Q. I have dull testicular pain on standing with enlarged veins. Please help.

Answered by
Dr. Ankush Jairath
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 18, 2020

Hello doctor,

My left testicle has a dull ache when I stand for a period of time. I can also see an enlarged vein on my testicle. It goes away when I sit or lay down for a little bit. I will attach a picture of the vein.



Welcome to icliniq.com.

I think it is a hernia. Kindly give some other details. Do it have cough impulse (it means the swelling expands upon coughing, it is said to have a cough impulse). Can you get over the swelling? (this means when swelling is there are you able to pinch your spermatic cord?) ignore if you are not able to understand. Do you do weight lifting? Diabetes or hypertension? Any medication?

Thank you doctor,

I do not notice it to have cough impulse. Do you want me to try and pinch my spermatic cord? Or just asking if I could. I am attaching a better picture, I could definitely pinch my spermatic cord. I have not lifted weights in probably three or four weeks. I do not have diabetes or hypertension and I do not take any medication.



Welcome back to icliniq.com.

My differential is between three things.

1. Inguinal hernia (cough impulse + cannot get over the swelling).

2. Varicocele (worm-like feeling in the scrotum, gives a vague feeling of heaviness, increases in size on prolong standing, decreases on lying down but cough impulse is absent but you can go over the swelling).

3. Epididymo-orchitis (painful) - I do not think you have this as you do not mention pain in your complaints.

So if I have to recommend a single test to rule out above things then it will be ultrasound scrotum and Doppler sos. Clinically, I would say it as varicocele (tortuous veins I can see).

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