What kind of diseases are these?
The epididymis is a small organ adjacent to the testicle in which sperm mature and accumulate. The infection most often enters it through the ascending route - from the urethra, prostate or bladder. Therefore, epididymitis usually develops first, and then inflammation can spread to the testicle itself.
Isolated orchitis is less common and is typical of viral infections, primarily mumps, in which the virus directly attacks the testicular tissue.
Symptoms
- Pain in the scrotum, usually on one side, increasing over several hours or days
- Swelling and enlargement of half of the scrotum
- Redness and increased local skin temperature
- Consolidation and sharp pain of the appendage when palpated
- Fever, chills, weakness
- Increased pain with walking and physical activity
- Discharge from the urethra, pain when urinating with concomitant urethritis
- Frequent urination
- Sometimes - decreased pain when lifting the scrotum
Testicular torsion: why you can’t wait
Testicular torsion is a condition in which the spermatic cord becomes twisted and the blood supply to the organ is cut off. Without restoration of blood flow within a few hours, the testicle dies.
- Characterized by sudden onset: pain occurs within minutes, often at night or after exercise
- More common in teenagers and young men
- The testicle can be pulled up and positioned horizontally
- Often accompanied by nausea and vomiting
- The temperature is usually normal in the first hours
- Urination is usually not impaired
The key study is ultrasound of the scrotum with Doppler sonography: with torsion, blood flow in the testicle is absent or sharply reduced, with inflammation it is increased. If in doubt, surgical revision is performed, since the cost of error is organ loss.
Reasons
- Sexually transmitted infections: chlamydia, gonococcus - typical for young men
- Intestinal flora from the urinary tract - more common in older men with prostate adenoma or after catheterization
- Prostatitis and urethritis
- Mumps is the main cause of isolated viral orchitis
- Tuberculosis of the genitourinary system
- Scrotal injuries
- Bladder catheterization and endoscopic operations
- Physical activity with straining when the bladder is full
- Taking certain medications
Diagnostics
- Examination by a urologist to assess the position and pain of the testicle
- Ultrasound of the scrotum with Doppler ultrasound is a mandatory and decisive study
- Urinalysis and urine culture
- Urethral swab and PCR for sexually transmitted infections
- General blood test
- Ultrasound of the prostate and bladder with determination of residual urine in older men
- Examination for chronic tuberculosis
- Spermogram after recovery when planning pregnancy
Treatment
- Antibacterial therapy, selected taking into account the most likely pathogen and test results; in young men, the scheme is focused on STIs, in older men - on intestinal flora
- Bed rest in the acute period
- Elevating the scrotum and wearing supportive underwear
- Local cold on the first day
- Painkillers and anti-inflammatory drugs
- Drink plenty of fluids
- Treatment of a sexual partner with an identified STI
- Hospitalization for severe disease, high fever, suspected abscess
- Opening and draining an abscess during its formation
- Surgery for torsion or gangrene
- Elimination of the cause: treatment of prostatitis, prostate adenoma, urethral stricture
Consequences and prevention
- Chronic epididymitis with long-term discomfort
- Abscess of the testicle or epididymis
- Testicular atrophy - especially after viral orchitis with mumps
- Impairment of the vas deferens and decreased fertility
- Hydrocele formation
- Prevention: vaccination against mumps in childhood
- Condom use and timely treatment of STIs
- Treatment of diseases that impair the flow of urine
- Avoiding prolonged catheterization unless necessary
- Immediate treatment for any acute pain in the scrotum
Where to get examined for pain in the scrotum in Tashkent
In case of acute pain in the scrotum, an urgent examination by a urologist and an ultrasound with Doppler sonography are needed - they allow one to distinguish inflammation from testicular torsion.
In Tashkent, such care, including inpatient treatment for complicated cases, is available at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
Do not try to wait out acute pain in the testicle at home and do not take painkillers “until the morning”: with torsion, the hours count, and delay means loss of the organ. Clinic contacts are below.
