion of the testicle is nothing more than an inversion of the spermatic cord. The pain is acute and sudden, the testicle swells, reddens, nausea and vomiting are added. Collapse is not excluded. Pathology is characteristic of adolescents during puberty. The cause may be injury. Blood supply in the testicle is blocked or completely absent. When the cord twists 180 degrees and for a period of more than 6 hours, the testicle dies, necrosis develops in it. Symptoms of torsion are very bright: acute pain in the scrotum before pain shock, vomiting, diarrhea. The testicle grows in size, compacts, palpation feels tuberosity. Measures should be emergency. The testicle is twisted in the opposite direction either manually or by operation.
Varicocele is a consequence of the expansion of veins going to the gonads. The pains are severe, the disease is usually treated promptly.
Spermatocele is a seminal cyst. This is a cavity benign testicular mass in the form of a congenital cyst. It grows rapidly and squeezes neighboring tissues, due to which pain occurs.
Inguinal hernia - the right testicle pulls and hurts with a right-sided hernia. The mechanism of pain is that a growing hernia begins to squeeze the ducts and spermatic cord. The testicle itself is not damaged, the pain is radiating.
The reason that the right testicle pulls may be hypothermia. In severe cold, the vessels spasm and pulling pain accompanies them. The same mechanism occurs with vascular pathologies.
Renal colic is a blockage in the ureter that compresses the genital nerve. Pain in this case is one-sided.
Treatment principles
The treatment regimen depends on the cause. When the right testicle is pulled in men, treatment may include drug therapy, surgery, physiotherapy, herbal medicine.
With bruising and severe pain, novocaine blockade is necessary, performed in an outpatient clinic. At home, applying cold is indicated to reduce pain and swelling.
With orchitis, conservative treatment includes the following measures. If the etiology is infectious, antibiotics with a wide spectrum of action are prescribed: fluoroquinolones, cephalosporins, macrolides. To relieve pain, you can take analgesics such as "Analgin", "Tempalgin", "Ketorolac", etc. Also anti-inflammatory non-steroid drugs are shown: "Diclofenac", "Ibuprofen", "Indomethacin" and others.
Additionally assigned:
- physiotherapy;
- laser and electrotherapy;
- Ural federal district;
- mineral baths and mud therapy.
- Exercise therapy.
If there is no effect, surgical treatment is indicated.
With varicocele, drugs are prescribed to strengthen the vascular venous wall: Actovegin, Detralex, Troxerutin, Venodiol, etc.
For local treatment in order to reduce inflammation, swelling and pain, anti-inflammatory ointments and gels are used: Fastum Gel, Finalgon, Fenistil, etc. Such treatment is permissible in the absence of an open wound. Ointment relieves pain in a day.
With epidermal treatment should be comprehensive. The patient is prescribed the following types of drugs:
- antibacterial;
- absorbable;
- multivitamin;
- anti-inflammatory.
With a non-infectious onset, physiotherapy is indicated.
What to do if pulling the right testicle with dropsy? The doctor should focus on the etiology. Infectious onset requires the appointment of antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) to relieve swelling and inflammation, diuretics. Veroshpiron is especially helpful. In advanced cases, surgical treatment is indicated.
With torsion, surgical intervention is necessary. In the presence of necrosis, amputation of the testicle is performed. In other cases, the cords unwind.
With inguinal hernia, the treatment is first conservative:
- wearing a bandage;
- compresses from acetic acid;
- physiotherapy;
- taking NSAIDs and analgesics.
In the advanced stage, hernia repair is possible only surgically.
Preventive actions
Athletes with a risk of sports should use protective devices for the genital area. Unprotected sex with promiscuous sexual intercourse must be excluded. It is important to maintain regularity of intimacy. Systematic preventive examinations by a urologist should not be neglected. You can be vaccinated against mumps, which provokes orchitis.