Exams and Tests

A health care practitioner must first determine whether the testicular pain is caused by an emergency condition (with testicular torsion being the most worrisome) or some other cause.

To help determine the cause of the pain, the doctor will obtain a history and perform a physical exam. The physical exam will include an examination of the following:

• abdomen,
  
  
• testicles,
  
  
• scrotum, and
  
  
• rectum.

Laboratory tests that may be helpful in making the diagnosis include:

• Blood tests
  
  
• Urinalysis
  
  
• A urethral swab if the patient has penile discharge

In many cases, in order to determine the cause of the testicular pain, one of the following imaging studies will be ordered:

Ultrasound: This non-invasive test evaluates the blood flow to the testicle when testicular torsion is suspected. It can also help in diagnosing other causes of testicular pain, including the following:

• rupture,
  
  
• hematocele/pyocele (a collection of pus),
  
  
• tumors, and
  
  
• hernias.

Nuclear scan: Some hospitals perform this test more commonly than they do ultrasound. It is non-invasive, although it does require the injection of radioactive dye through an IV line.

• A nuclear scan will diagnose testicular torsion by showing decreased accumulation of dye in the affected testicle compared to the normal testicle.
  
  
• In many hospitals, the time required to prepare the materials and perform a nuclear scan is so lengthy that it is not used when testicular torsion is suspected.
  
  
• In some cases, the doctor may be convinced that the patient has testicular torsion after examining the patient, and no diagnostic tests will be undertaken.