[30M] Experiencing sudden, sharp pelvic and testicular pain

Patient Description

A 30-year-old male presents with sudden onset of sharp pelvic pain, rated 8 out of 10 in severity, occurring on and off for a few months. The pain is primarily on the right side but also extends to the left side and is exacerbated by coughing, laughing, and changes in position. The patient also reports significant tenderness and swelling of the testicles, without any accompanying nausea, vomiting, fever, or urinary symptoms. There is no past medical history of similar symptoms, testicular torsion, chronic illnesses, or known allergies. The patient is sexually active, with recent unprotected intercourse, and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Testicular Torsion: This is a medical emergency that occurs when the spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted. This cuts off the testicle's blood supply and causes sudden, severe pain and swelling.

    • Treatment for testicular torsion is surgery to untwist the cord and possibly to attach both testicles to the inside of the scrotum to prevent future torsion.

  • Epididymitis: This is inflammation of the epididymis, the coiled tube at the back of the testicle that stores and carries sperm. Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia.

    • Treatment for epididymitis involves antibiotics. If an STI is the cause, your sexual partner also needs treatment.

  • Orchitis: This is an inflammation of one or both testicles, usually caused by an infection. Orchitis can be caused by many types of bacteria and viruses. One of the most common viruses that causes orchitis is mumps.

    • Treatment for orchitis involves antibiotics or antivirals, depending on the cause.

  • Inguinal Hernia: This occurs when part of your intestine pushes through a weak spot in the abdominal wall. The hernia can create a visible lump and cause pain in the groin area, which can worsen when you cough, bend over, or lift something heavy.

    • Treatment for an inguinal hernia usually involves surgery to repair the opening in the muscle wall.

What you can do

Given the severity of your symptoms, it's important to seek immediate medical attention. These conditions can worsen if not treated promptly. In the case of testicular torsion, prompt treatment can prevent loss of the testicle.

What you should look out for

Seek immediate medical attention if:

  • Your pain becomes unbearable
  • You develop a high fever
  • You experience nausea or vomiting
  • You notice blood in your urine
  • The swelling in your scrotum worsens

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago

People Also Ask

What are the symptoms of testicular torsion and why is it considered a medical emergency?

Testicular torsion symptoms include sudden, severe pain in the scrotum, swelling, and sometimes nausea and vomiting. It is a medical emergency because it cuts off blood supply to the testicle, which can lead to permanent damage or loss of the testicle if not treated promptly.

How is epididymitis diagnosed and treated, especially if it's caused by an STI?

Epididymitis is diagnosed through physical examination, urine tests, and sometimes ultrasound. Treatment typically involves antibiotics, and if caused by an STI, both the patient and their sexual partner need treatment to prevent reinfection.

What are the common causes of orchitis and how is it treated?

Orchitis is often caused by bacterial infections or viruses like mumps. Treatment depends on the cause and may include antibiotics for bacterial infections or supportive care for viral infections, such as pain relief and rest.

What are the signs of an inguinal hernia and when should one seek medical attention?

An inguinal hernia may present as a visible bulge in the groin area, accompanied by pain that worsens with activities like coughing or lifting. Medical attention is needed if the hernia becomes painful, enlarges, or if there are symptoms of bowel obstruction.

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2 Comments

Leo#3962

9 mo ago

Sounds like inguinal hernia or testicular torsion. Definitely get checked out by a doctor because this often needs to be resolved with a surgery. Waiting too long could lead to complications.

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Brian#4030

9 mo ago

Do you have any masses in the area that you can move or push back inside? That'd be suggestive of a hernia.

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