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Testicular Pain (Ball Pain) in Men and Boys: Causes, Symptoms, and Treatment Relief

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What are the testicles?

The testicles form part of the male reproductive organs, with a primary function of producing sperm and the male hormone testosterone.

  • Testicles are contained within an external sac-like structure called the scrotum, which is located between the penis and the anus.
  • Adult testicles are about the size two large olives
  • It is common for one testicle to hang lower than the other within the scrotum.
  • Located near the back of each testicle lies the epididymis, which is a coiled tubular structure that functions to store and transport sperm.
  • A tubular structure containing blood vessels, nerves, lymphatic vessels and the vas deferens called the spermatic cord courses from the abdomen and is connected to each testicle. Apart from containing vital structures for each testicle, the spermatic cord also suspends the testicles within the scrotum.

Picture of the male urinary and reproductive structures

Testicular pain definition and facts

  • Testicular pain refers to pain or discomfort felt in one or both testicles. The pain may be acute or chronic, dull, sharp, or a sensation of soreness or vague discomfort/ache.
  • The primary role of the testicle is to produce sperm and the hormone testosterone.
  • Many diseases and other health conditions can cause testicular pain, and some causes are medical emergencies.
  • Common causes of testicular pain include:
    • Inguinal hernia
    • Orchitis
    • Infections like the mumps
    • Epididymitis (caused by sexually transmitted diseases or STD)
    • Kidney stones
    • Testicular tumor, testicular torsion or trauma
    • Cancers
    • Twisted testicle(s) – testicular torsion
  • The signs and symptoms may include testicular:
    • Redness
    • Tenderness of the testicle and/or scrotum
    • Pain in one or both testicles
    • Swelling
  • You also may have nausea, vomiting, and fever.
  • The different causes of testicular pain can be diagnosed using blood tests, urinalysis, and imaging studies, in addition to a complete physical exam.
  • The treatment for testicular pain varies depending on the underlying cause, and/or may include pain medication, antibiotics, and surgical intervention.
  • The complications of the conditions causing testicular pain may include infection, impaired fertility, and permanent damage to the testicle, or loss of the testicle.
  • Only a few causes of testicular pain are preventable.
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What does testicular pain feel like? How severe is the pain?

Testicular pain is pain or discomfort that is felt in one or both testicles. The pain may originate from the testicle itself, or it may be the result of other conditions affecting the scrotum, groin, or abdomen. Though there are numerous medical conditions that can cause testicular pain, it is important to understand that a few of them constitute medical emergencies that require immediate medical attention in order to prevent impairment or loss of testicular function. Testicular pain can be an acute (short-term) or chronic (long-term) condition. The testicular pain may be constant or intermittent.

Causes and symptoms of pain in the testicles

Many diseases and other health problems can cause pain in one or both testicles. Testicular pain along with other symptoms and signs vary depending on the underlying cause. However, often times the symptoms can be very similar between the various causes, making it difficult to distinguish among the conditions which require urgent medical attention. Therefore, if you experience testicular pain, call your doctor immediately or go to the nearest Urgent Care or Emergency Department.

Testicular torsion causes, symptoms, and signs

Testicular torsion typically occurs because of an anomaly affecting the normal attachment of the testicle within the scrotum, often referred to as the “bell clapper” deformity. This abnormality allows the testicle to be freely suspended and twist spontaneously. Often times, this anomaly is present in both testicles. Trauma to the testicle is a rare cause of testicular torsion.

Testicular torsion is most common in males younger than 30 years of age, with a peak incidence between 12-18 years of age. It can also occur more frequently during the neonatal period. Testicular torsion most often affects the left testicle, and it is the most common cause of testicle loss in adolescent males.

Testicular torsion generally comes on suddenly. Severe testicle pain that only felt in one testicle may also have these signs and symptoms:

  • Abdominal pain
  • Fever
  • Elevation of the affected testicle within the scrotum
  • Horizontal positioning of the affected testicle within the scrotum
  • Nausea and vomiting
  • Testicular and/or scrotal tenderness
  • Testicular and/or scrotal swelling and redness
  • Loss of the cremasteric reflex on the affected side (normally, the testicle elevates with light stroking of the upper inner thigh area).
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Epididymitis causes, symptoms, and signs

Epididymis occurs when there is inflammation of the epididymis (a structure within the scrotum. Generally, the condition is result of an infection. Epididymitis primarily affects adult men, and is most common between the ages of 19 to 40 years; however, it can occur in prepubescent boys and elderly men.

Sexually transmitted diseases or STDs are the most common cause of epididymitis In sexually active men., most commonly caused by the bacteria Chlamydia trachomatis and Neisseria gonorrhoeae. In younger and older males, the infection usually is caused by bacteria that are found in the urinary tract, such as Escherichia coli (E. coli). Infection in these age groups is typically the result of an abnormality within the genitourinary system.

Epididymitis comes on gradually.The testicular pain can be mild, moderate, or severe, and that is only in one testicle also may have symptoms and signs including:

  • Nausea and vomiting
  • Fever
  • Urethral discharge
  • Urinary symptoms, such as burning, urgency, or frequency
  • Testicular and/or scrotal tenderness, typically localized to the area of the epididymis, though it can become more generalized and involve the whole testicle as the illness progresses.
  • Testicular and/or scrotal swelling and redness
  • Abdominal pain