Differential Diagnosis for Erection with Unilateral Testicular Pain
- 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 testicular pain and is sometimes associated with sexual activity, including erections. The pain is usually unilateral.
- Other Likely diagnoses
- Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections. It can cause pain and may be associated with sexual activity.
- Testicular torsion: Although more commonly associated with sudden, severe pain, it can sometimes present with less severe pain, especially if the torsion is intermittent. Sexual activity, including erections, might exacerbate the pain.
- Varicocele: An enlargement of the veins within the scrotum, similar to varicose veins. It can cause aching or discomfort, which might be exacerbated by erections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular cancer: While testicular cancer is not typically associated with pain during erections, any testicular mass or pain warrants investigation to rule out cancer due to its potential severity and the importance of early detection.
- Acute appendicitis (if pain radiates or is referred): Although less common, appendicitis can sometimes present with testicular pain if the appendix is located near the testicles (retrocecal appendix). It's crucial to consider this diagnosis due to the potential for severe complications if appendicitis is not promptly treated.
- Rare diagnoses
- Henoch-Schönlein purpura (HSP): A form of vasculitis that affects blood vessels and can cause testicular pain among other symptoms. It's rare but should be considered in the differential diagnosis, especially if other systemic symptoms are present.
- Spermatic cord cyst or hydrocele: These conditions can cause discomfort or pain, which might be noticed during erections, although they are less likely to be directly associated with sexual activity.