Testicular Pain (Orchialgia)
Causes, Symptoms, Diagnosis & Treatment
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What is Testicular Pain (Orchialgia)?
Orchialgia, also known as testicular pain, refers to any acute or chronic discomfort localized in one or both testicles. This pain can be intermittent, sharp, or persistent over an extended period. According to studies, approximately 5-10% of men experience testicular pain at some point in their lives.
Orchialgia can be caused by minor, temporary issues, such as injuries, but it can also be a symptom of more serious conditions, including testicular torsion or epididymal infections. Early diagnosis and proper treatment are crucial to prevent complications and ensure optimal testicular health.
Causes and Risk Factors of Orchialgia
What’s Behind Testicular Pain?
Testicular pain can arise from a wide range of causes, from minor, temporary discomforts to serious medical conditions requiring immediate intervention. Understanding these causes is crucial for accurate diagnosis and effective treatment.
1. Infections: A Hidden Threat to Male Health
Infectious agents can affect the testes and surrounding tissues, leading to inflammation and significant pain. The most common infections include:
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Epididymitis: Inflammation of the epididymis, often caused by bacteria or sexually transmitted infections (STIs).
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Orchitis: Viral or bacterial inflammation of the testicles, frequently linked to the mumps virus.
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Sexually Transmitted Infections (STIs): Chlamydia and gonorrhea are two common culprits that cause redness, swelling, and pain in the testicles.
💡 Tip: If the pain is accompanied by fever, burning during urination, or urethral discharge, immediate medical attention is required.
2. Injuries: When Pain is Immediate
A direct impact on the testicles, such as during sports activities or an accident, can cause sudden, intense pain or prolonged tenderness.
🔍 Warning: If the pain persists or is accompanied by bruising, a medical evaluation is necessary to prevent serious complications.
3. Testicular Torsion: A Medical Emergency
One of the most severe causes of acute testicular pain is testicular torsion—an emergency condition in which the testicle twists around its own axis, cutting off blood supply.
⚠️ Symptoms Requiring Immediate Action:
✔️ Sudden, severe pain in one testicle.
✔️ Swelling and discoloration (typically bluish or purplish).
✔️ Nausea or vomiting.
🆘 Emergency surgery is required within six hours to save the testicle!
4. Varicocele: The Persistent, Nagging Pain
Varicocele is the enlargement of veins surrounding the testicle, similar to varicose veins in the legs.
🩺 Characteristic symptoms:
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A feeling of heaviness or mild aching pain.
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Increased discomfort after prolonged standing or exercise.
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In advanced stages, it may affect fertility due to increased testicular temperature.
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5. Hydrocele: When Fluid Causes Pressure
A hydrocele refers to the accumulation of fluid around the testicle, leading to swelling and discomfort.
🔍 Who is most at risk?
✔️ Newborns and infants (usually resolves on its own).
✔️ Adult men after injury or inflammation.
6. Testicular Cancer: A Rare but Critical Cause
Although testicular cancer is not often associated with pain, some patients may notice:
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A painless lump or nodule in the testicle.
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A feeling of heaviness in the scrotum.
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Unexplained swelling of the testicle.
⚠️ Important: Any change in texture or size of the testicles requires immediate medical evaluation!
🔍 Why is Early Diagnosis Important?
Testicular pain should never be ignored. From temporary conditions to medical emergencies, early diagnosis ensures the best possible treatment and prevents serious complications.
Signs and Symptoms of Orchialgia
When Should You Be Concerned?
Testicular pain can manifest in different ways, ranging from mild discomfort to severe pain that disrupts daily life. Recognizing the accompanying symptoms is crucial for timely diagnosis and effective treatment.
🩺 Most Common Symptoms of Orchialgia
✔ Acute or chronic pain in one or both testicles.
📌 Acute pain: Sudden, intense pain, often an indication of a medical emergency, such as testicular torsion.
📌 Chronic pain: May signal varicocele, hydrocele, or another condition that progresses gradually.
