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Household remedies such as elevation of the scrotum and cold compresses applied regularly to the scrotum may relieve the pain in acute cases. Painkillers or anti-inflammatory drugs are often used for treatment of both chronic and acute forms. Hospitalisation is indicated for severe cases, and check-ups can ensure the infection has cleared up.
The "bell-clapper deformity," in which there is inappropriately high attachment of the tunica vaginalis over the spermatic cord and failure of the normal posterior attachment of the testicle to the inner scrotum, which allows the testicle to move freely within the tunica vaginalis and predisposes to intravaginal testicular torsion. [2]
Negative Prehn's sign indicates no pain relief with lifting the affected testicle, which points towards testicular torsion which is a surgical emergency and must be relieved within 6 hours. Positive Prehn's sign indicates there is pain relief with lifting the affected testicle, which points towards epididymitis.
Chronic scrotal pain (pain for greater than 3 months) may occur due to a number of underlying conditions. [3] It occurs in 15-19% of men post vasectomy, due to infections such as epididymitis, prostatitis, and orchitis, as well as varicocele, hydrocele, spermatocele, polyarteritis nodosa, testicular torsion, previous surgery and trauma. [3]
Chronic testicular pain is long-term pain of the testes. [2] [3] It is considered chronic if it has persisted for more than three months. [1]Chronic testicular pain may be caused by injury, infection, surgery, cancer, varicocele, or testicular torsion, and is a possible complication after vasectomy. [2]
A scrotal mass can be noncancerous or cancerous . [2] Benign scrotal masses will include hematocele which is a blood collection in the scrotum. [2] A scrotal hematocele is also called a hemoscrotum (or haemoscrotum in British English). Scrotal masses are abnormalities in the bag of skin hanging behind the penis (scrotum). [7]
Treatment depends on the proximate cause. In one study, it was reported that 9 of 13 men who underwent vasectomy reversal in an attempt to relieve post-vasectomy pain syndrome became pain-free, though the followup was only one month in some cases. [2] Another study found that 24 of 32 men had relief after vasectomy reversal. [19]
A pantaloon hernia (or saddlebag hernia) is a combined direct and indirect hernia when the hernial sac protrudes on either side of the inferior epigastric vessels. Additionally, though very rare, two or more indirect hernias may appear together such as in a double indirect hernia .
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