Testicle Problems

The testicles (also called testes) are two oval shaped organs that make and store sperm. They also make male sex hormones. The testicles are inside the scrotum. This sac of skin hangs under the penis. The scrotum can swell or be painful without a testicle problem. An example of this is an inguinal hernia.

Problems that affect the testicles include: Injury, swelling and infection; torsion; undescended testicles; and cancer.

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Signs & Symptoms

For Injury, Swelling, and/or Infection

Prostate Health

• Pain and swelling in the scrotum.

• Feeling of heaviness in the scrotum.

Jock Itch

For Torsion of a Testicle

• Sudden and severe pain in the scrotum.

• Swelling. Most often, this occurs in one testicle.

• Fever.

• Abdominal pain. Nausea. Vomiting.

For Undescended Testicles

• In baby boys, testicles do not descend into the scrotum from the abdomen before birth or within months of birth like they should.

For Cancer of a Testicle

In the early stages, there may be no symptoms. When symptoms occur, they include:

• A lump on a testicle, epididymis, or vas deferens.

• An enlarged testicle.

• A heavy feeling, pain or discomfort in the testicle or scrotum.

• A change in the way a testicle feels.

• A dull ache in the lower abdomen or groin.

• Enlarged or tender breasts.

• Sudden pooling of fluid in the scrotum.

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Resources

National Cancer Institute

800.4.CANCER (422.6237)

www.cancer.gov

Causes

For Injury, Swelling, and Infection

• Trauma to the testicles from being hit, kicked, struck, etc. Often, this occurs during sports. Though rare, trauma to the abdomen can cause the testicles to move outside the scrotum.

• Orchitis. With this, a testicle is inflamed. Often it is due to an infection, such as mumps or chlamydia. The epididymis can also be inflamed from an infection.

For Torsion of a Testicle

When the spermatic cord twists, a testicle rotates. This cuts off blood supply to and from the testicle.

• This usually occurs in males under age 30, most often between the ages of 12 and 18.

• Symptoms often occur after physical activity or during sleep.

• Symptoms may occur for no known reason.

For Undescended Testicles

Testicles fail to drop from inside the pelvic area down into the scrotum before birth or within a year of birth.

For Cancer of a Testicle

The cause is not known. Risk factors include:

• Undescended testicles that are not corrected in infants and young children. Parents should see that their infant boys are checked at birth for this problem.

• Having cancer of a testicle in the past.

• A family history of cancer of a testicle, especially in an identical twin.

• Injury to the scrotum.

Treatment

For Injury, Swelling, and/or Infection

• Pain from a minor injury to a testicle usually goes away on its own.

• Antibiotics treat bacterial infections. Untreated infections can cause infertility.

For Torsion of a Testicle

Emergency medical care is needed. The testicle may be untwisted by hand. If not, surgery is needed to restore blood flow to the testicle.

For Undescended Testicles

Surgery is done to bring the testicles down into the scrotum.

For Cancer of a Testicle

This kind of cancer is almost always curable if it is found and treated early. Surgery is done to remove the testicle. Other things can further treat the disease:

• Chemotherapy.

• Radiation therapy.

• If needed, lymph nodes are removed by surgery.

Questions to Ask

Question 1

Do you have any of these problems all of a sudden?

• Severe pain in the scrotum or in one testicle.

• Tenderness and swelling in the scrotum (most often in one testicle) with fever, abdominal pain, nausea, and/or vomiting.

• A tender nodule in the upper and outer area of a testicle.

• A testicle is bluish in color.

• Painful erection that lasts longer than 4 hours.

Get medical care without delay. If symptoms are life threatening go to the ER or call 9-1-1. Don’t call 9-1-1 or use the ER if symptoms do not threaten life. Ask your doctor ahead of time where you should go for a problem that needs prompt care, but not emergency care.

Question 2

Have you had an injury, trauma, or abuse (including sexual assault) to the genital area? Or, does bleeding come from the scrotum?

Question 3

Do you get a fever and swelling and pain in the testicle(s) after having the mumps?

Question 4

Are any of these problems present?

• Signs and symptoms of cancer of a testicle.

• Signs and symptoms of chlamydia.

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 5

Do you have any of these problems?

• Swelling in the scrotum that was soft and painless, but is now painful or very uncomfortable.

• Swelling in the scrotum and/or a change in the way the scrotum normally feels.

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 6

In a baby boy, has a testicle not descended into the scrotum by one year of age?

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Use Self-Care / Prevention:

You can probably take care of the problem yourself if you answered NO to all the questions. Use the “Self-Care” measures that are listed. Call your doctor if you don’t feel better soon, though. You may have some other problem.

Self-Care / Prevention

To Avoid Injury to the Scrotum

• Wear protective gear and clothing during exercise and sports.

• Wear an athletic cup to protect the testicles.

To Help Prevent Infections

• See that your children get vaccines for measles, mumps, and rubella (MMR) as advised by their doctor.

• To help prevent STDs, follow “Safer Sex” guidelines.

To Treat Infections

• Take medication as prescribed.

• Take an over-the-counter medicine for pain and swelling, if needed. Follow directions.

• Rest.

• Apply cold compresses or an ice pack to painful, swollen area.

Testicular Self-Exam

Talk to your doctor about doing testicular self-exams (TSEs). If you choose to do TSEs, follow your doctor’s advice.

The best time to do a TSE is after a warm bath or shower. This relaxes the scrotum, allows the testicles to drop down, and makes it easier to find anything unusual. Doing a TSE is easy and takes only a few minutes.

1. Stand in front of a mirror. Look for any swelling on the skin of the scrotum.

2. Examine each testicle with both hands. Place your index and middle fingers underneath the testicle and your thumbs on top. Gently roll one testicle then the other between your thumbs and fingers. One testicle may be larger. This is normal. Examine each testicle for any lumps. These are usually painless and about the size of a pea.

3. Find the epididymis. This is the comma-shaped cord behind the testicle. It may be tender to the touch. Check it for lumps.

4. Examine the vas deferens. This is the tubelike structure at the back of each testicle. Check it for lumps.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.

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