Q: I have been suffering from testis pain for the past two weeks. My doctor treated it for urine infection, but I still have pain. I also have leg pain and tiredness. Please advise.

A:Testicular pain may originate from a variety of pathologies like –

1. Local scrotal pathologies: The scrotum consists of the coverings under the skin apart from the testes and adjoining epididymis. Many times small cysts in the area of the epididymis may cause dull scrotal pain.
2. Pathologies of the cord connecting the testes to the body: most common of these being varicocoele, that is swelling and reversal of flow through the veins.
3. Referred pain from the distal part of the tube connecting the kidney to the bladder, called the ureter. Common cause could be a stone in this area.
4. Pathologies of the posterior part of the bladder, called the trigone, and the prostate.

A thorough examination, followed by urine and imaging investigations would be necessary to systematically exclude all these causes before coming to a diagnosis. It may some times be necessary to do a scrotal exploration under anaesthesia if all previous investigations prove futile in intractable cases.