Testicular pain can be concerning. The testicles are highly sensitive organs, and discomfort can arise from minor issues to conditions needing immediate medical attention. Understanding potential causes helps individuals recognize when to seek professional medical evaluation.
Potential Causes of Testicular Pain
Epididymitis is inflammation of the epididymis, a coiled tube behind the testicle that stores and transports sperm. It commonly results from bacterial infections, including sexually transmitted infections (STIs) like gonorrhea and chlamydia, or urinary tract infections (UTIs) where bacteria spread from the bladder or prostate. Viral infections like mumps can also cause epididymitis, leading to pain, swelling, and sometimes fever.
Orchitis involves inflammation of the testicle itself, often occurring with epididymitis (epididymo-orchitis). Viral orchitis is frequently linked to the mumps virus, especially in individuals contracting mumps after puberty. Bacterial infections, including STIs or UTIs, can also cause orchitis, leading to pain, swelling, and systemic symptoms like fever and nausea.
A hydrocele is fluid accumulation around the testicle, causing scrotal swelling. While often painless, a large hydrocele can cause discomfort. Common in infants, it may resolve naturally, but adults might need intervention if symptoms persist. A spermatocele is a fluid-filled cyst in the epididymis. Typically painless, these benign growths can cause heaviness or discomfort if large.
Varicoceles are enlarged veins within the scrotum, sometimes resembling a bag of worms. They can cause a dull, aching sensation, often improving when lying down. Minor trauma or injury to the testicles, such as a direct blow, can also cause acute pain, bruising, and swelling.
Testicular torsion is a medical emergency where the spermatic cord twists, cutting off blood supply to the testicle. It causes sudden, severe pain and requires immediate surgery to prevent permanent damage to the testicle. Testicular cancer is a serious concern, usually presenting as a painless lump or swelling in the testicle rather than pain. An inguinal hernia occurs when tissue, like part of the intestine, protrudes through a weak abdominal muscle spot into the scrotum, causing pain and a visible bulge, especially with straining.
When to Seek Medical Care
Immediate emergency care is necessary for sudden, severe testicular pain, which can indicate testicular torsion. This urgency increases if pain is accompanied by nausea, vomiting, fever, or visible scrotal swelling or redness. Any recent groin injury causing significant pain or a new lump also warrants immediate medical evaluation.
If pain is less severe but persists for more than a few days, worsens, or includes other concerning symptoms, schedule a medical appointment. Conditions like epididymitis or orchitis, while not always emergencies, require prompt diagnosis and treatment to prevent complications. Even mild, consistent discomfort or any change in testicle size or shape warrants professional assessment.
Diagnosis and Treatment Approaches
Healthcare providers evaluate testicular pain with a physical examination, checking for swelling, tenderness, lumps, or signs of infection/inflammation to narrow down causes. Further investigation may involve diagnostic tests.
Urine tests check for bacterial infections like UTIs or STIs, common causes of epididymitis or orchitis. Blood tests identify signs of infection or inflammation. Scrotal ultrasound provides detailed images, detecting fluid, cysts, enlarged veins, or blood flow issues like testicular torsion.
Treatment depends on the underlying cause. Bacterial infections like epididymitis or orchitis are typically treated with antibiotics. Anti-inflammatory medications reduce swelling and pain. Pain relievers, OTC or prescription, help manage discomfort. Surgery is necessary for certain conditions. Testicular torsion requires immediate surgery to untwist the spermatic cord and restore blood flow to the testicle. Painful or complicated inguinal hernias often require surgical repair to reposition the protruding tissue. Large or symptomatic hydroceles and spermatoceles may also be surgically removed if they cause significant discomfort. For chronic pain unresponsive to other treatments, microsurgical spermatic cord denervation, which treats nerves, may be considered.
Self-Care and Management at Home
For mild testicular pain, home management can provide comfort. Over-the-counter pain relievers like ibuprofen or acetaminophen alleviate discomfort and reduce inflammation. Always follow dosage instructions and consult a doctor if you have other health conditions or take other medications.
Cold compresses or ice packs reduce swelling and numb pain. Wrap ice packs in cloth and apply intermittently for 15 to 20 minutes. Supportive underwear, like a jockstrap or briefs, provides gentle compression and elevates the scrotum, reducing pressure and improving comfort. Rest and avoiding strenuous activities are beneficial. When lying down, placing a rolled towel or small pillow under the scrotum offers support and elevation, easing discomfort. These self-care measures complement medical treatment and should not replace professional diagnosis or care, especially for severe or persistent pain.