Testicular Pain (cont.)
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Testicular Pain Medical Treatment
The medical treatment and/or surgical treatment required for testicular pain depends entirely upon the underlying cause:
Trauma: After careful evaluation, if no serious underlying testicular injury has been identified, most cases of testicular trauma can be managed and treated at home. Treatment consists of the following measures:
More severe cases of testicular trauma such as testicular rupture, blunt trauma with an associated hematocele (a collection of blood) and penetrating traumatic injuries to the testicle often require surgical intervention.
Testicular torsion: This condition requires immediate surgery by a urologist (specialist in genital and urinary organs). Prior to surgery, a doctor may attempt to untwist the testicle manually to relieve the problem temporarily, though definitive surgery will ultimately still be required. Surgery will consist of untwisting the affected testicle, assessing its viability, and finally securing the testicle to the scrotal wall (orchiopexy) to prevent subsequent episodes of torsion. The other testicle also is often secured to the scrotal wall in order to prevent testicular torsion of that testicle.
Epididymitis: The treatment for this condition is generally managed on an outpatient basis, although patients with severe cases of epididymitis accompanied by complications may require hospitalization. Generally speaking, treatment consists of the following:
Rarely, individuals with epididymitis may develop a complication requiring surgical management, such as a scrotal abscess. Also, some cases of chronic epididymitis refractory to the above measures may require the administration of nerve blocks for pain control, or rarely surgical removal of the epididymis (epididymectomy). Patient's should work with their urologists in regard to their particular medical situation.
Torsion of a testicular appendage: The treatment for this self-limiting condition primarily consists of pain control with anti-inflammatory medication, scrotal support and elevation, and ice packs. The pain should generally go away within about one week.
Inguinal hernia: The definitive treatment for inguinal hernias requires surgery, which is generally accomplished electively as an outpatient. However, individuals with inguinal hernias that cannot be pushed back in (incarcerated hernia) require emergent surgical management.
Orchitis: The treatment measures for orchitis include pain medication, ice packs, scrotal support and rest. Antibiotics are reserved only for those cases of bacterial orchitis (not viral orchitis). Rarely, a complication from orchitis (such as an abscess) may require surgical drainage.
Testicular tumor: A testicular mass requires prompt evaluation by a urologist in order to establish a definitive diagnosis. If the patient has testicular cancer, he will be referred to a specialist for further treatment options.
Kidney stone: The treatment for an uncomplicated kidney stone generally involves pain medication, anti-nausea medication, and medication that facilitates the passage of the kidney stone (for example, tamsulosin [Flomax]). If the kidney stone is complicated by an infection, emergent urologic consultation is required.
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