Testicular problems
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Definition
Problems with the testicles (referred to as "balls" herein).
Epidemiology
Generally quite common, but rather rare in women.
Pathophysiology
Two main types of problem:
- Pain - hurting balls.
- Swelling - massive balls.
Clinical and Associated Features
Medical Emergency - Testicular torsion is a surgical emergency! It needs prompt treatment, and usually the ball in question can be saved.
Testicular torsion usually presents with sudden, severe one sided testicular pain, with sudden testicular swelling. Sometimes the testicular pain can present as generalised abdominal pain, or even just as indigestion.
A doppler ultrasound will show if the blood supply has arrested.
Other causes
There are a variety of other causes. The commonest problems are scrotal or testicular swelling, or pain. You can also get reddening.
Differential Diagnosis
- Tortion of the testis
- Incompletely descended testis - can cause a swelling in the affected ball. Predisposes you to...
- Testicular tumours - two main types - Teratoma, fast, aggressive, responds well to treatment. Seminoma, slow, less aggressive, responds less well to treatment.
- Hydrocoele - congenital, infective or caused by cancer.
- Varicoele - commoner on left side, due to vein draining to higher pressure renal vein (see picture on testis page.
- Hernias - especially inguinal can cause scrotal swelling.
- Epididymal cyst - common in cystic fibrosis (where congenital absence of the vas deferens occurs in 99%).
- Epididymo-orchitis - inflammation of the epididymis or the ball, with bacterial or viral infection.
- Referred pain - for example from renal colic.