Q: I sometimes have pain in my testis. The first time it happened in 1998 and since then it recurs after few months, for the past few months it has been worse. I cannot do any strenuous physical activity because of this. Also they tend to hang and pain if I exert myself too much. I also have frequent urge to urinate and burning sensation while urinating sometimes. One of my testes is lower than the other and I feel pain even by touching them. The situation first time was caused when I was exerting myself too much, is this due to hernia or hydrocoele. Can this be treated with medicines or an operation will be necessary and can it affect my married life?

A:Dull testicular pain, termed as orchalgia, can be due to hernia or hydrocoele, or even more commonly due to varicocoele. The latter condition is due to defective venous valves, and their engorgement during prolonged standing or exertion. In all these conditions urinary symptoms are not an accompaniment. Urinary symptoms with orchalgia may be a result of chronic prostatic inflammation, not an uncommon condition in young adults, called chronic prostatitis. Other uncommon causes could be a lower ureteric stone and local epididymal cysts with intermittent torsion. It would like you to have a thorough physical examination, and later to have urine routine examination and ultrasound examinations of urinary tract as well as scrotal contents, including Doppler examination of the latter. These should suffice to find a cause and treat it appropriately.