✔ Redness and swelling in the scrotal area.
📌 Typically indicates inflammation (orchitis, epididymitis) or trauma.
✔ Pain radiating to the lower abdomen or lower back.
📌 Some conditions, such as hernias or kidney stones, can cause referred pain in the testicles.
✔ Difficulty urinating or a burning sensation.
📌 May be associated with urinary tract infections (UTIs) or sexually transmitted infections (STIs).
✔ Presence of a lump or swelling in the testicle.
📌 A painless lump or asymmetry in the testicles could be a sign of testicular cancer and requires immediate medical evaluation.
✔ Nausea or vomiting (in severe cases).
📌 A common symptom of testicular torsion, a condition requiring urgent surgical intervention.
⚠ When to See a Urologist?
✅ If pain appears suddenly and is severe.
✅ If you notice changes in the shape, size, or texture of a testicle.
✅ If the pain is accompanied by fever, painful urination, or foul-smelling discharge.
✅ If pain persists for more than a week.
💡 Tip: Performing a self-exam once a month can help detect any abnormalities early.
Diagnosis of Orchialgia
How is the Cause of Testicular Pain Identified?
Diagnosing orchialgia is crucial for determining the underlying cause and providing prompt treatment. A systematic approach is followed by the doctor, using clinical examination, imaging techniques, and laboratory tests for an accurate diagnosis.
🩺 Steps in Diagnosing Orchialgia
🔎 1. Clinical Examination
The urologist conducts a physical examination of the area, assessing:
✔ Redness, swelling, or warmth in the scrotum.
✔ Pain upon palpation of the testicle or epididymis.
✔ Presence of lumps or hard nodules, which may indicate testicular cancer.
✔ Reflexes and testicular mobility, especially in suspected cases of testicular torsion.
💡 Tip: If pain is sudden and severe, testicular torsion is a medical emergency requiring immediate surgical intervention!
🛑 2. Testicular Ultrasound (Doppler U/S)
Ultrasound is the primary imaging method used for diagnosis, helping to detect:
✔ Testicular torsion (lack of blood flow).
✔ Hydrocele (fluid accumulation around the testicle).
✔ Varicocele (enlargement of veins).
✔ Inflammatory conditions, such as epididymitis or orchitis.
✔ Tumors or suspicious masses, which could be linked to testicular cancer.
📌 Why is it important? It is a non-invasive, painless, and highly accurate method that provides immediate results.
💉 3. Blood and Urine Tests
✔ Complete blood count (CBC) and inflammation markers (CRP, ESR): Help detect infections or systemic inflammation.
✔ Urinalysis: Identifies signs of urinary tract infection (UTI).
✔ Hormonal tests and tumor markers (AFP, β-hCG, LDH): Used in suspected cases of testicular cancer.
🦠 4. Urine Culture & STI Testing
✔ Urine culture & urethral swab: Detects bacteria causing urinary infections or sexually transmitted infections (STIs), such as gonorrhea and chlamydia.
✔ PCR or specific STI tests: Used if viral or bacterial infections, such as herpes, are suspected.
📌 Tip: If pain is accompanied by urethral discharge or burning sensation during urination, there is an increased likelihood of an STI.
🖥 5. MRI or CT Scan
In rare cases, if symptoms are complex or atypical, additional imaging may be required:
✔ Scrotal MRI: Provides a more detailed image in cases of testicular cancer or complications.
✔ Abdominal CT scan: Ordered if there is suspicion of widespread infection or metastasis.
📌 When is Urgent Evaluation of Orchialgia Necessary?
✅ Sudden and severe pain that does not subside.
✅ A hard, painless nodule in the testicle.
✅ Pain accompanied by fever, chills, or vomiting.
✅ Redness or swelling that worsens over time.
✅ Urinary issues or blood in semen.
⏳ Tip: Early diagnosis saves lives! If you experience persistent or sudden testicular pain, do not delay your visit to a urologist.
Treatment of Orchialgia
How is Testicular Pain Managed?
