Aching Testicles: What You Should Do?

A blow to the balls is no laughing matter – at least not to the guy on the receiving end!

Testicular pain can indeed arise from a blow or other type of injury such as, for example, testicular torsion, a condition that requires emergency medical attention.

Inflammation, sexually transmitted infections (STI), or even testicular cancer could cause that ache you’re feeling.

Not all testicular aches are grave, but it is important for you to be aware of when you may require immediate medical attention.

Testicular pain can be described as one of two types: acute or chronic

Acute testicular pain is typically caused by a sudden injury. The pain may be intense, but it usually goes away rather quickly – you know the type.

Chronic testicular pain arises gradually and lasts a long time. It may come and go, or it may constantly ache. It usually increases with time or with physical activity.

Either kind of pain could affect only one or both testicles. 

Testicular pain can be accompanied by swelling, which could be caused by a tumour. Other symptoms are a dull ache that spreads to the entire groin, or a noticeable lump.

While you’re grooming your pubes, you should make a habit of examining your balls for a lump or tumour. You have doubtless heard the same advice for women regarding breast cancer. Well, the same applies to your valuable jewels.

If you think you have a lump or tumour, you should definitely seek professional medical help. It may end up being nothing, but it’s best to let a medical professional diagnose what – if anything – is wrong down there.

Why is self-examination so important? Because testicular cancer does not necessarily cause noticeable pain. The best way to detect testicular cancer early is by examining yourself for a lump in your balls.

What are the risk factors for testicular cancer?

Testicular cancer can strike literally any man regardless of age. Men who engage in heavy work and in sports – especially the full contact variety – do have an increased risk.

And just because you don’t feel an ache in your balls doesn’t mean nothing is wrong. A pain or ache in another area, especially your grown or lower abdomen, can be a sign that the problem is actually in your testicles. This kind of pain is called ‘referred pain’ – the problem in one area causes pain in another.

Don’t ignore aching balls and hope it goes away. Testicular pain can be a symptom of a serious problem.

Aching Balls – Causes and Treatments

Epididymitis

Epididymitis describes an inflammation or swelling of the epididymis. And what, pray, is that? It is a group of tightly coiled tubes that convey sperm from the testicles to the sperm duct.

Several conditions can cause Epididymitis. In addition to groin injury, other causes are:

  • STIs such as chlamydia and gonorrhea
  • Bacteria arising from a prostate infection or urinary tract infection (UTI)
  • A viral infection such as the mumps.
  • Urine in the epididymis
  • Tuberculosis

Some symptoms of epididymitis include: 

  • Blood in the semen
  • Discharge from the penis
  • Swollen or red scrotum
  • Scrotum feels tender
  • Scrotum feels hot to the touch
  • Painful urination accompanied by the urgent need to urinate
  • Discomfort in the pelvis or lower abdomen
  • Gradual increasing testicular pain, usually on one side

There are some risk factors that can lead to getting sexually transmitted epididymitis. These risk factors are the same as those for other STIs like a history of STIs or sexual intercourse without condoms. Safe sex is the best way to protect yourself.

Another risk factor is a history of prostate infections or UTIs (urinary tract infection). This can lead to contracting epididymitis non-sexually and can be caused when a urinary catheter or a scope is inserted into the penis or any procedure involving the urinary tract or prostate.

Other infections like bacterial orchitis, which can be caused by epididymitis, can cause testicular pain. Viral orchitis can be caused by the mumps, which is only one of many good reasons to get vaccinated against it.

Treating Epididymitis

There are a few rather simple ways to treat Epididymitis:

  • Effective antibiotics can be prescribed
  • Elevating the scrotum
  • Cooling the affected area with ice
  • Promoting urination by increasing liquid intake

Factors involving the abdomen

Nerves lead from many organs in the abdomen to your testicles, especially the intestinal tract, kidneys and stomach.

Constipation can in fact cause pain in your testicles because the pressure constipation causes can affect the nerves that lead to your balls. Kidney stones and stomach aches can also lead to testicular pain.

