Testicular Pain
What is Testicular Pain?
Testicular pain refers to discomfort or pain affecting one or both testicles. The pain may develop suddenly or gradually and can range from a mild ache to severe, intense pain. In some cases, the discomfort may originate from nearby structures such as the epididymis, spermatic cord or groin rather than the testicle itself.
While many causes of testicular pain are relatively minor and respond well to treatment, sudden or severe pain should always be treated as a medical emergency. Conditions such as testicular torsion require immediate surgical treatment to restore blood flow and maximise the chance of saving the affected testicle.
Prompt assessment by a urologist helps identify the underlying cause and ensures that appropriate treatment is provided.
What are the Causes of Testicular Pain?
Testicular pain can arise from a wide range of conditions affecting the urinary and reproductive systems.
Common causes include:
- Testicular torsion, where the spermatic cord twists and cuts off the blood supply
- Epididymitis, inflammation of the epididymis, often caused by infection
- Orchitis, inflammation of the testicle, which may occur with viral or bacterial infections
- Urinary tract infections (UTIs)
- Sexually transmitted infections (STIs)
- Trauma or injury to the scrotum
- Inguinal hernia
- Varicocele, enlarged veins within the scrotum
- Hydrocele, a collection of fluid around the testicle
- Spermatocele, a benign fluid-filled cyst of the epididymis
- Kidney stones, causing referred pain to the groin and testicle
- Chronic pelvic pain syndrome
- Testicular tumours, although these are usually painless, they may occasionally cause discomfort
- Post-vasectomy pain syndrome
- Nerve-related or referred pain from the lower back or pelvis
In some men, no specific cause can be identified despite thorough investigation.
What are the Symptoms of Testicular Pain?
Symptoms vary depending on the underlying condition and the severity of the problem.
Common symptoms include:
- Pain in one or both testicles
- Sudden or gradual onset of pain
- Scrotal swelling
- Redness or warmth of the scrotal skin
- Tenderness when touching the testicle
- Pain radiating into the groin, abdomen or lower back
- A feeling of heaviness in the scrotum
- Pain during urination
- Pain during ejaculation
- Blood in the urine or semen
- Fever and chills if infection is present
- Nausea and vomiting, particularly with testicular torsion
Any sudden, severe testicular pain, especially when accompanied by swelling, nausea or vomiting, requires immediate emergency medical attention.
How is Testicular Pain Diagnosed?
Diagnosis begins with a detailed discussion of your symptoms, medical history and the timing of the pain.
A physical examination will assess the testicles, epididymis, spermatic cord, groin and abdomen for signs of swelling, tenderness, hernia or other abnormalities.
Additional investigations may include:
- Urine analysis and urine culture
- Blood tests
- Screening for sexually transmitted infections
- Scrotal ultrasound with Doppler imaging to assess blood flow
- CT scan if kidney stones are suspected
- MRI in selected cases
- Tumour marker blood tests if testicular cancer is suspected
Scrotal ultrasound is particularly valuable because it can quickly distinguish between conditions requiring emergency surgery, such as testicular torsion, and other causes of pain.
What are the Treatment Options for Testicular Pain?
Treatment depends entirely on the underlying diagnosis and may range from simple supportive care to emergency surgery.
Treatment options include:
- Emergency surgery for testicular torsion to restore blood flow
- Antibiotics for bacterial infections such as epididymitis or orchitis
- Anti-inflammatory medication to reduce pain and swelling
- Pain-relieving medication
- Scrotal support and rest
- Ice packs to reduce swelling after injury
- Treatment of sexually transmitted infections
- Surgical repair of an inguinal hernia, when present
- Varicocele repair in selected patients
- Hydrocele or spermatocele surgery if symptoms are significant
- Treatment of kidney stones where referred pain is the cause
- Management of chronic testicular pain, which may include medication, nerve blocks or surgery in carefully selected cases
- Cancer treatment, including surgery and additional therapies if a testicular tumour is diagnosed
Early diagnosis is particularly important because some causes of testicular pain, especially testicular torsion, require urgent treatment to prevent permanent damage. If you experience sudden, severe or persistent testicular pain, you should seek prompt assessment by a urologist or attend your nearest emergency department without delay.