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Pain in groin and scrotum, heaviness, feeling of full bladder, slow urination. Reason for discomfort?

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Practicing since : 2010
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I am having mild pain in my groin and scrotum area since one week. The pain gives a feeling of heavyness and full bladder. The pain is slightly lesser in loose boxers. I can also feel some swelling around both the testes, some lump like formation. The area becomes sensitive to touch when the sac is loose. Urination is slow, but it has been that way since a few years now. I am 40 years old. What could be the reason for this discomfort, and probable way forward?
Posted Fri, 5 Oct 2012 in Abdominal Pain
Answered by Dr. Muhammad Ishfaq Habib 2 hours later
Thanks for the query
The problem you have mentioned seems to be inguinal hernia along with hydrocele/spermatocele. However it is difficult to confirm it without any visible evidence. i would request you for some information like does the swelling increase on standing or coughing? place a hand on the swelling and then cough. try to feel any pulsation in the swelling. Also i will recommend you and Ultrasound which will reveal the definite diagnose in case of inguinal hernia.
will be waiting for your response
feel free for any further queries
Above answer was peer-reviewed by
Follow-up: Pain in groin and scrotum, heaviness, feeling of full bladder, slow urination. Reason for discomfort? 1 hour later

Thanks for your response.

You have suggested inguinal hernia. Further reading upon it, this is probably not likely as there is no external swelling anywhere except some small lump-like swelling on the edges of the testes. Neither does this swelling increase on standing / coughing or feel any different any other time.

Hydrocele is out of question as the scrotal sac is not enlarged or full of any fluid.

Your inference on Spermatocele sounds probable. Further investigation and Ultra-sonography would certainly be my next step with a consult from a urologist.

Also, could it be either hydronephrosis or varicocele? All of these have very similar symptoms and give the feeling of heaviness which I am having at the moment.

Will await your views on this.
Answered by Dr. Muhammad Ishfaq Habib 9 hours later
Thanks for the reply
Inguinal hernia have different sub-types so its not necessary to increase with standing or coughing or having pain. also along with the inguinal hernia there is compression of spermatic cord causing symptoms in the testes.
Hydrocele cannot be excluded as you just have developed the symptoms for last one week so with it may develop. so its out of exclusion
Along with the spermatocele there are also chances of epidimo-orchitis as its having swelling and touch sensitivity.
hydronephrosis do not present with such symptoms and vericocele presents with dilated vein and painless swelling, also it more commonly presents in the left scrotum
The above are the certain differential diagnosis that can be made. Provisional diagnosis can be made with detailed clinical examination and investigations to reach the definite diagnosis. so, again it is recommended to have an Ultrasound of inguinal and scrotal region to reach the diagnosis
Above answer was peer-reviewed by
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