Testicular Pain

In a man’s body, probably the most sensitive area is the scrotum and testicles. A minor injury such as a direct blow from a kick or punch can result in intense pain. Often such injuries, which could arise from a sporting or car accident, cause temporary pain, bruising and/or swelling.

Testicle pain (testicular pain) is pain that emanates from one or both testicles. There are actually three unique areas which could be causing the pain – the testicle itself, the epididymis, which is a tube that delivers sperm, or another area of the groin. In this case, the pain can be felt in the testicles but is really originating from somewhere else (this is called referred pain).

Should I see a doctor for severe testicular pain?

Men often ignore testicular pain and hope that it will simply go away. Often, this is the case. However, if severe testicular pain is experienced – whether from a truma or for no apparent reason, the man should see a doctor right away. There are a number of conditions that need to be addressed as soon as possible.

Testicular torsion

Inside the scrotum, a testicle can sometimes get twisted. This condition is a medical emergency because blood vessels within the spermatic cord will also twist, inhibiting blood flow to the testicle. Treatment is needed immediately to prevent the loss of the testicle.

Hematocele

A direct trauma (such as from a kick, a punch) can result in layers of the testicle becoming engorged with blood. To relieve the condition, a surgical procedure may be required to drain the excess blood.

Should I see a doctor for testicular pain that lasts for days?

There are other conditions that can result in less severe testicular pain. If the pain does not go away over the course of a few days, an evaluation by an experienced urologist is in order. Pain from testicles could result from one of the following conditions.

Epididymal Cyst

An epididymal cyst is a small fluid collection found in the epidymis or just outside the epididymis. This usually occurs at the very top or head of the epididymis . These cysts occur in a approximately one third of men and usually do not cause discomfort. However, in some men, these cysts can become inflamed or enlarged which can result in pain. Very often, the treatment is with NSAIDS such as Motrin or ibuprofen. In some case, surgical excision of the cyst is needed.

Epididymitis

This condition is usually caused by a sexually transmitted infection (STI or STD) or from a urinary tract infection. The epididymis (the tube that delivers sperm from the testicle) becomes inflamed and painful. In older men, epididymitis can also be caused by an enlarged prostate gland.

Orchitis

Orchitis, inflammation of a testicle, is often caused by a bacterial infection and frequently accompanies untreated epididymitis.

Varicocele

The veins transporting blood out of the scrotum can become weak or fail, resulting in blood to pool in the scrotum. Varicoceles can be resolved through a surgical procedure called a varicocelectomy.

Hydrocele

A hydrocele is a fluid-filled sac which surrounds a testicle and causes swelling, although there is normally no pain. Hydroceles in infants disappear on their own, but boys and men may develop a hydrocele because of other inflammation or injury to the scrotum. If a hydrocele doesn’t resolve on its own, it may need to be removed with a minor surgical procedure.

Vasectomy

Occasionally, a vasectomy may result in testicular pain, due to the development of a granuloma. This condition can usually be resolved through the use of anti-inflammatory medication. Sometimes the granuloma needs to be excised.

Other causes of testicular pain

There are other causes of testicular pain which have their source outside the scrotum, even though the pain is felt in the testicles. This is called referred pain, and indicates that there is an undiagnosed issue within the body.

Diagnosis and Treatment

Dr. Fisch sees many patients with testicular pain. The evaluation to determine the source of pain includes a physical examination, cultures of urine and semen, and possibly an ultrasound and/or doppler view of the testicles.