Testicular Pain (Pain in the Testicles)

  • Medical Author:
    Steven Doerr, MD

    Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Testicular (Ball) and Scrotum Pain Symptoms

Testicular pain can have a number of different causes, some of which constitute a medical emergency. Testicle or scrotum pain may be caused by

  • Trauma
  • Testicular torsion (a medical emergency)
  • Inflammation of the testicle or epididymis
  • Kidney stones
  • Tumors

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Testicular pain definition and facts

  • Testicular pain refers to pain or discomfort that is felt in one or both testicles. The pain may be acute or chronic, dull, sharp, or a sensation of soreness or vague discomfort/ache.
  • The primary role of the testicle is to produce sperm and the hormone testosterone.
  • There are numerous conditions that can cause testicular pain, and a few of them constitute medical emergencies. The common causes of testicular pain include testicular torsion, epididymitis (caused by sexually transmitted diseases (STDs), torsion of the testicular appendage, kidney stones, testicular tumor, testicular trauma, inguinal hernia, and orchitis.
  • The signs and symptoms may include
    • pain,
    • swelling,
    • redness, and
    • tenderness of the testicle and/or scrotum.
  • Nausea, vomiting and fever may also be present.
  • The different causes of testicular pain can be diagnosed using blood tests, urinalysis and imaging studies, in addition to a complete physical exam.
  • The treatment for testicular pain varies depending on the underlying cause, and/or may include pain medication, antibiotics, and surgical intervention.
  • The complications of the conditions causing testicular pain may include infection, impaired fertility and permanent damage to the testicle, or loss of the testicle.
  • Only a few causes of testicular pain are preventable.

What are the testicles?

The testicles form part of the male reproductive organs, with a primary function of producing sperm and the male hormone testosterone.

The testicles are contained within an external sac-like structure called the scrotum, which is located between the penis and the anus. Adult testicles are similar in size to large olives, and it is common for one testicle to hang lower than the other within the scrotum. Located near the back of each testicle lies the epididymis, a coiled tubular structure which functions to store and transport sperm. The spermatic cord (a tubular structure containing blood vessels, nerves, lymphatic vessels and the vas deferens) courses from the abdomen and is connected to each testicle. Apart from containing vital structures for each testicle, the spermatic cord also suspends the testicles within the scrotum.

Picture of the male urinary and reproductive structures
Picture of the male urinary and reproductive structures

What is testicular pain (pain in the testicles)?

Testicular pain is pain or discomfort that is felt in one or both testicles. The pain may originate from the testicle itself, or it may be the result of other conditions affecting the scrotum, groin or abdomen. Though there are numerous medical conditions that can cause testicular pain, it is important to understand that a few of them constitute medical emergencies that require immediate medical attention in order to prevent impairment or loss of testicular function. Testicular pain can be an acute (short-term) or chronic (long-term) condition. The testicular pain may be constant or intermittent.

What are the signs and symptoms of conditions causing testicular pain?

Because there are numerous medical conditions that can lead to testicular pain in one or both testicles, the symptoms and signs may vary depending on the underlying cause. However, often times the symptoms can be very similar between the various causes, making it difficult to distinguish among the conditions which require urgent medical attention. Therefore, if you experience testicular pain, seek medical evaluation immediately by a trained professional.

Testicular torsion symptoms

Testicular torsion generally presents as sudden onset, severe testicle pain (localized to one testicle, left or right) that may be accompanied by any of the following signs and symptoms:

  • Nausea and vomiting
  • Testicular and/or scrotal tenderness
  • Testicular and/or scrotal swelling and redness
  • Abdominal pain
  • Fever
  • Elevation of the affected testicle within the scrotum
  • Horizontal positioning of the affected testicle within the scrotum
  • Loss of the cremasteric reflex on the affected side (normally, the testicle elevates with light stroking of the upper inner thigh area).

Epididymitis symptoms

Epididymitis generally presents as gradual onset, mild to severe testicle pain (localized to one testicle, right or left) that may be accompanied by any of the following signs and symptoms:

  • Nausea and vomiting
  • Testicular and/or scrotal tenderness, typically localized to the area of the epididymis, though it can become more generalized and involve the whole testicle as the illness progresses.
  • Testicular and/or scrotal swelling and redness
  • Abdominal pain
  • Fever
  • Urethral discharge
  • Urinary symptoms, such as burning, urgency, or frequency

Torsion of a testicular appendage symptoms

With torsion of a testicular appendage, the onset of testicle pain may be sudden or gradual, and the severity of pain may range from mild to severe. Generally, patients do not experience systemic symptoms, such as nausea, vomiting, and fever.

The testicle and/or scrotum generally appear normal, without swelling and redness; however, the following symptoms may be present.

  • Testicular tenderness, typically only localized to the top of the right or left testicle.
  • In some cases, a small blue-dot is visualized near the top of the affected testicle (blue-dot sign).

Preservation of the normal vertical positioning of the affected testicle within the scrotum, and preservation of the cremasteric reflex is generally maintained.

Medically Reviewed by a Doctor on 12/14/2016

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