Testicular Pain Causes

Testicular pain has many causes, some of which are emergencies that require immediate medical attention.

Trauma: Trauma to the testicles often produces extreme pain. A direct blow to the scrotum, while very painful, usually causes only temporary pain.

• It may result in a bruise.
  
  
• Occasionally, trauma may cause a more significant injury that often requires emergency surgery, such as the following:
  
  
  • A hematocele - a collection of blood that surrounds the testicle
    
    
  • Rupture of the testicle

Testicular torsion: Testicular torsion is a medical emergency. This occurs when a testicle twists inside the scrotum. When a testicle twists, the blood vessels contained within the spermatic cord also twist and lead to an interruption of blood supply to the testicle.

• If the blood vessels twist around enough times, they close off, blocking the flow of blood to or from the testicle.
  
  
• Because blood contains oxygen, and testicles need oxygen to stay alive, the twisting may result in the "death" of a testicle.
  
  
• Thus, testicular torsion requires emergency surgery to save the testicle.
  
  
  • Torsion may occur at any age, but it is most common in the first few months of life (newborns) and in boys between the ages of 12-18 years.
    
    
  • Torsion often occurs in men who have an abnormal attachment of the epididymis to the wall of the scrotum. Many of these men have the same abnormal attachment in both testicles.

Epididymitis (testicle infection): Inflammation of the epididymis is usually due to an infection. It is the most common cause of testicular pain in men older than 18 years.

• In sexually active men, the most common cause of epididymitis is a sexually transmitted disease such as gonorrhea or chlamydia.
  
  
• Older and younger men may also get epididymitis, often because of an abnormality in the genitourinary system. In older men, enlargement of the prostate gland is a common cause.

Torsion of a testicular appendage: This is a common cause of testicular pain in younger boys.

• Almost all cases occur between the ages of 3-14 years.
  
  
• A testicular appendage is basically a functionless structure that sits in a groove between the testicle and the epididymis. Like a testicle, this structure can lose blood flow due to twisting, leading to varying amounts of pain.

Other, less common causes of testicular pain include the following:

• Inguinal hernia: This condition occurs when part of your intestine protrudes through a defect in the abdominal wall into the scrotum. This may cause pain or swelling.
  
  
• Orchitis (inflammation of the testicle): This inflammatory condition of the testicles occurs because of an infectious process. It is sometimes found along with epididymitis, especially when epididymitis has gone untreated for days. Most cases of orchitis are caused by a viral mumps infection, though other viruses and bacteria can also cause it.
  
  
• Testicular tumor: A tumor rarely causes pain but can cause swelling. Conduct regular self-examinations to locate lumps, as early detection improves the prognosis for testicular cancer.
  
  
• Kidney stone: The pain from kidney stones may sometimes radiate into the testicular area.
  
  
• Infections or bleeding in the abdomen: This rarely causes testicular pain.

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