Testicular Pain - Cause

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What causes testicular pain?

There are several medical conditions that can lead to testicular pain, and the pain can be acute or chronic in nature. As already described, some of these conditions require urgent evaluation and management in order to preserve testicular function.

Testicular torsion causes

This condition occurs when the testicle twists spontaneously within the scrotum, leading to a decrease in blood flow to the affected testicle (from the twisting of the vessels within the spermatic cord). If the blood supply is cut off for too long, the testicle will be permanently damaged. This condition is a medical emergency and requires immediate medical attention.

Testicular torsion typically occurs because of an anomaly affecting the normal attachment of the testicle within the scrotum, often referred to as the "bell clapper" deformity. This abnormality allows the testicle to be freely suspended and twist spontaneously. Often times, this anomaly is present in both testicles. Trauma to the testicle is a rare cause of testicular torsion.

Testicular torsion is most common in males younger than 30 years of age, with a peak incidence between 12-18 years of age. It can also occur more frequently during the neonatal period. Testicular torsion most often affects the left testicle, and it is the most common cause of testicle loss in adolescent males.

Epididymitis causes

This condition occurs when there is inflammation of the epididymis, generally as a result of an infection. Epididymitis primarily affects adults, and is most common between 19 to 40 years of age, though it can occur in the prepubertal and elderly age groups.

In sexually active men, the most common cause of infection is from a sexually transmitted disease (STD), most notably the bacterial organisms Chlamydia trachomatis and Neisseria gonorrhoeae. In younger and older individuals, infection is usually caused by bacteria that are found in the urinary tract, such as Escherichia coli. Infection in these age groups is typically the result of an abnormality within the genitourinary system.

Torsion of a testicular appendage causes

This condition occurs with torsion (twisting) of the testicular appendage or the epididymal appendage, functionless structures that are remnants of tissue from human development. The testicular appendage lies between the testicle and the epididymis, while the epididymal appendage typically projects from the epididymis. As with testicular torsion, twisting of these structures leads to a decrease in blood flow and subsequent testicular pain. This is a common condition in younger boys, with most cases occurring between 7 to 14 years of age. Though this condition is benign and self-limiting, it must be distinguished from the more serious testicular torsion.

Testicle rupture: This serious injury to the testicle results from a disruption to the connective tissue enveloping the testicle (tunica albuginea), leading to the extrusion of testicular tissue. This injury is often accompanied by a blood collection (hematocele) that surrounds the testicle.

Other types of injuries to the testicles include penetrating trauma and testicular dislocation.

Kidney stone causes

Occasionally, the pain associated with kidney stones can radiate into the groin area and cause testicular pain.

Testicular tumor causes

Though generally painless, tumors of the testicle can sometimes cause pain and discomfort of the testicle or scrotum.

Trauma causes

Any type of trauma or injury to the testicles can cause severe pain and discomfort. The most common mechanism of testicular trauma occurs from blunt trauma (~85%), which can occur from sports injuries, a direct kick to the area, car accidents, and straddle injuries. In most instances, the pain will improve with the passage of time. However, in a few instances, trauma to the testicles can cause more severe injuries requiring immediate medical attention.

Inguinal hernia causes

An inguinal hernia is a bulge or protrusion of intestine through a defect in the abdominal wall musculature of the groin area. This protrusion can sometimes cause swelling of the scrotum and subsequent testicular pain.

Orchitis causes

This condition is characterized by inflammation of the testicle, typically as a result of an infection. Most cases of orchitis arise from a viral infection, with mumps being the most common causative illness. Mumps orchitis most commonly occurs in prepubertal males, though there has been an increase in cases in adolescent and postpubertal males secondary to the decreased use of the mumps vaccine. Less commonly, orchitis can occur from a bacterial infection, most often as the result of progression of epididymitis (epididymo-orchitis).

Return to Testicular Pain (Pain in the Testicles)

See what others are saying

Comment from: Suzy, 13-18 Male (Caregiver) Published: January 05

My son had testicular cancer at age 18 when the pain became excruciating. No doctor, health class, or media had ever told boys to check their testicles monthly. If my son had known, the cancer could have been caught before it spread. This is a serious flaw in our medical system and health education. At the time, the American Cancer Society produced a shower hang tag which described to boys how to check their testicles monthly. No one provided these to the boys; I picked some up at a clinic. Let's not endanger the lives of boys and men through an excess of prudery.

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Comment from: Shocked1, 19-24 Male (Patient) Published: April 13

I was shocked by a light switch while living in a bad apartment. I told the landlord and he ignored it. The house burnt down a few days later due to electrical problems. Because the landlord didn't report me as a client of his, I received no help getting back on my feet. The Red Cross could not do anything. It took me about 5 years. Well, I finally got a place of my own now! I just moved in a month or two ago, and I just got shocked again. By a standard household light switch. The apartments are in the same area, I wonder if they hired a really bad electrician. I don't know what to do, I hope I don't keel over soon because after the shock I have had a headache, anxiety, ringing ears, and my heart is racing. I wish there was more information online on what to do!

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