Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 07, 2018
Last Modified Date: Dec 07, 2018
Published Date: Apr 08, 2018
Testicular pain or discomfort is an issue that can stem from many causes. These range from bacterial or viral infections, physical injuries and other medical conditions. Some of these problems may be quite serious, requiring urgent medical attention, while others may be fairly minor. However, it can be tough to know what you’re dealing with when it comes to these very sensitive male sex organs, so here, we’ll outline some of the more common causes of testicular pain and similar symptoms.
1. Orchitis – Among the most common causes of testicular pain, orchitis is painful inflammation in one or both testicles. It is most commonly caused by bacterial infections. Sexually transmitted diseases (STDs), such as gonorrhea or chlamydia, among others, are often the infections at the root of this condition. It can also be caused by viral infections, such as mumps, for example. Symptoms of orchitis can include swelling in one or both testicles, testicular pain that can range from mild to severe, tenderness in the testicles, blood in the semen and, in some cases, fever, nausea and vomiting.
2. Epididymitis – This condition is inflammation in the epididymis, which is a coiled tube, located in the back of each testicle, that stores sperm. The most common cause of epididymitis is bacterial infections, including sexually transmitted diseases, like gonorrhea and chlamydia, or infections caused by coliforms, which are bacteria found in the intestines. Less commonly, mumps and certain other viral infections can be the case of this condition. Symptoms of epididymitis may include swelling and redness in the testicles, pain, ranging from mild to severe, especially during ejaculation, blood in the semen, frequent urination, and in some cases, fever and/or chills.
3. Trauma – Injuries caused by trauma, such as a kick or blow to the testicles, can cause significant testicular pain. In most cases, that pain is short-lived, but in others, significant injury can be a factor. Among the more common problem that can happen due to trauma is a hematocele, which is when blood collects between layers or the protective sac that surrounds the testicles, causing swelling and pain. Another common injury that can be caused by trauma to the testicles is testicular rupture, which is a tear in the protective membrane that surrounds the testicles – a condition that causes lingering and severe testicular pain and requires immediate surgical treatment.
4. Testicular torsion – This is a condition that occurs when a testicle rotates within the scrotum, twisting the spermatic cord, which supplies the scrotum with blood. This reduces blood flow, leading to severe testicular pain and swelling of the scrotum. Other symptoms that may occur with this condition include abdominal pain, nausea and vomiting, painful urination, fever and a testicle that has changed from its normal position, sitting higher or at a different angle. This condition requires immediate medical attention, and often, emergency surgery.
5. Varicocele – This condition occurs when veins within the scrotum become enlarged, rather like varicose veins commonly seen in the legs. This happens when valves in these veins fail, weakening their ability to circulate blood as efficiently as they should. The result is blood build up in those veins, causing them to increase in size. This leads to testicular pain, which may be mild to severe, and generally worsens as the day goes on, and lessens with rest.
6. Spermatocele – This is a cyst that can develop in the epididymis (tube that carries and stores sperm), generally behind or above the testicle. These cysts often contain dead sperm cells and vary in size. While smaller cysts generally cause no symptoms, larger ones can lead to mild to moderate testicular pain.
7. Hydrocele – This is a condition in which fluid builds up around the testicle. It can be caused by trauma to the scrotum or surgeries, like hernia repair. Symptoms of hydrocele include testicular pain and swelling.
8. Referred pain – This is a condition that occurs when pain from elsewhere, usually the abdomen or groin area, is felt in the testicles. This commonly happens with problems like kidney stones, which often produce referred pain in the left testicle, or hernias, which can cause pain to be felt in one or both testicles. The most common symptom of this condition is testicular pain that persists for more than a week without other obvious symptoms, like swelling or fever, for instance.
9. Testicular cancer – While many men who develop cancerous tumors in the testicles have no obvious symptoms of the disease, some will experience testicular pain, which can range from minor discomfort to severe pain. Other symptoms that may present with this form of cancer include a feeling of heaviness in the testicles, fluid buildup and swelling in the scrotum, pain in the abdomen or lower back, and in some cases, tenderness or enlargement in the chest/breasts.
What to Do If You Have Testicular Pain
If you are experiencing pain in the testicles, seeing your doctor is your safest course of action – particularly if that pain is severe, comes on suddenly, has persisted after a blow to the groin, and/or comes with other symptoms. Your doctor will be able to assess your symptoms to find the cause and treat your pain. This typically involves a physical examination to check for swelling, lumps, fluid buildup and other symptoms. It may include medical imaging, and lab tests, including blood and urine tests to screen for STDs and other bacterial and/or viral infections that may be related to your testicular symptoms.
Treatment will depend upon the specific cause of your symptoms. Bacterial STDs, like gonorrhea or chlamydia, or other types of bacterial infections can generally be cleared up with antibiotics. Viral infections can also be treated with medications. Other pain causing conditions associated with blood or fluid buildup may simply require time, rest and perhaps some pain medication, while hernias, ruptures, testicular torsions or cancers may require surgery. The most important thing is that these symptoms are not ignored. While testicular pain is often due to minor problems, it can be a sign of serious ones that threaten your fertility – and, in rare cases, your life.