Why do my testicles hurt

Testicular pain: uncomfortable, but mostly treatable

Redness, dull or even stabbing pain, swelling or a very uncomfortable pulling that extends into the groin or even into the back: Almost every man suffers from testicular pain at some point - and it can be easy to bear, but also very uncomfortable be.

Perhaps the most sensitive part of a man are the testicles. It is not for nothing that football players hold their hands protectively in front of this body part during free kicks in order to protect themselves from possible pain. However, there are other causes of testicular pain that must be taken much more seriously than a bouncing ball. A twisted testicle, which doctors call testicular torsion, is very common. Testicular cancer cannot be ruled out as a trigger either.

od pain can have many different causes. A doctor should therefore always be consulted in the event of persistent testicular pain.

First, a few facts about the male genitalia.

The male testicle: structure and function

The two paired testes are the male gonads, this is where the sperm are produced. These have an elongated shape, an average of three centimeters in diameter and hang freely on the spermatic cord in the scrotum (scrotum). With good reason: Because the temperature-sensitive sperm are in good hands in the scrotum. The temperature in the scrotum is about two to three degrees lower than in the abdomen. Ideally, it is a constant 34 to 35 degrees.

At the onset of puberty, around 200 million sperm are produced every day. The development of the sperm in the seminal canals within the testicle takes about ten weeks in humans. Then the mature sperm cells are stored in the epididymis (epididymis). The spermatic duct (ductus deferens) starts from the epididymis. It connects the testicle to the urethra in the prostate. During an ejaculation, the sperm are expelled through the urethra along with the seminal fluid formed in the prostate and seminal vesicles.

Most of the male sex hormone testosterone is also formed in the testes - in the so-called Leydig cells. The testicle size varies from man to man. Before puberty, the testicle is the smallest. In adulthood, the testicle increases in size and begins to shrink again around the age of 50.

Why are the testicles so sensitive?

There are numerous nerves and muscles in the testicles. This makes the testicles a particularly sensitive part of the male body - depending on the situation in life, this can be perceived as positive or negative. When making love, for example, the testicles are one of the most erogenous zones. However, as soon as there is some kind of disorder in the testicular area, sometimes severe pain can occur.

Testicular Pain - Where Can It Come From?

There is widespread concern that testicular pain is primarily associated with testicular torsion or even testicular cancer. But that is - in the truest sense of the word - too short-sighted. Because the triggers for testicular pain can also be located in parts of the body that are relatively far away from the testicle. For example, even an inguinal hernia or a herniated disc can lead to pain in the testicles.

Our recommendation: If you experience severe or prolonged pain or extreme pulling in the testicle area, please consult a doctor you trust.

Mild, moderate, or severe testicular pain, possible causes

1. Inflammation of the epididymis (epididymitis)

Inflammation of the epididymis is usually caused by bacteria that enter the epididymis either through the blood or, in the case of a urinary tract or prostate infection, through the vas deferens. Infection during unprotected sexual intercourse is also possible. Typical symptoms of epididymis: burning sensation when urinating, the affected side is hot, red, swollen and sensitive to the touch. Those affected should consult a doctor immediately if they have these symptoms so that they can prescribe antibiotics and possibly also pain relievers.

2. Inflammation of the testicles (orchitis)

Inflammation of the testicles is much less common than inflammation of the epididymis. Bacterial testicular inflammation usually occurs in combination with epididymitis. Viral testicular inflammation in boys is usually the result of a mumps infection.

Symptoms of testicular inflammation include a burning pain when urinating, for example, high fever, increased urination and nausea. If a testicular inflammation is left untreated for a long time, there is a risk of permanent damage to the testicular tissue, which in the worst case can lead to infertility because the sperm production no longer works .

Treatment: Bacterial testicular infections are treated with antibiotics. The treatment of viral orchitis, on the other hand, is mostly limited to relieving pain and fighting the inflammation.

Protection against testicular inflammation

Those who protect themselves against mumps - with a vaccination - can also lower the risk of testicular inflammation. Mumpf vaccinations are only possible in childhood. Adults who do not have protection against mumps - whether because they have not been vaccinated or because they never had the disease themselves - should stay away from children who are infected with mumps.

