Why does the perineum under one testicle feel swollen like a cramp?

Pain or cramping in the perineum under one testicle may be related to varicocele, epididymitis, testicular torsion, prostatitis or muscle spasm. It is recommended to seek medical treatment promptly for a clear diagnosis to avoid delays in treatment.

1. Varicocele

Varicocele is a dilation of blood vessels caused by obstruction of venous blood return in the scrotum, and is common in the left testicle. It may be caused by standing for a long time, increased abdominal pressure, or venous valve insufficiency. It manifests as a sinking and distended feeling in the scrotum on the affected side, which is aggravated when standing and can be relieved by lying down. The diagnosis can be confirmed by scrotal color ultrasound. In mild cases, tight underwear can be worn to hold up the scrotum. In severe cases, high spermatic vein ligation is required. In terms of medication, you can use Maizhiling tablets, diosmin tablets, etc. as directed by your doctor to improve venous return.

2. Epididymitis

Epididymitis is mostly caused by bacterial infection and is often accompanied by urinary system symptoms such as frequent urination and urgency. In the acute phase, the scrotum on the affected side is red, swollen, hot and painful, while in the chronic phase, the scrotum is mainly dull, painful and swollen. Routine urine examination and scrotal ultrasound examination are required. After diagnosis, antibiotics such as levofloxacin tablets and cefixime dispersible tablets are required, along with scrotal elevation and local physical therapy. If an abscess forms, surgical drainage is required.

3. Testicular torsion

Testicular torsion is a urological emergency in which the blood supply to the testicles is interrupted due to rotation of the spermatic cord. Sudden severe pain in the affected testicle accompanied by nausea and vomiting, failure to reset within 6 hours may cause testicular necrosis. The diagnosis can be confirmed through scrotal color ultrasound examination of blood flow signals. Immediate manual reduction or emergency surgical fixation is required after diagnosis. If you miss the golden time for treatment, you may need to remove the necrotic testicle.

4. Chronic prostatitis

Radiating pain from prostatitis can manifest as perineal swelling and pain, often accompanied by abnormal urination and pelvic discomfort. It may be related to sitting for a long time, drinking alcohol or bacterial infection. A digital rectal examination and prostate fluid examination are required. Tamsulosin sustained-release capsules and celecoxib capsules can be used as directed by the doctor to relieve symptoms, along with warm water sitz baths and regular semen ejaculation.

5. Muscle neurotic spasm

Excessive contraction of the perineal muscles may be caused by exposure to cold, strenuous exercise, or nerve irritation. It manifests as paroxysmal cramp-like discomfort without organic disease. It can be relieved through hot compress and massage, and avoid long-term riding or sitting. If recurrence occurs, the possibility of disc herniation compressing the nerve root must be ruled out.

In daily life, you should avoid wearing tight pants, reduce pressure on the perineum such as riding for long periods of time, and keep the area clean and dry. In case of acute pain, immediately stop activities and apply ice, and record the pain characteristics and duration. Limit spicy and irritating foods in the diet, and supplement vitamin B in an appropriate amount to nourish the nerves. If symptoms last for more than 24 hours or are accompanied by fever or hematuria, emergency treatment is required. If severe pain occurs at night, you can go directly to the emergency department. It is recommended to add urinary system ultrasound examination during regular physical examinations. In particular, those with related medical history need to pay more attention to testicular and prostate health.