A bruised testicle, or scrotal contusion, occurs when blunt force trauma causes blood vessels in the scrotum to break, leading to internal bleeding. Testicles are generally resilient due to their loose attachment and spongy composition, allowing them to absorb minor impact without permanent damage. However, because they are positioned outside the body, they lack the bony and muscular protection afforded to most other organs. While many bruises are minor, the area is sensitive and can sustain more severe damage, requiring quick assessment.
Identifying the Appearance of a Bruise
The most immediate sign of a bruised testicle is the discoloration of the scrotal skin, reflecting the leakage of blood beneath the surface. Initially, a fresh contusion presents as a bluish-red or purple mark, similar to a bruise elsewhere on the body. This color is caused by blood pooling in the soft tissues following the rupture of capillaries.
Localized swelling often accompanies this discoloration, making the scrotum appear enlarged and tense. Significant swelling can obscure the testicle itself from direct view or touch.
As the body reabsorbs the pooled blood, the bruise follows a predictable color progression, changing from dark red or purple to shades of green and then yellow over several days. Bruising can vary widely, from a small patch of discoloration to a hematocele, which is a larger collection of blood within the scrotal sac.
Distinguishing Symptoms of Minor vs. Severe Injury
A minor testicular contusion involves localized pain at the site of impact that subsides gradually, usually within an hour. Swelling and bruising may be present but do not rapidly worsen, and the pain is manageable with rest and over-the-counter medication. These injuries rarely have long-term effects on function or sperm production.
A simple bruise is distinct from a severe injury, which presents with “red-flag” symptoms demanding immediate emergency medical attention. Persistent or rapidly escalating severe pain that does not lessen after an hour is a serious warning sign. Systemic symptoms, such as nausea, vomiting, or fever, also indicate a potentially complex underlying issue.
Signs of Severe Injury
Severe injuries can include testicular rupture, where the testicle’s tough outer covering is torn, or testicular torsion, where the spermatic cord twists and cuts off the blood supply. These conditions cause extreme pain that may radiate to the lower abdomen. They are often accompanied by a noticeable change in the testicle’s position or the presence of a hard, expanding lump. Blood in the urine or difficulty urinating also suggest a more extensive injury requiring urgent evaluation.
Immediate Care and Recovery Expectations
For a minor contusion where severe symptoms are absent, immediate self-care helps manage discomfort and swelling. Resting and avoiding strenuous activity is advised to prevent further irritation. Applying a wrapped cold pack to the injury for 10 to 20 minutes at a time helps reduce pain and swelling.
Wearing snug, supportive underwear or an athletic supporter helps gently compress the area and provide elevation, which assists in reducing swelling. Most minor bruising and tenderness resolve within a few days to a week. If symptoms do not improve within 48 hours or if any severe symptoms develop, seek professional medical advice immediately.