Can varicocele or hydrocele cause dull testicular pain?

Question

Hello doctor,

I have been dealing with a dull pain in my right testicle on and off for the last two weeks. It has been less lately, but occasionally if I sit in a certain position or make a certain movement it comes back. I have also noticed visible veins in it but no ‘bag of worm’ feeling, and occasionally it looks a little bigger than the left one. I was using a penis pump for a few months and not sure if that is what caused it. Can this be a varicocele, a hydrocele, or something else completely? Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Please help me with a few details so that I understand the situation better:

Are you diabetic or hypertensive?
Have you undergone any surgeries in the past?
Do you have any trouble passing urine such as increased frequency, urgency, the feeling of incomplete bladder emptying, or straining to pass urine?
Do you have any trouble when you ejaculate such as pain or discomfort?
What does your daily routine involve? Are you standing up for most of the day or sitting down?
Are you sexually active or masturbating regularly?
Do you regularly pick up heavyweights at the gymnasium or work?
Have you tried any medication for this?
Have you got any tests done for this?

The vein that is visible in the picture (attachment hidden to protect the identity of the patient) is not a varicocele, however, it is difficult for me to say what is going on inside without you getting an ultrasound as this could be anything from a hernia, varicocele or hydrocele.

Please revert with the details. I will do my best to assist you

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Thank you for reverting to the details.

I see this to be one of three possibilities: Prostatitis, a small hernia, and a varicocele (least probable). You will need some tests and treatment, and you will also need to follow a set of instructions. The tests that need to be done (because without these tests we cannot have a confirmatory diagnosis):

Ultrasound KUB (kidneys, ureters, and urinary bladder).
Ultrasound groin (with Doppler).
Urine routine and microscopy.
Semen culture and sensitivity.
Uroflowmetry with post-void residual.

The advice that you need to follow:

Avoid prolonged sitting, get up every one to one and a half hours for a couple of minutes, and give your perineal area some rest.
Drink at least 0.7 gallons of water a day.
Masturbate or have sexual activity at least two to three times a week.
Wear slightly smaller underwear than you normally do (at least for a couple of weeks), so that the testicles remain slightly elevated.
Avoid heavy weightlifting until it is established that this is not a hernia.

I would also like to prescribe you some medication but that depends on your country of residence as you may need your local general practitioner’s prescription to get the medication. Where are you currently living? I will have to check if these medications are available in your country. The first thing you should do is to get the tests so that we know exactly what we are dealing with.

I hope this helps.

Thank you.