Testicular Pain

Testicular pain is a symptom that should definitely not be ignored, although very often it is caused by relatively non-serious conditions. It is necessary to know that pain occurring in testicles can actually radiate from another part of the body.


Direct mechanical damage

A stroke in testicles is accompanied by a sharp unpleasant pain. Testicles are innervated by nerve fibers that also supply digestive tract. That is why sudden injuries of testicle also provoke nausea and vomiting.

Sexual activity

With higher frequency of sexual intercourse mild unpleasant pain of testicles may occur. The pain is not intense and retreats quickly after short period of sexual abstinence.

Testicular torsion

This dangerous condition is also labeled as strangulation of the testicle. Testicle is nourished by blood vessels abdominal cavity. If the testicle rotates in scrotal sac, its artery can become strangled halting blood flow and nutrition to affected testicle. The condition is most common in boys under 18 years of age. It manifests with sudden onset of severe testicular pain that may, radiate towards the groin. It is inevitable to visit a doctor as soon as possible. This is a urological emergency situation and quick surgical intervention may save the testicle's tissue. During such intervention, testicle is derotated and blood reperfusion is assured. Otherwise irreversible damage and necrosis of the testicle can occur with total loss of its function.

Infectious diseases

Bacterial infectious inflammation affects particular the tissue of epididymis (so-called epididymitis). This is a small glandular organ located in scrotum above the upper pole of both testicles. The infection causes strong testicular pain (more precisely scrotal pain) that is accompanied by elevated temperature. Some sexually transmitted infections cause epidydimitis as well such as gonorrhea or chlamydia infections. However, there is also an infectious inflammation that directly causes inflammation of testicular tissue (so-called orchitis). It is the mumps virus (not so common thanks to vaccination).

Urinary tract stones

Stones in urinary tract often cause kidney colic. This annoying intermittent pain may by a male radiate from the abdomen towards his testicles.


This condition is associated with impaired outflow of venous blood from the testicle. It appears as uncomfortable feeling that sometimes turns into a small intense pain.

Note: Malignant and benign tumors of the testicles usually do not hurt, they more often cause a painless enlargement of the affected testicle. Therefore, regular self-examination of testes is a good idea as is breast self-examination by women. Asymmetry of testicles should be addressed to a urologist, who examines the patient by palpation and who may indicate a scrotal ultrasound.

Diagnostic approach

Any stronger testicular pain should be checked by a doctor, ideally by a urologist. In addition to inspection and palpation, scrotal sac including testicles is well-examinable by ultrasound. Further tests may be directed according to clinical suspicion – blood tests for diagnosing an infection (leukocytes and CRP levels), abdominal X-ray or ultrasound to confirm urinary stones etc.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources