Av. de los Tules 168, Las Aralias, Puerto Vallarta
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Key points
Key points- Testicular pain can start in the testicle, the epididymis, or the spermatic cord, or come from other areas such as the groin or lower back.
- Sudden, severe pain with nausea or vomiting may be testicular torsion and requires emergency care.
- Varicocele, viral orchitis, and recurrent bacterial epididymitis can affect fertility.
- Testicular cancer does not usually hurt in its early stages, so any lump or change in the testicle should be evaluated.
- A urological evaluation includes a physical exam and, depending on the case, Doppler ultrasound and urine, blood, or semen tests.
Why does testicular pain occur?
Testicular pain can have very different causes, from a varicocele or an infection to testicular torsion, which is a medical emergency. Identifying the source of the pain is the first step toward an accurate diagnosis.
It is one of the most common symptoms that lead men to see a urologist, and also one of the most underestimated. Many patients wait days or even weeks, expecting the discomfort to go away on its own.
The testicles are highly sensitive organs with a complex network of blood vessels and nerves. That is why pain can start in the testicle itself, in the epididymis, or in the spermatic cord, or come from other structures such as the groin or lower back.
Go to a hospital emergency room right away
Sudden, severe testicular pain
If testicular pain is sudden, very intense, or comes with nausea and vomiting, go to the emergency room or call 911. Testicular torsion cannot wait.
- Sudden, very intense pain
- Nausea and vomiting
Call 911
The office does not handle emergencies: go directly to a hospital.
7 causes of testicular pain you should know
Varicocele
Widening of the veins of the spermatic cord, frequent in young men. It causes a dull, heavy, or throbbing ache that worsens with standing and improves when lying down. Most common on the left.
Epididymitis
Inflammation of the epididymis, frequent between ages 18 and 35. Pain increases gradually, with swelling and local warmth. The most common causes are sexually transmitted infections.
Orchitis
Inflammation of the testicle. The most widely known cause is the mumps virus. Pain is usually intense, with visible swelling and fever. In unvaccinated adults, it can lead to testicular atrophy.
Testicular torsion
A medical emergency: the testicle rotates on the spermatic cord and blood flow is cut off. Pain is sudden and severe. Without surgery within the first 4 to 6 hours, irreversible damage can occur.
Inguinal hernia
It can cause pain or pressure that spreads toward the scrotum and is mistaken for a testicular problem. If you notice a groin bulge with exertion, an evaluation is advisable.
Hydrocele and spermatocele
A hydrocele is fluid around the testicle; a spermatocele, a benign cyst in the epididymis. They usually do not hurt, but can cause chronic discomfort and should be evaluated to rule out other causes.
Referred testicular pain
It comes from other structures, such as the kidneys (renal colic), the lower back, or abdominal nerves, and is felt in the scrotum with no direct testicular injury. It calls for a thorough evaluation.
Can testicular pain be a tumor?
A frequent question in the office is whether testicular pain can indicate a tumor. Unlike most of the causes above, testicular cancer does not usually cause pain in its early stages.
It most commonly shows up as a hard lump that does not hurt or as a feeling of heaviness in the testicle, noticed by the patient during self-examination or by chance. When there is pain, it tends to appear in more advanced stages or because of associated inflammation.
This does not mean that pain rules out a tumor, but rather that it is not its main symptom. Early detection of a testicular tumor is associated with a more favorable prognosis.
When does testicular pain affect fertility?
Some causes of testicular pain have a direct impact on male fertility.
Varicocele
It raises scrotal temperature and impairs sperm production and quality. When left untreated, it can worsen over time and progressively compromise reproductive function.
Viral orchitis and recurrent bacterial epididymitis
These can also leave lasting damage to the seminal ducts.
If you are trying to have children
Testicular pain, even if mild and occasional, should be evaluated with a semen analysis and a complete urological exam. Detecting and treating the cause in time can help protect your fertility.
Diagnosis: how testicular pain is evaluated
A urological evaluation for testicular pain includes the following studies.
Physical exam
A detailed exam of the scrotum, epididymis, and spermatic cord.
Testicular ultrasound with Doppler
Shows the structure of the testicle in real time, assesses blood flow, and detects masses, inflammation, or varicocele.
Urinalysis and culture
To rule out infection.
Blood tests
When infection or a hormonal imbalance is suspected.
Semen analysis
In selected cases, to assess fertility.
When to see a urologist for testicular pain
- The pain lasts more than a week without an apparent cause, or is chronic, even if mild, and worsens at the end of the day or after prolonged standing.
- You notice swelling, firmness, or a change in size in one or both testicles, or a hard lump or irregularity, even if it does not hurt.
- The pain appears after an injury and does not improve within a few hours.
- You have fever, burning during urination, or discharge along with the pain.
- You are trying to conceive and have recurring testicular pain.
Book an evaluationUrological evaluation in Puerto Vallarta
In Puerto Vallarta, Dr. Bricio performs a comprehensive urological evaluation to identify the source of testicular pain and propose the appropriate treatment for each case. The consultation is available to local patients and to those traveling from the United States or Canada.
Testicular pain should not be ignored or put off. What seems like minor discomfort may be a treatable condition. If you have concerns, the first step is having your case assessed by a specialist.
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