Why is there pain in the lower right side of the lower abdomen involving the testicles?

Testicular pain on the lower right side of the lower abdomen may be related to varicocele, epididymitis, ureteral stones, inguinal hernia, testicular torsion, etc. Intervention can be done through physical examination, imaging examination, drug treatment, surgical treatment, etc. It is recommended to seek medical treatment promptly to determine the cause of the disease to avoid delaying the condition.

1. Varicocele

Varicocele is an abnormal expansion of blood vessels caused by obstruction of the venous return of the spermatic cord. It may be related to factors such as prolonged standing and increased abdominal pressure. It manifests as a feeling of swelling in the scrotum on the affected side, and pain can radiate to the lower abdomen. Diagnosis requires scrotal ultrasound. For mild cases, intravenous active drugs such as diosmin tablets and Maizhiling tablets can be used as directed by the doctor. For severe cases, laparoscopic high spermatic vein ligation is required. Avoid standing for long periods of time and wear loose underwear to help relieve symptoms.

2. Epididymitis

Epididymitis is mostly caused by bacterial retrograde infection. The common pathogen is Escherichia coli. It is manifested by swelling and tenderness of the epididymis, and the pain can radiate to the groin area. In the acute stage, antibiotics such as levofloxacin tablets and cefixime dispersible tablets need to be used as directed by the doctor, along with bed rest and scrotal elevation. Epididymectomy may be considered in patients with chronic recurrent disease. During treatment, sexual life should be prohibited and spicy and stimulating foods should be avoided.

3. Ureteral stones

Stone impaction in the lower ureter can produce radiating pain, typically manifesting as paroxysmal colic radiating to the perineum, which may be accompanied by hematuria. The diagnosis can be confirmed by urinary tract CT. For stones smaller than 6 mm, you can take Paishi granules and diclofenac sodium suppositories as directed by your doctor to relieve pain, and drink plenty of water. Stones larger than 6 mm require extracorporeal shock wave lithotripsy or ureteroscopic lithotomy. Daily high purine dietary intake needs to be controlled.

4. Inguinal hernia

When the contents of an inguinal hernia compress the spermatic cord, it may cause referred pain. A mass can be seen in the groin area when standing, but it can be relieved when lying down. Hernia sac needs to be identified by ultrasound or CT. Laparoscopic hernia repair should be performed as soon as possible after diagnosis to avoid incarcerated necrosis. Heavy physical labor is prohibited within three months after surgery. When coughing, press the incision area with your hands to reduce abdominal pressure impact.

5. Testicular torsion

Testicular torsion is a urological emergency. The blood supply is interrupted due to the rotation of the spermatic cord, which manifests as sudden severe pain and elevated testicular position. It requires surgical reduction and fixation within 6 hours to avoid necrosis. Manual reduction can be attempted before surgery, and orchiopexy can be performed immediately after diagnosis. The contralateral testis should also be fixed at the same time to prevent recurrence. Adolescents who experience sudden pain after strenuous exercise should be highly vigilant about this disease.

When you experience pain in the right lower abdomen and testicles, you should avoid applying heat on your own or taking painkillers to cover up the condition. It is recommended to record the nature, duration and accompanying symptoms of pain, and provide detailed information when seeing a doctor. Acute severe pain or accompanied by fever and vomiting require immediate emergency treatment. During the recovery period, maintain a regular schedule, drink more than 2,000 ml of water every day, and avoid activities that increase abdominal pressure such as cycling and weightlifting. Regular ultrasound examinations are performed to evaluate the treatment effect. Chronic pain patients can try warm water sitz baths to relieve discomfort.