Kidney stones can cause a wide range of symptoms which include:

  • You feel nauseated or vomit
  • Your urine smells bad or is cloudy
  • It burns when you urinate
  • Your urine appears brown, pink or red (a sign of blood in the urine)
  • You feel a constant and increasingly frequent need to urinate, and you urinate in small amounts 
  • You experience sharp cramps that shoot from the back to the groin
  • You experience pain in your sides, back, and below the ribs
  • You experience fluctuating pain
  • You have difficulty urinating

Smaller kidney stones can be easily treated. Pain relievers are available, and alpha blockers can be prescribed to relax your ureter muscles.

Larger kidney stones are a different matter since they are too large to pass through your ureter. They can also cause bleeding. Thus, a medical procedure is almost always required. Treatments include: 

  • Introducing a ureteroscope into and up your ureter. This has a camera and incorporates lighting to see the stone and break it into smaller pieces that can then be passed.
  • Extracorporeal shock wave lithotripsy (ESWL) uses sound waves to break up the kidney stone so that it can be passed.
  • If an ESWL is not successful, an operation may be necessary. In this case, the stone is surgically removed from the kidney.

Inguinal Hernia

Should a part of the abdominal muscle wall near the groin weaken, the intestine there could actually push through the wall and result in an Inguinal Hernia. This is an especially serious condition that can cause your balls to ache and swell.

An inguinal hernia can often be treated by pushing the intestine back into place. However, surgery may be required. Although not necessarily dangerous, one should seek help if it becomes too painful.

Testicular Torsion

A spermatic cord attaches your testicles to your body. This cord conveys sperm to your urethra. If this cord is twisted, it cuts off the flow of blood to your balls, which can cause your scrotum to swell, produce intense pain and cause serious damage.

Although most common in men aged 12 to 18, men can incur it at any age. This condition can occur very suddenly during sex, a workout, or even while sleeping. There are, unfortunately, no clearly identified “early warning signs”. It can be caused by injury to the testicle or by a so-called “bell clapper” deformity.

Bell-Clapper Deformity describes a condition in some males where the balls are not firmly attached to the scrotum. The balls therefore swing freely, clapping together (thus the term). This increases the chances of a spontaneous twisting of the spermatic cord.

Signs and Symptoms of Testicular Torsion

You will suddenly feel extreme pain, usually in one testicle and almost always in the left testicle.

If this sudden pain was not caused by any injury you experienced, you would be right in suspecting that something is seriously wrong down there. Seek medical attention immediately if you experience the following symptoms:

While sudden, sharp pain in your scrotum, that’s not caused by an injury or accident, might let you know that all’s not well with your balls, see a doctor immediately if you also experience symptoms such as: 

  • Your balls are larger than normal – the average size of men’s balls is 3cm to 5cm long and 2cm to 3cm wide.
  • Your ball sack is swollen
  • You experience pain in the lower abdomen
  • You feel a frequent urge to urinate
  • One ball hangs much higher than normal
  • Nausea and vomiting

Treating Testicular Torsion

The severity of cutting off blood flow to your balls requires immediate medical attention. 

Testicular torsion is a condition that requires prompt medical treatment. The affected gonad needs to have its blood supply restored.

If you experience sharp, intolerable pain in your balls that medication cannot treat, you need to see a doctor as soon as possible. Don't wait and hope it goes away!

Surgery will be necessary – and fast. If you don’t get this condition treated within six hours, that lack of blood supply to your ball will lead to cell death, and you’ll lose the ball! 

In Summary

Your balls should be pretty darned important to you. You can’t always prevent something from happening, but you can do a lot to get them properly treated. 

Your physician may use ultrasound to scan your testicles and scrotum to find out what is wrong. Your urine will probably be tested for bacteria or other irregularities as well as your prostate secretions.

The following table summarizes the causes, the risk factors and the treatments for testicular pain:

Condition

Risk Factors

Treatment

Epididymitis

  • STIs 
    • Gonorrhea
    • Chlamydia
  • UTIs
  • Mumps virus
  • Prostate infection
  • Urine in the epididymis
  • Antibiotics

Abdominal Issues

  • Referred pain caused by:
    • Kidney stones
    • Stomach ache
    • Inguinal hernia
  • Treat source of referred pain

Testicular torsion

  • “Bell clapper” deformity
  • Injury to testicle
  • Surgery 

Become familiar with symptoms and other warning signs and get into the habit of examining your balls whenever you shave down there. It may save you a lot of pain, and even your balls!