The treatment of orchialgia depends on its underlying cause, as each condition requires a different approach. In some cases, conservative management is sufficient, while others require urgent medical intervention.
🩺 Treatment Approaches Based on the Cause
1. Infections: Targeted Antibiotic & Antiviral Therapy
🔹 Antibiotics are prescribed for bacterial infections, such as:
✔ Epididymitis & Orchitis – The most common inflammatory conditions affecting the testicles.
✔ Sexually Transmitted Infections (STIs) – Treated with antibiotics such as doxycycline, azithromycin, or ceftriaxone, depending on the causative pathogen.
✔ Urinary Tract Infections (UTIs) – Managed with broad-spectrum antibiotics.
📌 Tip: Early treatment reduces the risk of complications, such as infertility.
2. Testicular Torsion: Emergency Surgical Intervention
⚠ Testicular torsion is a medical emergency requiring immediate surgery within 6 hours to save the testicle.
🔹 Orchiopexy (surgical fixation of the testicle) is performed to prevent future torsion.
📌 Important: Delayed diagnosis increases the risk of testicular necrosis, potentially leading to surgical removal.
3. Varicocele: Surgical Correction for Severe Cases
🔹 In most cases, varicocele is managed conservatively, but surgery is recommended if it causes:
✔ Chronic pain
✔ Reduced fertility
✔ Noticeable swelling
➡ Surgical treatment via microsurgical varicocele repair is advised for persistent symptoms.
4. Hydrocele: Aspiration or Surgical Treatment
🔹 A hydrocele may resolve on its own, but if it becomes large or uncomfortable:
✔ Aspiration is performed to remove excess fluid.
✔ Surgical removal is recommended for recurrent hydroceles.
5. Pain Relievers & Conservative Management
🔹 For non-emergency conditions, such as mild trauma or chronic discomfort, the following are recommended:
✔ Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (e.g., ibuprofen) to reduce pain and inflammation.
✔ Scrotal support with specialized underwear to minimize discomfort.
✔ Avoiding prolonged standing or heavy lifting, which may worsen varicocele symptoms.
✔ Applying ice packs for injuries to reduce swelling.
📌 Early Diagnosis Saves Lives
Prompt recognition of symptoms and immediate medical intervention can prevent complications such as:
✅ Permanent testicular damage (e.g., due to torsion or untreated infection).
✅ Reduced fertility caused by varicocele or inflammation.
✅ Infection spread affecting the urinary or reproductive system.
Prevention of Orchialgia
How to Protect Your Testicular Health
Preventing testicular pain is just as important as treating it, as some conditions can be avoided with simple lifestyle changes. From proper hygiene to early diagnosis through self-examination, maintaining male reproductive health starts with prevention.
🔹 1. Use Protective Gear During Sports
Direct trauma to the testicles can cause intense pain, bleeding, or even permanent damage. To avoid injuries:
✔ Wear an athletic cup (protective gear) during high-impact sports such as football, martial arts, or cycling.
✔ Choose well-fitted underwear that provides support and protection.
📌 Tip: Even minor injuries can lead to complications such as hematomas or chronic discomfort, making prevention essential.
🔹 2. Regular Testicular Self-Exams: A 5-Minute Practice That Can Save Lives
Performing self-exams can help detect changes such as lumps or abnormalities, which may indicate serious conditions like testicular cancer.
✔ How to Perform a Testicular Self-Exam:
📌 Conduct the exam once a month, preferably after a warm shower when the scrotum is relaxed.
📌 Use both hands to gently feel each testicle separately.
📌 Check for hard lumps, unusual swelling, or changes in size and texture.
📌 If you notice pain, swelling, or asymmetry, consult a urologist.
📌 Tip: 90% of testicular cancer cases are detected by the patient. Early diagnosis increases recovery rates to 95%.
🔹 3. Protection Against Sexually Transmitted Infections (STIs)
✔ Use condoms during every sexual encounter to prevent chlamydia, gonorrhea, herpes, and other STIs, which can cause epididymitis and orchitis.
