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Testicular torsion may also be caused by trauma to the scrotum or exercise (in particular, bicycle riding); [10] however, only about 4–8% of cases are the result of trauma. [1] [2] There is thought to be a possible genetic basis for predisposition to torsion, based on multiple published reports of familial testicular torsion. [10]
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 ]
Diagnosis is typically based on symptoms. [1] Conditions that may result in similar symptoms include testicular torsion, inguinal hernia, and testicular cancer. [1] Ultrasound can be useful if the diagnosis is unclear. [1] Epididymitis usually has a gradual onset.
The differential diagnosis of testicular pain is broad and involves conditions from benign to life-threatening. The most common causes of pain in children presenting to the emergency room are testicular torsion (16%), torsion of a testicular appendage (46%), and epididymitis (35%). [4] In adults, the most common cause is epididymitis. [citation ...
Testicular torsion is the twisting of the testicle within the scrotum and can rapidly result in damage due to interruption in blood flow to the affected testicle. [6] Unlike varicoceles, [ 19 ] testicular torsion is considered a medical emergency.
Testicular cancer is highly treatable and usually curable. [5] Treatment options may include surgery, radiation therapy, chemotherapy, or stem cell transplantation. [2] Even in cases in which cancer has spread widely, chemotherapy offers a cure rate greater than 80%. [4] Globally testicular cancer affected about 686,000 people in 2015. [6]
According to Prehn's sign, the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. [4] 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.
PT-DLBCL is by far the most common form of testicular cancer in men >60 years of age. [2] It usually develops in this age group (median age ~65 years old, range 10–96 years) and presents as a painless testicular mass or swelling in one testis or, in ~6% of cases, both testes: [1] PT-DLBCL is the most common testicular cancer to present with disease in both testicles. [8]