Differential Diagnosis for Dull Ache in Testicles Relieved with Ejaculation
Single Most Likely Diagnosis
- Epididymitis: This condition, which is an inflammation of the epididymis (a tube at the back of the testicle that stores and carries sperm), can cause a dull ache in the testicles. The pain can sometimes be relieved with ejaculation, as it helps to reduce the pressure in the epididymis.
Other Likely Diagnoses
- Prostatitis: Inflammation of the prostate gland can cause pain in the testicles, perineum, and penis. Ejaculation may provide temporary relief by reducing prostate congestion.
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections, can lead to testicular pain that might be alleviated by ejaculation due to the release of tension.
- Spermatocele: A spermatocele is a cystic structure filled with sperm that arises from the head of the epididymis. It can cause a dull ache in the testicle, and while less common, ejaculation might relieve the discomfort by potentially reducing the cyst's size or pressure.
Do Not Miss Diagnoses
- Testicular Torsion: Although testicular torsion typically presents with sudden, severe pain, it's crucial not to miss this diagnosis due to its emergency nature. Delayed treatment can result in loss of the testicle. While less likely given the description of dull ache relieved by ejaculation, any testicular pain warrants consideration of torsion.
- Testicular Cancer: While testicular cancer is less likely to cause pain that is relieved by ejaculation, it's a critical diagnosis not to miss. Pain in the testicles can be a symptom, although it's more commonly associated with a painless testicular mass.
Rare Diagnoses
- Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins, can cause a dull ache in the testicle. The pain might be relieved by ejaculation due to changes in venous pressure, although this is less commonly reported.
- Henoch-Schönlein Purpura (HSP): A rare condition that can cause testicular pain among other symptoms like purpura, joint pain, and gastrointestinal issues. It's less likely but should be considered in the differential diagnosis, especially if other systemic symptoms are present.