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Medical Author:

Steven Doerr, MD

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Testicular Pain Diagnosis

In order to diagnose the underlying cause of testicular pain, the health care practitioner will conduct a complete history and physical exam on the patient. The physical exam will focus on examining the following areas:

• abdomen/groin,
  
  
• penis,
  
  
• testicles, and
  
  
• scrotum.

Laboratory tests that may be useful in helping make the diagnosis include:

• blood tests
  
  
• urinalysis
  
  
• a urethral swab to check for sexually transmitted diseases if the patient has penile discharge

In many cases, in order to help determine the cause of the testicular pain, an imaging study also may be ordered at the discretion of the health care practitioner.

Testicular ultrasound: This non-invasive test can evaluate the blood flow to the testicle (if testicular torsion is suspected), in addition to helping diagnose other anatomical abnormalities within the scrotum that can cause testicular pain, including the following:

• testicular rupture,
  
  
• hematocele (a collection of blood),
  
  
• abscess (a collection of pus)
  
  
• testicular tumor, and
  
  
• inguinal hernia.

In cases of epididymitis, testicular ultrasound may reveal an inflamed epididymis with increased blood flow to this structure.

Nuclear scan: Some hospitals may perform this test to help evaluate the cause of testicular pain. 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 practical when testicular torsion is suspected.
  
  
• Finally, in some cases after examining the patient, the health care practitioner may  have such a high degree of suspicion that testicular torsion is present, that no imaging tests will be ordered and the individual will be taken straight to the operating room.