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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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The medical treatment and surgical for testicular pain depends entirely upon the cause of the underlying cause:

Trauma: After careful evaluation, if no serious underlying testicular injury have been identified, most cases of testicular trauma can be managed and treated at home. Treatment consists of the following measures:

• pain medications, including anti-inflammatory agents;
  
  
• scrotal support and elevation;
  
  
• ice packs; and
  
  
• rest.

More severe cases of testicular trauma involve testicular rupture, blunt trauma with an associated hematocele (a collection of blood) and penetrating traumatic injuries requiring surgical intervention.

Testicular torsion: This condition requires immediate surgery by a urologist (specialist in genital and urinary organs). Prior to surgery, a doctor may attempt to untwist the testicle manually to relieve the problem temporarily, though definitive surgery will ultimately still be required. Surgery will consist of untwisting the affected testicle, assessing its viability, and finally securing the testicle to the scrotal wall (orchiopexy) to prevent subsequent episodes of torsion.

Epididymitis: The treatment for this condition is generally managed on an outpatient basis, although patients with severe cases of epididymitis accompanied by complications may require hospitalization. Generally speaking, treatment consists of the following:

• antibiotics for 10 to 14 days with the choice of antibiotic prescribed varying depending on the age and sexual history of the individual;
  
  
• pain medications, including anti-inflammatory drugs;
  
  
• scrotal support and elevation;
  
  
• ice packs; and
  
  
• rest.

Rarely, individuals with epididymitis may develop a complication requiring surgical management, such as a scrotal abscess. Also, some cases of chronic epididymitis refractory to the above measures may require the administration of nerve blocks for pain control, or rarely surgical removal of the epididymis (epididymectomy). Patient's should work with their urologists in regard to their particular medical situation.

Torsion of a testicular appendage: The treatment for this self-limiting condition primarily consists of pain control with anti-inflammatory drugs, scrotal support and elevation, and ice packs. The pain should generally go away within about one week.

Inguinal hernia: The definitive treatment for inguinal hernias requires surgery, which is generally accomplished electively as an outpatient. However, individuals with inguinal hernias that cannot be pushed back in (incarcerated hernia) require emergent surgical management.

• Individuals with hernias should be instructed to avoid straining and to avoid lifting heavy objects. Also there are various medical devices used to provide support for those individuals with hernias. Consult with your health care practitioner for more information.

Orchitis: The treatment measures for orchitis include pain medication, ice packs, scrotal support and rest. Antibiotics are reserved only for those cases of bacterial orchitis (not viral orchitis). Rarely, a complication from orchitis (such as an abscess) may require surgical drainage.

Testicular tumor: A testicular mass requires prompt evaluation by a urologist in order to establish a definitive diagnosis. If the patient has testicular cancer, he will be referred to a specialist for further treatment options.

Kidney stone: The treatment for an uncomplicated kidney stone generally involves pain medication, anti-nausea medication, and medication that facilitates the passage of the kidney stone (for example, tamsulosin [Flomax]). If the kidney stone is complicated by an infection, emergent urologic consultation is required.

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Cancer of the Testicle Testicular cancer is an abnormal growth of cells in the testicles. The testicles are the male reproductive organs (gonads), where sperm are produced. The ...learn more >>

Testicular Torsion Testicular torsion is a painful condition caused by the twisting of the spermatic cord, which causes a loss of blood flow to the testicle. It is a surgical emer...learn more >>

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