What causes testicular and lower abdominal pain?

If the testicles and lower abdomen are swollen, men need to pay attention to which reproductive diseases are causing it, such as common orchitis, sprains, and testicular injuries. These problems may cause bloating and pain in the testicles or lower abdomen.

1. Orchitis

Orchitis is a common cause of testicular pain. There are many causes of orchitis, such as patients with mumps may suffer from orchitis, testicular pain and swelling; gonorrhea; gonorrhea is the most common sexually transmitted disease, and in severe cases it can cause orchitis, testicular pain and swelling; chronic prostatitis can also cause testicular pain, which manifests as unilateral pain, mostly dull pain or pulling pain, which is persistent. Microscopic examination of prostatic fluid can reveal a large number of white blood cells. Most patients are young and strong, and it is rare in the elderly.

2. Testicular torsion

Testicular torsion is one of the common acute diseases in the scrotum. It can occur in newborns to 70-year-olds, and 65% occur between 12 and 19 years old. Generally, there is vigorous activity a few hours before the onset of the disease, or the testicles have been subjected to external force. Severe testicular pain occurs suddenly during sleep or quiet time. This is the first symptom of this disease and one of its main diagnostic bases. Some patients are accompanied by nausea and vomiting, scrotal swelling, and obvious tenderness. For patients who suspect or cannot rule out testicular torsion, surgical exploration and reduction and fixation should be performed as soon as possible to save the testicles and protect spermatogenesis. It is generally believed that the testicular rescue rate can reach 80% for those who undergo testicular torsion within 6 hours, but only 20% for those who undergo treatment after 24 hours. Even if the testicle can be preserved, the function of the affected testicle is often damaged.

3. Testicular damage

The testicles are more mobile in the scrotum and are protected by a tough white membrane, so the chance of closure injury is relatively small. Testicular injuries are mostly related to violence, car accidents, etc. After injury, the testicles are severely painful, nausea, vomiting, and even fainting or shock. During physical examination, there are swollen testicles, unclear contours or scrotal congestion, and obvious tenderness. B-ultrasound and CT are not only helpful for the diagnosis of this disease, but also can clarify the location and range of testicular injury. The treatment principle of testicular injury is first sedation, analgesia, and anti-shock. Secondly, the degree of testicular injury is determined based on physical examination, B-ultrasound or CT findings and the measured testosterone, LH, and FSH values, so that different treatment measures can be taken. Minor injuries can be treated conservatively, and severe injuries should be treated with surgical exploration within 24 hours. For those with low sex hormone levels after testicular trauma, male hormone supplementation or allogeneic testicular transplantation can be used to maintain their male characteristics and improve their sexual function.

4. Testicular ischemic pain

Testicular ischemic pain is more common in the elderly. The pain is more severe, aggravated by activity, and relieved by rest. Prostatic fluid microscopy is normal. It is often caused by sclerosis of the testicular artery, which leads to stenosis of the artery. Testicular artery atherosclerosis is often a local manifestation of systemic vascular disease. It is usually unilateral and more common on the left side than on the right side. The main basis for diagnosis of this disease is: (1) age; (2) progressive aggravation of unilateral testicular pain; (3) color Doppler showing insufficient blood supply to the affected testis. There is no effective treatment method yet. Vasodilators, enteric aspirin and calcium channel blockers can be used. For patients with severe pain and who are ineffective with the above treatments, orchiectomy on the affected side can be considered.