Testicular Pain – Symptoms, Causes, Tests

Testicular Pain in males is a sensitive issue. There are varied causes of this disorder. It is necessary for the patient to consult a health expert and find out the appropriate cause and get treated accordingly.

The affected individual may experience any of the following symptoms:

  • Swelling, tenderness, or redness of the testicles and scrotum
  • Nausea and vomiting
  • Fever
  • Painful urination or penile discharge
  • Pain with sexual intercourse, pain with ejaculation, or blood in the urine or semen

The causes of the “acute scrotum” or testicular pain include:

Testicular torsion:  This is a common cause of acute scrotal pain in young men (though more classically seen in the pediatric population).  This is due to inadequate fixation of the testis to the tunical vaginalis via the gubernaculum testis.  The testis may twist, squeezing off blood flow in the spermatic cord, eventually causing ischemia.

Epididymitis: A common cause of acute scrotal pain in adults.  This can be infectious or non-infectious.  Given the patient’s recent trauma, non-infectious epididymitis would be more likely.  This is thought to occur due to reflux of urine, which then causes a chemical inflammation.  This may be prompted by prolonged periods of sitting or vigorous exercise (such as heavy lifting), though may also occur after local trauma.

Torsion of testicular appendage:  The appendix testis is a small vestigial outpouching on the anterosuperior part of the testis.  This can twist upon itself and is a common cause of testicular pain in the pediatric population.

Trauma causing hematocele, intratesticular hematoma, or rupture:  This usually occurs after severe trauma (direct blow or straddle injury, causing testicle to become compressed against pubic bones).  A hematocele occurs when blood accumulates within the tunica vaginalis; you can also get a bruise within the testicular parenchyma known as an intratesticular hematoma.  Finally, there can be disruption of the testicular capsule (tunica albuginea) causing rupture.

There are various tests like blood tests, urinalysis, testicular ultrasound etc to detect the problem.  Depending on the cause of the pain, treatment is prescribed to the patient.  Various antibiotics and pain killers help the patient to overcome testicular pain.