I'm 23 years old and have had an on-and-off dull ache in my
right testicle. I'm concerned because this seems so be one of
the signs of testicular cancer. I've done numerous self-exams,
but have found nothing out of the ordinary. I have not had it
looked at yet, but I was hoping someone could give me a rough
opinion to possibly put my mind at ease.
I had a similar pain when going through puberty a number of years
ago. It went away after a couple of weeks and has been sporadic
ever since. I don't believe I had an undescended testicle, but my
right one can "slide" up and down when I tighten my abdominal muscles.
I have no idea if this is normal or not.
Thanks very much for any advice.
Testicular pain can be due to the testicle itself, its surrounding structures, or referred from another area. A dull ache in the scrotal area may be due to infection, dilated veins which drain the testicle (varicoceles) or cancer. Cancer is usually a painless mass, but it may present as a dull aching pain. The pain may also be due to disease processes which affect structures adjacent to the testicle, for instance, the epididymitis or testicular appendages--remnants of tissue on the testicle. A testicular appendage can intermittently twist on its blood supply and cause pain. Classically this is seen as a blue dot through the scrotum. Sometimes a kidney stone can cause pain which spreads to the groin as well.
To determine if the mass is inside the testicle, a physical exam and an ultrasound of the scrotum should be performed. A patient with a solid, firm, intra-testicular mass is testicular cancer until proven otherwise. The cancer is usually painless. It most commonly affects 20-40 year old men. Whites are affected 3 X more than blacks. Risk factors include prior testicular tumor and cryptorchidism (undescended testis). It does not sound like you have testicular cancer, but you are in the age group. You have not felt anything abnormal but you should continue monthly self testicular examination.
With respect to your testicle being pulled into the abdomen with contraction of your abdominal muscles, this is called the cremasteric reflex. When the abdominal wall muscles contract, the testis will be pulled higher into the scrotum. This reflex usually goes away before puberty, but it is not uncommon for it to persist longer.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians' notes and lab test results that you may be able to obtain. These will help us greatly.
HFHS JHL M.D.
*Keyword: testicular cancer/pain
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