What to do in a case of Testicular Trauma

Dear Ask The Doctor: Earlier this year I got hit in the testicles and was in considerable pain. After week the pain subsided. But now I have noticed the 'cord' that attaches to my left testicle is coild or bunched up. I researched this and found out it could be a varicocele (but they are not supposed to be caused by injury from what I read). I am planning to go to the doctors because I have had on-and-off pain in that area. Also, when ever I gently touch or feel that area it hurts and is sore for along time. I am 18 years old. Is this a possible varicocele and can it be dangerous? Thank you in advance for your help.

Dear Alex: I do understand you concern about testicular trauma. A varicocele is formed when the veins along the spermatic cord enlarge due to defective flow. They develop slowly and may present as painless scrotal swelling.

I do not think you have a varicocele. However, your doctor may need to rule out blunt trauma of the testicle which may present as a hematocele or a ruptured testis. I would advise you to consult your doctor for a thorough physical examination and scrotal ultrasonography or doppler studies if required.

Treatment will depend on the extent of scrotal injury. Conservative management includes scrotal support, non steroidal anti-inflammatory medication, ice packs and bed rest. Hematocele may often require surgical exploration. I hope the information help you.