Final answer:
The differential diagnosis for chronic testicular pain includes epididymitis, orchitis, prostatitis, and testicular cancer. These conditions can cause pain, swelling, and other symptoms in the testicular region. Careful evaluation is necessary to determine the correct diagnosis and to provide effective treatment.
Step-by-step explanation:
The differential diagnosis for chronic testicular pain includes a variety of conditions that doctors must consider. Foremost among these conditions are infections of the male reproductive structures such as epididymitis, orchitis, and prostatitis. Chronic epididymitis can present with pain in the scrotum, testicles, and groin, along with swelling and redness, and is sometimes associated with back pain following physical strain. Orchitis, often a bacterial infection spreading from the epididymis or a viral disease such as mumps, shares similar symptoms to epididymitis. Prostatitis can lead to fever, chills, pain in the pelvic area, and urination issues.
Another condition to consider is testicular cancer, which typically affects younger men between 15 and 35 years old. Signs of testicular cancer can include a lump or swelling in one of the testes, fluid in the scrotum, and the aforementioned testicular pain or tenderness. Other differential diagnoses might include inguinal hernia, renal colic, and testicular torsion, though these are distinguished by their own unique signs and clinical presentations.
In summary, when a patient presents with chronic testicular pain, healthcare providers consider a range of potential causes from infections to malignancy and must evaluate through history, examination, and possibly imaging and labs to establish the correct diagnosis and initiate appropriate treatment.