Testicular Pain: Possible Causes & Treatments – Cleveland Clinic

Possible Causes

What causes testicular pain?

The source of the testicular pain may be obvious if you have had a recent injury or an accident, but in other cases it may not be clear why you have pain.

Causes of testicular pain might include:

• Injury or trauma: An injury to your testicles may happen during sports, exercise or an accident.
• Orchitis: Inflammation (swelling and a burning sensation) in one or both testicles may be caused by a bacterial or a viral infection. In children, the mumps virus is also a possible cause of orchitis. In the case of mumps the swelling usually starts four to six days after the start of the mumps.
• Inguinal (groin) hernia: An inguinal hernia occurs when part of your intestine pushes through a weak part of your abdominal muscles near the groin. It’s usually not dangerous but it can be painful. If it is painful, you should seek immediate medical attention as you may require urgent surgery.
• Epididymitis: This condition is due to inflammation of the epididymis. The epididymis is a tightly coiled group of thin tubes carrying sperm from the testicles to the sperm duct and out of the body. Epididymitis symptoms include pain and inflammation. The scrotum may be swollen and hot to the touch. This can last for days to weeks. Chronic epididymitis lasts longer than six weeks.
• Spermatocele: A spermatocele is a space filled with fluid that can form inside the epididymis near the testicle. These cysts aren’t cancerous and are usually not painful, but at times they can grow to a large size and become uncomfortable.
• Hydrocele: A hydrocele forms when fluid builds up around the testicles. Hydroceles are common, and sometimes they can cause pain or become infected.
• Hematocele: A hematocele occurs when blood surrounds the testicle. This is usually the result of an injury.
• Varicocele: A varicocele is a group of abnormally large veins near the testicles. These large veins may cause a dull discomfort in the affected testicle during daily activities. The testicle pain usually improves when lying down. Varicoceles may sometimes affect the ability to have children, and are sometimes surgically treated.
• Testicular torsion: Torsion is the twisting of the blood supply to the testicle. This cuts off the blood supply to the testicle and results in a severe, sharp pain. Torsion can occur at any time. This condition needs immediate surgery to save the testicle.
• Kidney stones: Kidney stones happen more commonly when you are dehydrated. Stones can get stuck in the ureters (tubes draining urine from the kidney into the bladder), causing pain in the back, groin or scrotum. Small stones may pass if fluids are increased. Larger stones may need surgery.
• Post-vasectomy pain syndrome: Men who have had a vasectomy sometimes get testicular pain afterwards. This pain can be caused by higher pressure in the vas deferens (tubes carrying sperm) or epididymis and can result in a post-vasectomy pain syndrome.
• Testicular cancer: Testicular cancer is the most common cancer in men aged 15-35. It can sometimes present with a dull ache or pain in the groin or testicles, testicular swelling or heaviness and aching in the lower abdomen or scrotum. Imaging methods can be used to examine the testicles for signs of testicular cancer.

What are some other symptoms that may occur?

Symptoms may include:

• Pain: Testicular pain can feel different depending on the cause. A sudden injury results in sharp, sudden pain, followed by a dull ache. The pain of epididymitis can worsen with time. Kidney stones can cause sharp pains in the back that spread to the testicles and to the tip of the penis.
• Bruising: There may be bruising on the scrotum if the testicles were injured.
• Nausea and vomiting: Feeling sick to your stomach and vomiting can be a symptom of many conditions. These include testicular injury, orchitis or kidney stones.
• Swelling: There may be a lump in the scrotum. The scrotum may appear red or shiny. These can signs of injury, orchitis, epididymitis or a testicular tumor.
• Fever: Fever together with testicular pain is a sign of orchitis or epididymitis.
• Urination problems: Some kidney stones can cause frequent urination. There may also be a burning sensation on urination, or blood may be seen in the urine.

Who treats testicular pain?

If you have testicular pain or if you have recently had high-risk sexual activity, you should seek medical help. High-risk sexual activity includes having more than one partner or having a partner who has had more than one partner. You can get diagnosed by specialists including:

• Urologist: If you have signs of testicular cancer or kidney stones, you may be referred to an urologist (a surgical specialist who treats urinary problems).
• Nephrologist: If you have kidney infections or poorly functioning kidneys, you may be referred to a nephrologist (a medical specialist who treats urinary problems).

How is testicular pain diagnosed?

Your doctor will exam you standing up and lying down. You’ll be asked questions about when the pain started, how long you have had it, how much it hurts and exactly where you hurt. You’ll also be asked about your sexual, medical and surgical history. Tell your doctor if any activities make your pain better or worse, like going to the bathroom, exercise, sex or sitting.

Blood or urine tests can help to rule out infections as a possible cause. If there’s a lump in your testicle, an ultrasound will be ordered to check for testicular cancer. If the ultrasound scan shows signs of cancer, you’ll be referred to an urologist to have the cancer removed.

If you get diagnosed and treated early, testicular cancer has a very high cure rate.