Testicular pain can be caused by varicocele, inguinal hernia, epididymitis, testicular torsion or a direct injury to the area.
In more rare cases, this type of pain could also indicate the presence of testicular cancer. However, with testicular cancer, pain is not commonly felt and is more often suspected due to the presence of a hardened node or lump.
If the testicular pain lasts for several days or presents with symptoms such as swelling, heat in the area or the appearance of a small lump, it is important to see a family doctor or a urologist for a diagnosis and treatment as necessary.
Why do my testicles hurt?
Testicular pain can be caused by:
1. Varicocele
Varicocele is characterized by the swelling of the testicle veins. It occurs most often in the left testicle, but it can also affect only the right or both at the same time. This condition causes constant discomfort, swelling of the testicles, and a sensation of heat, especially after walking or engaging in physical activity.
How to treat it: in most cases, pain caused by varicocele is treated with analgesics like acetaminophen. However, if there is a risk of infertility or if the pain doesn't improve with the use of medication, a small surgery may be needed to "bypass" the affected veins and make the blood only circulate through healthy vessels.
2. Inguinal hernia
An inguinal hernia is commonly diagnosed in children and young adults. It occurs when a portion of the intestine, or other abdominal tissue, bulges through a weakened area of the abdominal muscles. It can enter the scrotum and causing constant swelling and pain. The discomfort worsens when getting up, bending over, or lifting weights, for example.
How to treat it: The only treatment available is inguinal hernia surgery, which allows for the portion of the intestine to be put back in the correct place. The abdominal muscles that are weakened are then reinforced.
3. Epididymitis
Inflammation of the epididymis, also known as epididymitis, can be caused by a bacterial or viral infection. Common symptoms include severe pain, swollen testicles, redness, and fever with chills.
How to treat it: You should seek medical attention for assessment. The infection may require treatment with antibiotics like ceftriaxone or quinolones (usually ciprofloxacin). The treatment duration may vary.
4. Testicular torsion
Testicular torsion is a medical emergency that is more common before the age of 25 and causes very intense pain. However, there are cases in which this torsion doesn't happen completely, resulting in more mild symptoms like pangs of pain that appear with certain movements.
How to treat it: If you suspect you have testicular torsion, you should proceed immediately to the emergency room to confirm the diagnosis. Surgery may be necessary to reposition the testicle to the correct place, which can prevent constipations like infertility.
5. Prostatitis
Inflammation of the prostate, known as prostatitis, usually causes symptoms like painful urination, fever, perineal pain, and a feeling of being unable to completely empty the bladder. Pain with palpation of the testicles may also occur.
How to treat it: A good way to relieve pain is to take a sitz bath with warm water for 15 minutes and do Kegel exercises to strengthen the pelvic floor. However, it is almost always necessary to also take prescription antibiotics, such as ciprofloxacin or levofloxacin.
6. Mumps
Although mumps usually affect the parotid glands, which are found on the side of the face, the virus that causes the disease can also make its way down to the testicles, causing inflammation. Therefore swelling and associated pain in the testicles is possible if mumps spreads systemically.
How to treat it: The doctor will usually recommend anti-inflammatory and analgesic drugs, such as ibuprofen or acetaminophen to treat symptoms. Staying hydrated and resting are also very important to eliminate the virus from the body.
7. Testicular cancer
Testicular cancer rarely causes pain; however, this may happen in more advanced cases. Other symptoms - such as intense swelling, changes in testicle size and lumps - will usually appear before, indicating that something is affecting the area.
How to treat it: Whenever cancer is suspected, you should see a doctor as soon as possible, as early diagnosis will improves your chances of a cure. However, the removal of the affected testicle is necessary in almost all cases of testicular cancer.
8. Orchitis
Orchitis is an inflammation that can affect one or both testicles. It can be caused by a blow to the area, testicular torsion, or a bacterial or viral infection, especially the mumps virus.
Orchitis can lead to symptoms such as pain, swelling, redness, and sensitivity in the testicles. In more severe or untreated cases, this condition can interfere with fertility, although this is not very common.
How to treat it: Anti-inflammatory and analgesic medications, such as ibuprofen or acetaminophen, are usually prescribed to help manage symptoms. This condition will resolve once the underlying cause is addressed.
9. Hydrocele
A hydrocele is an abnormal accumulation of fluid in the scrotum. It is more common in newborns, although it can also affect adults.
In addition to testicular pain, this condition can also lead to scrotal swelling and heaviness.
How to treat it: Hydroceles in adults are usually conservatively treated as they tend to resolve on their own in about 6 months. If the fluid is not reabsorbed, or continues to worsen, the doctor may advise surgery or aspiration of the fluid.
10. Spermatocele
A spermatocele is a small cyst that develops in the epididymis, the region where the duct that transports semen joins the testicle. This cyst can cause a feeling of heaviness in the testicles, as well as pain on the side of the affected testicle, especially when the cyst is large.
How to treat it: most cases of spermatoceles do not cause any type of discomfort and generally do not require treatment. In cases where pain is moderate, the urologist may prescribe anti-inflammatories to reduce swelling in the area. However, if symptoms persist, an evaluation may be necessary to determine whether surgery is necessary.
11. Hematocele
A hematocele is the accumulation of blood in the scrotum that can be caused by a strong blow to the scrotum. This condition is associated with symptoms like inflammation, pain and a feeling of pressure in the affected area. It can also cause a change in testicular shape. If left untreated, it can lead to complications such as infection.
How to treat it: Treatment for a hematocele depends on the severity. Mild cases may involve just periodic monitoring, while more severe cases may require drainage or surgery.