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Having discomfort in scrotum. Uncomfortable if the underwear is tight. Dull pain. What can this be?

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I have been having discomfort in my scrotum, more so in my left testicle. If my underwear is too tight this affects it. It's sort of a dull pain.
Posted Sat, 9 Nov 2013 in Testicle Problems
Answered by Dr. Manuel C See IV 35 minutes later
Brief Answer:
Suggest doing an ultrasound of the testis.

Detailed Answer:
Good Day and thank you for being with health care magic!

Testicular pain means pain felt inside the scrotum and not in the skin itself. For a 59 year old male my primary consideration would be in the order of occurence hernia, infection and inflammation, testicular mass, and varicocoele. It is very important to have a scrotal ultrasound with Doppler studies to be sure that there is nothing serious happening inside the scrotum and to rule out dreaded diseases of the testis like tumors.

Hernia is also a possibility due to your age and usually presents with dull pain. Often you may feel a small lump in the groin area or in the scrotum but is often missed if the hernia is still small and just beginning. An ultrasound and a physical examination by a medical specialist can surely not miss this. Treatment with hernia is primarily surgery to close down the abnormal defect in the abdominal wall.

Infection and inflammation often goes hand in hand and caused by Sometimes the infection is not so evident in the urine (causing no or little symptom ) but the bacteria may go into the testis causing swelling and pain. I would also suggest doing a urinalysis to check on this. Treatment will be pain relievers and will help bringing down the inflammation and proper antibiotics if infection is documented.

Testicular masses is not very common but is one of the dreaded diseases that should be properly ruled out. We can do this properly by doing the ultrasound because small masses may be missed by palpating alone.

Varicocoele is a condition where in there is abnormal dilation of the spermatic vein and is one of the usual causes of pain felt in the testis. It is usually dull in character and can be seen as a bag of worms near the testis. Diagnosis is by scrotal ultrasound with Doppler and treatment is ligation the veins to decrease pressure and regulate testicular temperature.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.
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