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About Arthur Goldstein, M.D.
Expertise
Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience
I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations
American Medical Association, American Urological Association, American College of Surgeons
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You are here: Experts > Health/Fitness > Urology > Urology > Hernia?
Expert: Arthur Goldstein, M.D.
Date: 9/4/2008
Subject: Hernia?
Question
Recently I noticed something wrong with my left testicle. I work as a
dishwasher and this job requires a lot of physical activity. I also started
running more often (up hill/down hill) and this week my left testicle seems to
be higher and at a different angle from which it usually lies. I also feel like I
have a cramp in this spot, it feels sort of numb but it isnt. It is just
uncomfortable. Also noticed a little acute pain following excercise. What
could it be!?!
Answer
D, as you might imagine, for this type of problem it is not possible for me to make an exact diagnosis over the internet because of the inability to do a physical examination. However, I shall try to help you. The testicles in the fetus are formed high up just below the kidneys and under the diaphragm in a space called the retroperitoneum. Just before birth, they begin to descend toward the scrotum. In order to reach this site, they must actually force a whole in the lower abdominal muscles. The spermatic cord supports the testicle(s) and contains the vas deferens, arteries, veins and nerves necessary for their function. Remnants of the abdominal muscles actually wrap around the cord as a permanent envelopment called the cremaster muscles. When one contracts the abdominal muscles, they simultaneously contract the cremaster muscles. The cremasters can be injured by strenuous physical activity. The pain is often transmitted to the testicles. Rest, heat, elevation, anti-inflammatory drugs and avoiding the activity leading to excessive strain are the treatment.
There are several other conditions that may cause this symptom, a hernia being one of them. A hernia is due to a weakness in the muscles of the abdominal wall. This weakened area allows the membrane (peritoneum) that contains the abdominal organs & intestines) to protrude through this defect and into the inguinal canal or scrotum. The hernia usually protrudes and may cause pain precipitated by any physical activity associated with straining. Typically one can feel a bulge in the groin area with bearing down but sometimes this finding is subtle. Symptomatic hernias generally require surgical repair by general surgeons (not urologists).
Sometimes discomfort in this area is referred from an inflamed prostate gland, so called prostatitis. Partial twisting (torsion) of the testicle may also cause such discomfort. The bottom line is that a diagnosis has to be made. I suggest that you see either a general surgeon or urologist in consultation. After a correct diagnosis is established, options for treatment can be discussed. Good luck.
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