The testicle is a complex organ, particularly sensitive to minor lesions, and extremely sensitive. Any testicular problem can cause immense pain.

Testicular pain or the presence of swelling in the testicle are abnormal signs that require medical attention. The diagnosis can never be done at home alone. The problem can be mild or sometimes very serious, going so far as to require the testicle to be removed.

Testicular pain is scrotal pain, ie pain that encompasses the entire scrotum. It is a pain which goes up by following the anatomical course of the various channels to reach the iliac fossa and even the lumbar fossa.

The first diagnosis of testicular pain is testicular torsion: torsion of the spermatic cord containing blood vessels resulting in testicular ischemia and then necrosis (i.e. death of the testicle) if no treatment is provided in time. :

• it is a sudden, intense pain, without a triggering factor

• it affects children and young adults and is exceptional in men over 30 years old

• it is accompanied by swelling and redness

• palpation is made impossible as the pain is great

• it requires rapid surgical exploration in order to untwist the spermatic cord. Once this step is over, the doctor fixes the testicle to prevent a recurrence.

Pain is considered to be testicular torsion until proven otherwise. Again, it is necessary to consult a doctor as soon as possible.

Other possible causes of pain and swelling in the testicles are:

• orchiepididymitis: inflammation of an epididymis (or epididymitis) and inflammation of a testicle, most often accompanied by fever and burning when urinating

• a testicular trauma, following a blow to the testicles: it may be a scrotal hematoma, a contusion or even a “fracture” of the testicle
• testicular cancer (possible presence of a lump, pain and swelling)

Note that hydrocele, or accumulation of water around the testicle, sometimes causes impressive swelling of the entire scrotum. But most often there is no associated pain.

Sometimes the pain and swelling don’t have clear causes, but it’s important to do it through elimination and rule out other potential causes.

The pain may become chronic. It can then be:

• of a varicocele: varicose dilation (varicose veins) of the veins of the spermatic cord. The blood circuit is blocked and blood circulation is slowed down. Result: sperm production is reduced.

• the presence of cysts on the epididymis (we speak of spermatocele)

The pain and swelling of the testicles cause more or less discomfort, yet affect the sex life of the affected person. If these problems are poorly treated or not taken care of in time, the consequences can be dramatic: sterility, and even removal of a testicle (especially in the event of testicular torsion not treated in time).

The urgent consultation of a doctor is essential in the event of pain and swelling of the testicles. The doctor may, depending on the case:

• perform a scrotal ultrasound

• perform surgery

• suggest wearing underwear that provides special support, if necessary.

To prevent a hydrocele, varicocele, or testicular problem from occurring, it is important to perform a regular self-examination (self-examination).