Causes of Scrotal Pain
Scrotal pain, both acute and chronic, is a difficult medical issue because a diagnosis is not always certain. Subclinical symptoms may occur in cases of chronic scrotal discomfort. This means that, except from chronic pain, there are usually no other observable indications and symptoms. Prostatic surgery is one of the leading causes of persistent discomfort (Srinath, 2013). More than 15% of men who have had a vasectomy have post-vasectomy pain. Pain, which is frequently felt during intercourse and ejaculation, is one of the symptoms, as is epididymal pain. NSAIDs can be used to relieve the pain, and epididymectomy may be considered if the epididymis is painful (Gordhan & Sadeqhi-Nejad, 2015). The reversal of the vasectomy can also be used to treat post-vasectomy pain.
Testicular Torsion
Testicular torsion is another leading cause of scrotal pain. The main symptom is sudden and intense scrotal pain. This can be accompanied by nausea and vomiting. In some cases, the patients may have a history of scrotal pain. A physical examination will show that the testis is 'high-riding' and in a transverse position (Gordhan & Sadeqhi-Nejad, 2015). Cremasteric reflex is often absent in people with testicular torsion. Treatment involves immediate surgery often involving detorsion, exploration, and orchidopexy. This helps to prevent the loss of the affected testis.
Epididymitis
The most widespread cause of scrotal pain, particularly adults, is epididymitis. This is differentiated from testicular torsion as it is caused by an infection which leads to epididymal inflammation. This is often observed amongst sexually active men, who are prone to infections from Chlamydia and Gonorrhea, and older men who have undergone genitourinary surgery. Symptoms include scrotal pain, swollen and tender epididymis. A diagnosis is made through physical examination and urinalysis to determine the bacteria causing the infection. To treat it, antibiotics are administered if the urine culture confirms the presence of bacteria (Srinath, 2013). If the problem involves abnormalities, then surgery is the best option (Gordhan & Sadeqhi-Nejad, 2015).
References
Gordhan, C. & Sadeqhi-Nejad, H. (2015). Scrotal pain: Evaluation and management. Korean J Urol, 56(1), 3-11.
Srinath, H. (2013). Acute scrotal pain. Australian Family Physician, 42(11), 790-2.
