Brief Answer:
Infection or spermatocele can be the cause- details below on further steps to diagnosis and treatment

Detailed Answer:
Hello,

Thank you for asking at "Ask a Doctor" service. I carefully read your query.

Because the pain in the testicle is not settled and you also notice a lump in the area it is good to see your doctor and have an ultrasound done and also tests for chlamydia, gonorrhea and trichomonas which are sexually transmitted infections.
Testicular infections, especially in young age are very likely related to sexually transmitted infection (STI) and sometimes sexually transmitted infections tend to relapse, especially due to the risk of re-exposure. Generally when treating for potential sexually transmitted infections it is recommended to treat the patient and the sexual partners to better reduce chance of recurrence and another check in 3 months to rule out recurrence is needed.

So to conclude I would say:
- it is safer for you to see your doctor and have an ultrasound done and also urethral samples for chlamydia, gonorrhea (NAAT test is the most sensitive and specific one for these two) and trichomonas.
- You can be treated empirically for these infections but it is best practice to have tests done to confirm the infection.
- If STI is found you will need treatment for it, your sexual partners as well and in 3 months after treatment you will need to repeat the tests to rule out recurrence (sometimes STI might recur and not cause much symptoms)
- if the tests do not show STI this does not rule them out 100% and the doctor might still choose to treat you for STI but there is no point of repeating the tests in 3 months if they were negative in the first place.
- If the doctor is convinced you do not have STI (physical findings and no high risk sexual behaviors) then the spermatocele (a cyst in the epididimus) might be considered as the cause of the pain (which is very rare, especially if the spermatocele is small). In this case the doctor will decide if surgery is needed to remove it but most of the time there is no need for surgery as it is not a dangerous diagnosis, is self limiting and does not cause much discomfort.

I hope I have answered your query. Let me know if I can assist you further.

Regards,
Antoneta Zotaj,
General & Family Physician

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Brief Answer:
Thanks for reverting back

Detailed Answer:
Hello,

Its a pleasure to assist.

The visit with the doctor and findings in examination and the ultrasound will lead to better understanding of the needed for further steps in diagnosis and treatment.

I wish you good health.


Regards,
Antoneta Zotaj,
General & Family Physician

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Brief Answer:
Varicocele does not change size quickly and would feel like a bag of worms

Detailed Answer:
Hello,

A varicocele feels like a bag of warms and does not change so quickly in size. Hydrocelle is a collection of fluid between layers that surround the testicle and this is more likely to change quickly is size.

The examination that the doctor will perfom and the ultrasound examination will better determine the cause of the lump.

I hope this answers your query. Let me know if I can assist you further.

Regards,
Antoneta Zotaj, General and Family Physician

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