Testicle pain

  • Definition
    • Testicle pain is discomfort in one or both testicles. The pain can spread into the lower abdomen.

  • Alternative Names
    • Pain - testicle; Orchalgia; Epididymitis; Orchitis

  • Causes
    • The testicles are very sensitive. Even a minor injury can cause pain. In some conditions, abdominal pain may occur before testicle pain.

      Common causes of testicle pain include:

      • Injury
      • Infection or swelling of the sperm ducts (epididymitis) or testicles (orchitis)
      • Twisting of the testicles that can cut off the blood supply (testicular torsion). It is most common in young men between 10 and 20 years old. It is a medical emergency that needs to be treated as soon as possible. If surgery is performed within 6 hours, most testicles can be saved.

      Mild pain may be caused by fluid collection in the scrotum, such as:

      • Enlarged veins in the scrotum (varicocele)
      • Cyst in the epididymis that often contains dead sperm cells (spermatocele)
      • Fluid surrounding the testicle (hydrocele)
      • Pain in the testicles may also be caused by a hernia or kidney stone.
      • Testicular cancer is almost always painless. But any testicle lump should be checked out by your health care provider, whether or not there is pain.
  • Home Care
    • Non-urgent causes of testicle pain, such as minor injuries and fluid collection, can often be treated with home care. The following steps may reduce discomfort and swelling:

      • Provide support to the scrotum by wearing an athletic supporter.
      • Apply ice to the scrotum.
      • Take warm baths if there are signs of swelling.
      • While lying down, place a rolled towel under your scrotum.
      • Try over-the-counter pain relievers, such as acetaminophen or ibuprofen. Do NOT give aspirin to children.

      Preventive measures to take:

      • Prevent injury by wearing an athletic supporter during contact sports.
      • Follow safe sex practices. If you are diagnosed with chlamydia or another STD, all of your sexual partners need to be checked to see if they are infected.
      • Make sure that children have received the MMR (mumps, measles, and rubella) vaccine.
  • When to Contact a Medical Professional
    • Sudden, severe testicle pain needs immediate medical care.

      Call your provider right away or go to an emergency room if:

      • Your pain is severe or sudden
      • You have had an injury or trauma to the scrotum, and you still have pain or swelling after 1 hour
      • Your pain is accompanied by nausea or vomiting

      Also call your provider right away if:

      • You feel a lump in the scrotum
      • You have a fever
      • Your scrotum is warm, tender to the touch, or red
      • You have been in contact with someone who has the mumps
  • What to Expect at Your Office Visit
    • Your provider will do an exam of your groin, testicles, and abdomen. Your provider will ask you questions about the pain such as:

      • How long have you had testicular pain? Did it start suddenly or slowly?
      • Is one side higher than usual?
      • Where do you feel the pain? Is it on one or both sides?
      • How bad is the pain? Is it constant or does it come and go?
      • Does the pain reach into your abdomen or back?
      • Have you had any injuries?
      • Have you ever had an infection spread by sexual contact?
      • Do you have any other symptoms like swelling, redness, change in the color of your urine, fever, or unexpected weight loss?

      The following tests may be performed:

  • References
    • Barthold JS. Abnormalities of the testis and scrotum and their surgical management. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 132.

      Montgomery JS, Bloom DA. The diagnosis and management of scrotal masses. Med Clin North Am. 2011;95:235-244. PMID: 21095426 21095426.

      Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician. 2009;79(7). PMID: 19378875

      Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010;37:613-626. PMID: 20705202 20705202.