Anyone who has had changing sex partners should always protect themselves with a condom - also to prevent testicular inflammation. Regular prostate check-ups should also be a matter of course for men over the age of 45. As is so often the case here, the earlier a disease is discovered, the greater the chances of success of the subsequent treatment. This is especially true for testicular cancer.

3. Bruised testicles

The scene mentioned at the beginning during a soccer game also hurts the viewer: the ball lands with full force in a man's testicles. From a medical point of view, this is a testicle bruise. A comparable injury is possible through a blow or kick in this area or car and bicycle accidents.

In the best-case scenario, a bruise of the testicles will only result in a bruise. Although this is extremely painful in the first few minutes, it usually has no health effects. Above all, good cooling is recommended for those affected and patience when the bruise subsides, which can take several weeks.

Violence of any kind on the testicles must be taken much more seriously whenever the pain does not subside and symptoms such as nausea, swelling, redness or even bleeding occur. It may then have ruptured the testicle, which is a tear in the testicular tissue. This usually has to be treated surgically.

By the way: handball goalkeepers are among those athletes who are particularly at risk of bruising their testicles. Therefore, wearing a jockstrap, also jokingly called an egg cup, is part of their basic equipment.

4. Testicular rupture

When the testicle ruptures, the skin that surrounds the testicle tears. The pain is usually worse than an ordinary blow or kick "in the twelve". Here, too, it is important to provide cooling and to see a doctor immediately. With the help of ultrasound and palpation, the doctor can determine whether the tunica albuginea is torn. If so, they will be sewn back together.

5. Abscesses in the testicle

An abscess is a collection of pus in a newly formed cavity in the tissue. Abscesses can form anywhere in the body, including the testicles. Here they are usually accompanied by severe pain and tenderness. Abscesses are mostly triggered by bacteria that invade the body, multiply there and are therefore fought by the immune system. As a result, there is an inflammatory reaction and the abscess forms. An abscess on the testicle usually has to be removed surgically. The procedure often takes place under general anesthesia.

6. Testicular torsion

At aTesticular torsion, which arises without external influences, the testicle (or the epididymis) twists around its longitudinal axis on the spermatic cord. This means that adequate blood flow to the testicle is no longer guaranteed because the blood vessels that supply the testicles are constricted. In this case, a doctor must be consulted as soon as possible. Because such a torsion can interrupt the blood supply to the testicles. If this is not restored in a timely manner, there is a risk of permanent and irreparable damage.

Symptoms: how does a testicular twist become noticeable?

Testicular torsion is very painful. If severe testicular pain is accompanied by nausea, this can indicate a twisted testicle. Additional symptoms are swelling and redness of the testicles.

Therapy: How is a testicular twist treated?

Sometimes an external twist through the skin of the scrotum is sufficient. Most of the time, however, a twisted testicle can only be repaired surgically. The corresponding intervention, in which the testicle is first brought back into its correct position and then fixed with a seam inside the scrotum, usually also includes an intervention in the second testicle. This is done preventively. Because if there is a torsion in one testicle, there is also an increased risk of torsion in the second.

Amputation of the testicle may only be necessary as a last resort for pain relief if torsion is dragged on and not treated in time.

Hydatid twisting (torsion), which is harmless to men, can lead to symptoms similar to those of testicular torsion. Hydatiden are the appendages of testicles (epididymis). Here too, if in doubt, the testicle should be surgically exposed.

Causes: how does a twisted testicle come about?

The possible causes of testicular torsion are very different. They range from complications in the embryonic phase to a simply unfavorable lying position when sleeping. The latter is also evident from the fact that half of all torsions and the associated testicular pain appear for the first time at night.

Testicular torsion can affect men of all ages. A twisted testicle is particularly common in the first year of life and in teenagers.

7. Broken testicle

A broken testicle (scorthal hernia) can also cause severe pain, but it doesn't have to be. However, some men feel really sick or have blood in their stools. A testicle hernia is not a classic break, but rather a tear in the tissue in the abdominal wall. Testicular ruptures occur mainly in boys and young men - or between the ages of 40 and 50. Possible causes: Usually a scrotal hernia develops as a result of heavy and improper lifting.

