Be careful! "Pain in the balls" is definitely not about being idle, but...

I believe everyone is familiar with Internet slang such as "bored to death" and "sadness of the egg". Of course, these sentences are just ridicule.

But in real life, if men do experience "pain in the testicles", they must not take it lightly and must go to the hospital for treatment in time, because this often indicates a certain disease, and in the most serious cases it may even lead to testicular removal, causing lifelong damage.

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So what diseases can cause "testicular pain"?

01

Varicocele

The spermatic cord is a cord-like tissue located above the testicle. It is a small branch of the human vein. Under the action of the heart's "pump", blood flows from the smaller spermatic vein into the larger renal vein above, returning to the heart.

Why does varicocele occur?

Let's make an analogy, think of the heart as a pump and the varicocele as a water pipe. When we stand, it is equivalent to placing the "bucket" at a very low position. At this time, the pump will use a lot of force to control the water flow, and the vein as a water pipe will bear more pressure. Therefore, standing for a long time is prone to varicocele in men.

In addition, there is a one-way valve in this pumping system, called a venous valve. The venous valve controls the single direction of water flow to avoid backflow. However, if the venous valve is missing or malfunctioning, it is equivalent to a broken one-way valve, and blood will accumulate below, causing a certain amount of pressure on the spermatic vein.

Of course, if the wall of the water pipe is thin and has poor elasticity, the water pipe will expand and bend abnormally due to too much water accumulated below. The wall of the water pipe is the wall of the vein and the connective tissue around it. When there is a problem with them, varicocele can also occur[1].

However, only a small number of patients with this disease will experience symptoms such as scrotal swelling and pain, and most of them can relieve the pain through self-adjustment, such as eating a light diet, quitting smoking and drinking, and wearing loose and breathable pants.

When exercising, try to avoid exercises that increase abdominal pressure, such as sit-ups and squats, to prevent symptoms from worsening.

02

Epididymitis

In addition to the two testicles in the male scrotum, there are two epididymis hidden behind the testicles. Don't underestimate these two epididymis, they have a big role.

The epididymis is a pair of slender, flat organs attached to the lower end of the spermatic cord. Its head is connected to the testicles, and its tail is connected to the vas deferens. It has the function of temporarily storing semen and secreting epididymal fluid to nourish sperm, thereby promoting further maturation of sperm.

However, when the body's immunity is weakened, various pathogens will retrogradely invade the epididymis and testicles through the vas deferens, causing inflammation. This inflammation can be divided into acute and chronic types.

Patients with acute epididymitis have symptoms such as obvious swelling of the testicles and epididymis, which are painful when touched. Some patients also experience scrotal distension and heaviness. In severe cases, there is also referred pain in the lower abdomen and groin, accompanied by high fever.

If acute epididymitis is not cured, it will turn into chronic epididymitis. At this time, the patient's pain is not as severe as acute, mostly mild pain, or just dull pain and discomfort. However, its cause may also be secondary to chronic urogenital tract inflammation such as chronic prostatitis. Therefore, when other adjacent organs are inflamed, attention should also be paid to the health of the epididymis.

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03

Impact on the perineum

In daily life, the most common "ball pain" situation for male friends is often caused by falls, blows or traffic accidents, when the perineum straddles a hard object, squeezing the bulbar urethra against the lower edge of the pubic symphysis.

Specific symptoms may include:

Mild contusion may not cause dysuria, while severe contusion may cause hematuria, dysuria or urinary retention. Complete urethral rupture may cause urinary retention.

· Local pain and tenderness at the time of injury.

Hematoma, subcutaneous ecchymosis and swelling may occur in the perineum and scrotum.

04

Testicular torsion

Testicular torsion is a urological emergency that is more common in adolescents aged 12 to 18 years.

This condition often occurs when you just wake up or after strenuous exercise. Testicular torsion is caused by irregular contraction or spasm of the cremaster muscle or positional change due to excessive testicular activity.

Symptoms of testicular torsion include sudden severe pain in the lower abdomen or testicular area, redness and swelling of the scrotal skin, and possible nausea and vomiting.

The testicles have a lot of nerves and are very sensitive to pain, which makes them very fragile. Once torsion occurs, surgery is required immediately.

Generally speaking, if surgery is performed within the “golden 6 hours” of torsion, the testicular salvage rate is high. As time goes by, the testicle will become completely congested and necrotic, and then surgery to remove the testicle will be necessary[2].

Therefore, when a boy experiences abdominal pain or pain in the scrotal area, in addition to considering gastrointestinal diseases, he should also be alert to the possibility of testicular torsion.

In short, if male compatriots encounter the problem of "testicular pain", they must go to the urology or emergency surgery department of the hospital in time for treatment and conduct necessary examinations to clarify the diagnosis. Otherwise, a carelessness may make you regret it for the rest of your life.

Author: Zhou Haijiang, deputy chief physician of the emergency department of Beijing Chaoyang Hospital, Capital Medical University

Reviewer: Guo Shubin, Chief Physician of the Emergency Department, Beijing Chaoyang Hospital, Capital Medical University

References

[1] Peng Aijin, Li Haisong. “Pain in the testicles” may be caused by varicocele. Public Health, 2022(1):108.

[2] Li Tian. “Pain in the balls” is no small matter. Don’t let face delay things. Jiangsu Health Care, 2022(3):8-9.