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1/5/23 blog post

when to be concerned about testicle pain

Boy laying in pain

in this article:

Testicular pain can be a result of several different causes, ranging from normal growth of the testicles, infection, injury or testicular torsion. Testicular torsion is one of the most serious causes of testicular pain and needs to be addressed urgently to prevent permanent damage to the testicle.

what is testicular torsion?

Testicular torsion is a very painful twisting of the testicle and spermatic cord that can occur in boys. About one in every 400 boys will experience testicular torsion. Typically, this will result in a sudden, severe pain in the affected testicle or the scrotum in general.

Other causes of testicular pain often start gradually and may not be as severe. The pain caused by testicular torsion is usually described as the worst pain the child has ever experienced or could imagine.

Additional symptoms or signs can include:

  • Scrotal swelling and redness
  • Abdominal pain
  • Nausea or vomiting.

It is most likely to occur in boys 10 years of age or older, but can also occur in a baby right before or after birth. When the twisting occurs, it prevents blood from flowing to the testicle, and if it is not corrected quickly, the testicle may die and need to be removed.

what causes testicular torsion?

Testicular torsion occurs because the testicles (or the small sac around them) are not fully attached to the scrotum. This allows the testicles to move more than they otherwise would. It can be preceded by physical activity but will more often occur when a child is at rest (not associated with trauma or injury).

how is testicular torsion treated?

First, a torsion is diagnosed by the patient's history, a physical exam and potentially an ultrasound of the scrotum to evaluate the testicles and their blood flow. Once a diagnosis is made, to prevent permanent damage to the testicle, it needs to be untwisted as quickly as possible (ideally within six hours of the start of the pain). This may be done in the emergency department but is typically performed in the operating room. To prevent it from happening again in the future, both testicles are secured to the inside of the scrotum during the surgery.

what to watch out for?

Boys should understand that it is possible for the testicles to twist and that it is a very serious problem if this happens. If they experience sudden, severe testicular pain or swelling, they should tell a trusted adult immediately (rather than trying to "tough it out") and seek evaluation at an emergency department as soon as possible to ensure that they receive appropriate care.

If your child is experiencing non-urgent testicle pain or discomfort that is not described above, you can schedule an appointment online with one of our urology specialists.


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Christopher Brown, MD

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