10 Causes of Testicular Pain You Shouldn't Ignore

The kind of pain you can't hide

If you're like most men, you'd rather ignore the pain than go to the doctor and figure out why you're falling apart. That goes double when it comes to pain "down there." Most men experience testicular pain from just thinking about it, but many have experienced the real thing -- from a cyst to varicose veins in your scrotum that make it feel like a bag of worms.

As much as you might want to avoid a visit to a doctor's office, testicular pain isn't something you can disregard. There are a number of reasons why the egg-shaped sex glands in your scrotum may be hurting, and none of them are good. In many cases, trying to pretend the pain away could mean worsening your problem -- even to the point of needing surgery or getting your testicles removed. So sit up and take notice -- and click to the next page for a very common cause of the suffering.


10: Inguinal Hernia

Though hernias are quite common among men, most guys don't actually know what they are -- they only know it's something they don't want. You can get hernias in all different places on your body, but generally, a hernia occurs when a portion of fatty tissue or intestine squeezes through its "container" -- often the abdominal wall. Imagine a sausage casing splitting open and letting some of its contents poke through.

If you have testicular pain, you could have an indirect inguinal hernia, which occurs near the seam where your thigh meets your body. Why would it make your testicles hurt? The hernia travels the same route your testicles took when your body was forming as a fetus.


That pathway starts in the abdomen and ends in the scrotum, following the pathway your fetal testicles took as they descended from your abdomen. And that just may be where your indirect inguinal hernia has ended its journey -- in your scrotum, the location of your pain and discomfort.

9: Testicular Cancer

Here's some good news about testicular pain: It's rarely a symptom of testicular cancer. Only 1 out of 10 men with testicular cancer feels pain [source: James Buchanan Brady Urology Institute]. Instead, it's usually detected when you or your doctor feels a lump. But for 10 percent of men, testicular pain is a sign that a cancerous tumor has developed on a testicle. It may not even be painful -- your testicles may just feel uncomfortable or heavy, or become visibly larger and swollen.

Those symptoms, in addition to pain in the lower back or abdomen, fluid collecting in the scrotum, and tenderness in the chest, add up to something that needs to be checked out. A good rule of thumb: If you feel, see or notice any change in anything in, on or around your testicles, see a doctor. When it comes to testicular cancer, early detection is incredibly important.


Next: An unwelcome twist to this testicular tale.

8: Testicular Torsion

Some sources of testicular pain are emergencies, and failing to seek immediate treatment may result in losing a testicle. This is the case with testicular torsion.

A strong force of torque is great when discussing a truck engine, but less so when discussing forces inside your scrotum. Ideally, your scrotum is a torque-free zone. Sometimes, however, the spermatic cord gets twisted and shuts off blood flow to your testicles.


The name sounds painful, and it is. You'll feel it in one testicle or the other, and you probably couldn't ignore this kind of agony even if you tried. And you wouldn't want to -- leaving it untreated could result in the loss of the affected testicle. The pain is a clear and definite sign that something is terribly wrong. You'll need surgery, and fast.

If the testicle can be saved, it will be re-set and then stitched to the inside of your scrotum to prevent future twisting. A follow-up procedure will do the same for your other testicle. This doesn't sound so great for a best-case scenario, but after experiencing the pain of testicular torsion, you'll welcome a helpful and simple sew-job to prevent it from happening again.


7: Hematocele

That was below the belt.

All males (and their evil sisters) are familiar with the crippling, delayed pain that accompanies a blow to the testicles. For just a second following impact, it feels like you may have dodged the bullet. Then, the growing, leg-weakening awfulness sets in.

Usually, the pain passes and everything's OK. You pick yourself up, dust yourself off, and look for your high-kicking sister, who has wisely vacated the area. But sometimes, taking such a direct shot to the testicles can cause other problems.


The testicles are each surrounded by a multi-layered sac, and a direct blow can cause blood to collect between these protective layers. This is called a hematocele.

A hematocele may simply be cured with bed rest and taking it easy, or it may require drainage during minor, same-day surgery. It depends on the level of discomfort, as well as the source of the bleeding that caused the hematocele. If the source isn't an external blow, your doctor will be hunting for another cause, in case it's something serious that's leading to the pain.

6: Epididymitis

Don't put the storage system at risk.

The epididymis is a coiled tube located in the back of each testicle. Straightened out, it would be about 20 feet (6 meters) in length. It's a storage and delivery system for sperm. Its length allows not only more sperm to be stored there, it also gives them time to mature.

It's possible for the epididymis to get inflamed. Since the epididymis connects to the testicle, this can lead to a form of testicular inflammation known as epididymitis. The most common cause is bacterial infection. The bacteria don't reach the epididymis through the blood; rather, bacteria usually enter through the urethra and work their way back.


The bacteria generally come from one of two different sources: STDs, such as gonorrhea or chlamydia; and coliforms, bacteria that live in the intestines. (There are also less common sources of inflammation, such as the heart drug amiodarone, and certain viral infections, such as mumps.)

When the epididymis becomes inflamed, the testicles commonly get slightly swollen and red. The condition can be very painful, especially during ejaculation or even bowel movements. You may feel the frequent need to urinate, or see blood in your semen. You may even periodically feel chills.

The good news is that antibiotics usually do the trick. However, more serious cases may require surgery in order to remove part or all of the epididymis. The longer you wait to see a doctor, the more serious your treatment is likely to be, so don't delay.

5: Varicocele

Do you have a mass in your testicles that feels like a bag of worms when you're standing up, but goes away when you sit down? Get thee to a doctor's office.

You're probably familiar with varicose veins -- swollen or knotted veins that are most commonly present in the legs. Think of varicoceles as another version of that -- one that makes your scrotum feel like it's full of spaghetti. The condition is an enlargement of the veins inside the scrotum that transport oxygen-depleted blood back to the heart. The valves in the veins have failed, and blood builds up where it shouldn't.


The pain can be mild or severe, and tends to grow worse over the course of a day. As the varicoceles grow in size, they will become easier to identify. Due to the positioning of the veins and testicles, the overwhelming majority of varicoceles occur on the left testicle.

Fortunately, varicoceles are fairly easy to treat through either the use of doctor-prescribed anti-inflammatories or through minor surgery that removes obstructed veins.

4: Spermatocele

As we discussed earlier, the epididymis is a tightly coiled tube located in the back of each testicle. It stores your semen and helps deliver it when needed. If you're feeling a pain in your testicles, there's a chance it's caused by a cyst -- a spermatocele -- growing inside the epididymis.

The cyst is benign, and it started out as accumulated sperm cells. It forms at the head of the epididymis, though these cysts can develop on the testicle or along the vas deferens. Spermatoceles are often found during procedures for other issues, and they're thought to be pretty common. Most of the time, they're very small and don't cause any problems. Sometimes, however, they grow to the size of several centimeters, and at this point, you may feel a sense of heaviness in your testicles, discomfort or even pain.


Most of the time, spermatoceles require no medical treatment. The doctor will want to periodically check it to make sure it's not growing, and to verify that it's not cancerous. However, if it's causing you any kind of suffering, you may be prescribed antibiotics. In extreme cases, the spermatocele can be removed, though there is significant risk that the patient will lose the ability to father children as a result.

3: Orchitis

Orchitis is a painful swelling of the testicles that can be caused by another condition we've discussed: epididymitis. It's also commonly caused by some type of bacterial or viral infection, such as mumps, brucellosis and certain STDs.

You'll know you have orchitis if you're experiencing a fever, blood in your semen, and an increase in pain when the penis or testicles are moved, used, thought about or mentioned in casual conversation.


Since there are many different causes of orchitis, it's especially important to seek treatment quickly. The doctor will run tests to discover the source of swelling, and will likely be able to treat the underlying problem with nothing more than antibiotics, along with anti-inflammatories for the swelling itself.

Unfortunately, orchitis caused by mumps (its most common viral cause) can't be treated, and it may result in sterility. Boys may experience shrinking of the testicles when experiencing orchitis caused by mumps.

For cases not caused by mumps, prompt medical attention should result in a happy outcome. In addition to a course of antibiotics and anti-inflammatories, you may need to elevate your scrotum for a few days -- and hopefully your co-workers will be understanding when they drop by your cubicle.

2: Kidney Stone


There's one type of testicular pain that will result in these words coming out of a doctor's mouth: "The good news is there's nothing wrong with your testicles. The bad news is that you have a kidney stone."

