Testicle Pain

Reviewed by Frank Cockerill, MD, July 21, 2017

Testicle pain is an uncomfortable symptom that men can experience and has a variety of causes. Pain in one or both testicles can be caused by an infection (whether by an STD or non-STD agent), an injury, testicular torsion, hernia, or a testicular swelling/mass.

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Infectious causes of testicular pain include epididymitis (inflammation of the tube that carries sperm from the testicle to the penis) caused by the sexually transmitted diseases chlamydia or gonorrhea , or orchitis (inflammation of one or both of the testicles) caused by several types of bacteria and some viruses.

Injury to the testicles, even when seemingly minor, can also cause painful testicles. The testicles are very sensitive to even minor injuries, but this type of pain subsides quickly (generally over a few hours), and does not have any other accompanying findings such as a swelling or mass.

Testicular torsion is a situation in which the spermatic cord (cord that carries the blood supply to the testicle) becomes twisted within the testicular sac, causing a great deal of pain. Since the blood supply to the testicle is cut off, this is an emergency situation that requires immediate surgery or the testicle will die.

Testicular pain can also be caused by inguinal hernias, which occur when part of the intestine migrates down the inguinal canal into the testis, creating a noticeable bulge in the testicular sac, swelling, and pain.

Testicular masses, such as a hydrocele, spermatocele, or (rarely) testicular cancer can also cause pain in the testicles. A hydrocele (fluid collection around the testicle), spermatocele (cyst that forms in the epididymis), and testicular cancer can all be painless, but typically cause pain when they become large enough to press on other structures in the groin.

Because testicular pain can be caused by some potentially life- or testicle-threatening processes, it's important that anyone experiencing testicular pain be evaluated by a physician to determine the cause. Sudden, severe testicle pain requires immediate medical care. You should seek immediate care if:

  • Your pain is severe or sudden
  • Pain is accompanied by vomiting or nausea
  • You feel a lump in the scrotum
  • Your pain is accompanied by fever
  • Your scrotum is tender to the touch, red, or warm
  • You have been in recent contact with someone who has mumps (virus that can cause orchitis)
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