✔ Avoid risky sexual behaviors that increase the risk of infection.
✔ Get regular STI screenings, especially if you have a new or multiple sexual partners.
📌 Tip: 50% of epididymitis cases are caused by STIs—prevention is easier than treatment!
🔹 4. Prompt Treatment of Urinary or Genital Infections
Urinary tract infections (UTIs) can lead to severe complications if left untreated. Reduce your risk by:
✔ Not delaying treatment for symptoms such as burning urination, blood in urine, or frequent urination.
✔ Drinking plenty of water to flush bacteria from the urinary system.
✔ Avoiding a sedentary lifestyle and prolonged use of tight underwear, which can worsen symptoms.
📌 Tip: If you experience fever, testicular pain, and foul-smelling urine, it’s likely a bacterial infection requiring immediate antibiotic treatment.
🔹 5. Regular Medical Checkups for Prevention & Early Detection
✔ Annual urological checkups for early detection of testicular conditions.
✔ If you have a history of varicocele, infertility, or chronic testicular pain, more frequent monitoring is required.
✔ PSA tests & urinalysis for men over 40 years old, especially if there are symptoms of urological disorders.
📌 Tip: Prevention is the key to male health. Routine checkups prevent complications that could have serious long-term effects.
Frequently Asked Questions (FAQ) About Orchialgia
🔹 Is testicular pain always serious?
No, in many cases, it may result from minor and temporary causes, such as a small injury or prolonged sitting. However, if the pain persists, worsens, or is accompanied by other symptoms, it could indicate a more serious issue like an infection or testicular torsion, which requires immediate medical attention.
🔹 When should I see a doctor?
An urgent visit to a urologist is recommended if:
✔ The pain is sudden, intense, and does not subside.
✔ There is swelling, redness, or hardness in the testicle.
✔ The pain radiates to the lower abdomen or back.
✔ There are accompanying symptoms such as fever, nausea, or difficulty urinating.
✔ The pain persists for more than 1-2 days, even if it is mild.
🔹 How can I reduce the risk of infections?
Proper hygiene and safe sexual practices are essential. Preventive measures include:
✔ Daily washing of the genital area with mild soap.
✔ Using condoms in every sexual encounter to prevent STIs.
✔ Avoiding prolonged moisture exposure or tight underwear, which can create a favorable environment for infections.
✔ Regular checkups and prompt treatment of urinary infections and inflammation.
🔹 What is the role of testicular self-examination?
Self-examination is a simple but vital preventive practice. It helps in the early detection of changes such as:
✔ Lumps or hard masses.
✔ Asymmetry or changes in testicular size.
✔ Pain or a feeling of heaviness in the scrotum.
📌 Tip: Self-examination is recommended once a month, ideally after a warm shower when the scrotum is relaxed.
🔹 Can orchialgia affect fertility?
In chronic or severe cases, orchialgia may impact fertility, especially if caused by varicocele, infections, trauma, or testicular torsion. Early diagnosis and treatment are critical for maintaining reproductive health.
📌 Conclusion: Do not ignore testicular pain. If you experience persistent or intense discomfort, consult a urologist for early diagnosis and proper management. 🚑
Θεραπεία των Πέτρων στα Νεφρά (Νεφρολιθίαση)
Η θεραπεία για τις πέτρες στα νεφρά εξαρτάται από το μέγεθος, τη θέση, τη χημική σύσταση της πέτρας, τα συμπτώματα του ασθενούς και τυχόν επιπλοκές που έχουν προκύψει. Στόχος της θεραπείας είναι η απομάκρυνση της πέτρας, η ανακούφιση των συμπτωμάτων και η πρόληψη υποτροπών.
1. Συντηρητική Θεραπεία
Αναμονή και Αυθόρμητη Αποβολή
- Μικρές πέτρες (διάμετρος έως 5-6 χιλιοστά) συχνά αποβάλλονται μόνες τους μέσω των ούρων.