This illustrates another important reason why you should never ignore testicular pain: It may lead your doctor to discover a related health issue.


Though the source of the pain -- the kidney stones -- doesn't originate in the testicles, it can feel like it because the pain projects downward. These stones are compacted masses that develop in your kidneys from urinary crystals. Doctors aren't sure exactly why they form, or why some men are more susceptible to them than others.

Most of the time, you can pass the stone without treatment (though pain medication is often prescribed). You'll drink lots of water -- and then deal with the pain that comes when the small stone passes from your kidney into your bladder and then exits through your urethra.

1: Testicular Rupture

There are certain types of testicular problems that sound about as bad as they are. You can add to that list testicular rupture.

There's a protective membrane that surrounds the testicle known as the tunica albuginea. A testicular rupture is caused by a rip in this membrane that causes blood to leak into your scrotum. What would cause the membrane to rip? Generally, ruptures are caused by external trauma -- a sports injury, car crash or a prize-winning appearance on "America's Funniest Home Videos."

You have 72 hours to get your ruptured testicle surgically treated -- there's a 4 out of 5 chances that your testicle can be saved if you make it in time.

Making an appointment with your doctor should be at the top of your to-do list any time you experience lingering testicular pain. Because it when it comes to testicular pain, treating it and doing so quickly is the key to recovery.

Lots More Information

Related Articles

  • Balentine, Jerry R. "Hernias."  DO, FACEP.  Feb. 26, 2010. (June 20, 2010) http://www.emedicinehealth.com/hernia/article_em.htm
  • Cleveland Clinic. "Disorders of the Testes." Jan. 14, 2010. (June 20, 2010) http://my.clevelandclinic.org/disorders/testicular_cancer/hic_disorders_of_the_testes.aspx
  • Dogra, Vikram S., MD. "Testicle, Trauma." Dec. 7, 2009. (June 20, 2010) http://emedicine.medscape.com/article/381131-overview
  • James Buchanan Brady Urology Institute. "Testicular Cancer." (June 20, 2010) http://urology.jhu.edu/testis/cancer.php
  • Madan, J.; Madan, U. "Idiopathic Chronic Hematocele Of The Scrotum." The Internet Journal of Surgery. 2007. Volume 11, Number 1 http://www.ispub.com/journal/the_internet_journal_of_surgery/volume_11_number_1/article/idiopathic_chronic_hematocele_of_the_scrotum.html
  • Mayo Foundation for Medical Education and Research. "Epidiymitis." Nov. 19, 2009. (June 20, 2010) http://www.mayoclinic.com/health/epididymitis/ds00603
  • Mayo Foundation for Medical Education and Research. "Scrotal Masses." July 14, 2009. (June 20, 2010) http://www.mayoclinic.com/health/scrotal-masses/DS00410
  • Mayo Foundation for Medical Education and Research. "Spermatocele." Jan. 21, 2010. (June 20, 2010) http://www.mayoclinic.com/health/spermatocele/ds00619
  • Mayo Foundation for Medical Education and Research. "Testicular Cancer." Oct. 3, 2009. (June 20, 2010) http://www.mayoclinic.com/health/testicular-cancer/ds00046
  • Mayo Foundation for Medical Education and Research. "Varicocele." (June 20, 2010) http://www.mayoclinic.com/health/Varicocele/DS00618/DSECTION=causes
  • MedlinePlus. "Orchitis." Sep. 7, 2008. (June 20, 2010) http://www.nlm.nih.gov/medlineplus/ency/article/001280.htm
  • National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). "Kidney Stones in Adults." (June 20, 2010) http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/
  • Pais Jr, Vernon M., MD."Spermatocele." June 26, 2009. (June 20, 2010) http://emedicine.medscape.com/article/443432-overview
  • Spanierman, Clifford, MD. "Testicular Tortion." May 15, 2007. (June 20, 2010) http://www.emedicinehealth.com/testicular_torsion/article_em.htm
  • Vorvick, Linda, MD. "Orchitis." MedlinePlus. Sep. 7, 2008. (June 20, 2010) http://www.nlm.nih.gov/medlineplus/ency/article/001280.htm
  • White, Wesley M., MD. "Varicocele." July 28, 2009. (June 20, 2010) http://emedicine.medscape.com/article/438591-overview