Believe it or not, your testicles do more than just keep your hands warm on a cold winter’s day. Aside from secreting somewhere around 95% of your testosterone, the testicles are actually little assembly lines of sperm production. Your little swimmers are put together in the testicle itself, packaged up in the epididymis (the “squishy thing” you feel behind your testicle.) Then they are shipped out through the vas deferens (the “tubey thing” you feel above your testicle), mix with seminal and prostatic fluid and jet out the end of your penis, landing in various orifices, or if you are lucky, the ceiling fan.
Testiculopathy… aka “Nut Pain”
Over the years, I have been asked again and again, “Why does it hurt so bad when I get kicked in the balls?” The answer is simple really, you see your testicles do really important stuff. Mother Nature, in her infinite wisdom, wants you to pass on your DNA so our species can, you know, continue to exist. Since men are afraid of ball injuries, we wear cups to protect our potential offsping during sports and we don’t drop bowling balls onto our groins from the balcony….except in the movie “Jackass.” Mother Nature appreciates this and allows us to go most of our days with out ball trauma. Make sense?
Bottom line…don’t be a jackass.
Unfortunately, testicular pain is quite common and sometimes embarrassing to discuss, so let’s lay out the skinny on some of your man parts.
As I alluded to before, your testicles hang inside the scrotum from a collection of tubes called the spermatic cord. This tube consists of the vas deferens, the testicular artery and the testicular vein. For most of us, this structure is sort of “tacked” into place as we form embryologically. But for a few, this cord can twist causing a testicular torsion; allowing the testicle to rotate 180 or 360° (or even more.) This process kinks the blood supply and after about 6-12 hours, the testicle can die, which sounds really painful…BECAUSE IT IS.
ACUTE ONSET OF SEVERE TESTICLE PAIN IS A SURGICAL EMERGENCY.
This process can happen during physical activity or even at night while you are asleep. Sometimes this feels more like lower abdominal pain and is associated with nausea and vomiting. So remember, severe testicular pain that begins suddenly or wakes you up from sleeping should prompt a trip to your local emergency room. Got it? Don’t be a Jackass!!
For different reasons, the epididymis can get inflamed or even infected causing epididymitis. In younger, sexually active men, this is often caused by organisms like chlamydia or gonorrhea, which are sexually transmitted. In men older than 40, this condition is often more of a “plumbing problem” where infected urine refluxes into the epididymis. The infection can occasionally spread into the testicle itself causing orchitis. Whatever your age, these conditions can usually be treated with prescription antibiotics, an antibiotic injection, or some combination of the two.
Pain from epididymitis/ochitis is usually more gradual onset than pain from testicular torsion. However, occasionally, these two conditions can be difficult to distinguish. An ultrasound can be done in the emergency department to help your medical provider decide if you need to go the operating room for surgery or the pharmacy for a medication. So, bottom line, severe nut pain without any preceding trauma warrants a trip to the emergency room every time!
Hydroceles, Varicoceles and Baby Seals
Mild testicular pain can be caused by small fluid collections in the scrotal (aka nutt) sac. Hydroceles develop in between two of the layers that cover the testicle. If the testicle feels enlarged and has some give to it, like a water balloon, this might be a hydrocele. These fluid collections, can sometimes be due to a persistent space between these two layers that usually closes when you are developing in utero. Occasionally they develop from a hernia in your groin.
Varicoceles are fluid collections around the testicular veins which brings blood up from the testicle. Just like the veins in your legs which can become dilated and plump… (think varicose veins), the valves in your testicular veins can become less functional, resulting in dilated testicular veins. This process becomes more pronounced when you stand and improves when you lie down and is sometimes compared to a bag of worms… (except there are no actual worms, which would be REALLY gross!)
Whatever the cause of your nut pain, the important thing is that you get your boys checked out. There are no two balls exactly like yours!They are your own miniature spherical sweatshops, producing and packaging testosterone and DNA. So, no matter where you are shipping your DNA, remember to take care of your boys and they will take care of you!
Like learning about balls? Great! Next time lets talk about testicular cancer and hernias. Until then, lets try to be a little more grateful for all that our scrotal contents do for us. “Nutmaste!”