- Συνιστάται:
- Αυξημένη κατανάλωση υγρών για την προώθηση της πέτρας μέσω του ουροποιητικού.
- Αναλγητικά φάρμακα (π.χ. ιβουπροφαίνη) για την ανακούφιση του πόνου.
- Φάρμακα για τη χαλάρωση του ουρητήρα (π.χ. α-αδρενεργικοί ανταγωνιστές) για τη διευκόλυνση της αποβολής.
Διατροφική Αλλαγή και Φαρμακευτική Θεραπεία
- Εξατομικευμένη δίαιτα με περιορισμό τροφών που συμβάλλουν στο σχηματισμό λίθων, όπως οξαλικά (σπανάκι, παντζάρια), ζωικές πρωτεΐνες και αλάτι.
- Φαρμακευτική αγωγή για τη μείωση της δημιουργίας λίθων, ανάλογα με τη χημική σύστασή τους:
- Διουρητικά θειαζιδικά για λίθους ασβεστίου.
- Αλλοπουρινόλη για λίθους ουρικού οξέος.
- Κιτρικά άλατα για την αύξηση των επιπέδων κιτρικών στα ούρα.
2. Επεμβατικές Θεραπείες
Όταν οι πέτρες δεν αποβάλλονται φυσικά ή προκαλούν σοβαρά συμπτώματα ή επιπλοκές, μπορεί να απαιτηθεί επεμβατική αντιμετώπιση:
Λιθοτριψία με Κρουστικά Κύματα (ESWL)
- Μη επεμβατική μέθοδος που χρησιμοποιεί κρουστικά κύματα για τη διάσπαση της πέτρας σε μικρότερα κομμάτια, τα οποία αποβάλλονται μέσω των ούρων.
- Ιδανική για πέτρες μικρού ή μεσαίου μεγέθους.
- Μπορεί να προκαλέσει παροδικό πόνο ή αιματουρία.
Ενδοσκοπική Λιθοτριψία (URS)
- Μέσω ενός λεπτού ενδοσκοπίου, η πέτρα εντοπίζεται και αφαιρείται ή διασπάται με laser.
- Ιδανική για πέτρες στον ουρητήρα ή στην ουροδόχο κύστη.
Διαδερμική Νεφρολιθοτριψία (PCNL)
- Χρησιμοποιείται για μεγάλες ή πολύπλοκες πέτρες στους νεφρούς.
- Πραγματοποιείται μέσω μικρής τομής στο δέρμα, με τη χρήση ειδικών εργαλείων για τη διάσπαση και αφαίρεση της πέτρας.
Λαπαροσκοπική Χειρουργική
- Σπάνια απαιτείται και συνήθως επιλέγεται σε περιπτώσεις πολύ μεγάλων λίθων ή ανατομικών ανωμαλιών του ουροποιητικού συστήματος.
3. Θεραπεία Επιπλοκών
- Τοποθέτηση ουρητηρικού καθετήρα (Pig-tail) για την ανακούφιση της απόφραξης.
- Αντιβιοτική αγωγή σε περίπτωση λοίμωξης του ουροποιητικού συστήματος.
4. Πρόληψη Υποτροπών
Μετά την απομάκρυνση της πέτρας, είναι σημαντικό να υιοθετηθούν μέτρα πρόληψης:
- Αυξημένη κατανάλωση νερού για τη διατήρηση αραιών ούρων.
- Διατροφικές τροποποιήσεις με τη βοήθεια διαιτολόγου ή ειδικού.
- Τακτική παρακολούθηση με απεικονιστικές και εργαστηριακές εξετάσεις για την έγκαιρη ανίχνευση νέων λίθων.
Η σωστή θεραπεία της νεφρολιθίασης εξαρτάται από την έγκαιρη διάγνωση και την εξατομικευμένη προσέγγιση, ώστε να επιτευχθεί η μέγιστη ανακούφιση και πρόληψη των υποτροπών.