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.

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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/scrotum 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 10/7/2015

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