Treatment for a testicle hernia is based on the extent of the injury. The classic truss, a kind of corsage, is a conservative treatment method. If it is possible to push the hernial sac back into its original position, it is important to close the gap that has formed. This is done using a special, minimally invasive sewing technique. In order to avoid a broken testicle, the tissue should always be protected from excessive pressure. Jerky movements and lifting heavy loads should also be avoided if possible.

8. Wandering or pendulum testicles

In some men, the testicle pulls all the way up into the inguinal canal in response to certain stimuli such as cold or sexual arousal. As a rule, a pendulum testicle does not require treatment, at least if the testicle then moves back into the scrotum by itself.

9. Difficult to spot: testicular cancer

Many men fear that testicular pain is a sign of cancer. Testicular cancer is one of the most common types of cancer, especially in the age group of 25 to 45 year old men. The tricky thing about testicular cancer is that it is hardly noticeable and is therefore often only discovered at an advanced stage. Testicular cancer causes almost no testicular pain. However, it can be felt well. Similar to the way women should regularly feel their breasts for possible lumps while washing, men are also recommended to check their testicles from time to time. Consult a doctor immediately in the event of any changes.

Sometimes testicular cancer is diagnosed in men who are actually being examined because they have not yet fulfilled their wish to have children. In this case, the testicular cancer has already led to infertility. A cancerous testicle can usually no longer be saved; a distance is the result. Learn more>

10. Undescended testicles

The undescended testes are one of the most common congenital malformations of the urinary and reproductive system in male newborns. With an undescended testicle, the testicle is located in the inguinal canal or abdomen.

In the embryonic phase, the testes initially have a different, internal position. Only from about the seventh month of pregnancy do they gradually take the upstream position in the scrotum. However, complications can already arise in this phase. If this so-called lowering of the testicles to the desired external position in the scrotum is not completed by the time of birth, doctors speak of an undescended testicle. The risk of undescended testicles is therefore particularly high in premature births.

If an undescended testicle is still present in the sixth month of life, it should be treated urgently. Otherwise, there is a risk of later infertility or even testicular cancer. Untreated undescended testicles can also result in testicular twisting (testicular torsion) in the course of the next few years. Only in a few cases (around 7 percent) does the testicle return to its normal position in the scrotum after birth without further treatment. However, if the first year of life is reached, spontaneous migration of the testicle is rather unlikely.

If the scrotum remains empty until the age of six months, drug (hormonal) therapy is recommended. If this does not lead to the desired success, a surgeon must surgically correct the position of the testicle. The chances of success of the operation are significantly greater than with hormone therapy. There are two different surgical procedures to choose from: open and laparoscopic surgery. Relocating a misplaced testicle can be extremely challenging. The surgeon should therefore have sufficient experience with this procedure.

Sometimes men only notice in adulthood that a testicle is missing in the scrotum.

11. Other causes of testicular pain

Although the testes are external to the body, there is of course a direct or indirect connection to many other organs. On the one hand, this is essential for full functionality of the testicles, on the other hand, the testicles can also be easily affected if there are disturbances in neighboring body regions.

If testicular pain is accompanied by swelling and a burning pain occurs especially when urinating, this may be due, for example, to the fact that bacteria have found their way into the testicles and / or the epididymis via the urethra. In addition to an inflamed urethra, an inflamed vas deferens can also lead to testicular pain. In this case, the actual testicular pain was very often preceded by pain that occurred immediately after sexual contact.

12. Testicular pain - is it caused by varicose veins?

If changes are noticed when palpating the testicles, varicose veins on the scrotum (varicocele) can also be a reason. These can cause testicular pain, but it is also possible that they spread without any symptoms at all. Interestingly, in the majority of cases the varicocele occurs in the left testicle. The greatest risk group for such a disease are men between 14 and 25 years of age. In this context, it is important to know that even if varicose veins on the scrotum are not painful, they should be treated in men who are still planning to father children. Because varicose veins on the scrotum can have a negative effect on sperm production. Learn more>