What Causes Pain in One Testicle?

Less common cause types

Less common causes of pain in one testicle includes the following.

• Bacterial infections: These are usually from sexually transmitted diseases, or from infection with E. coli bacteria. E. coli is a normal inhabitant of your colon and is found in feces.
• Prostatitis: This condition is inflammation of your prostate and usually spreads to other parts of the urinary and reproductive system, causing pain and discomfort throughout.
• Scarring of the epididymis: Chronic inflammation can damage the epididymis, the long, coiled tube that carries semen. Inflammation is likely to occur from prostatitis or sexually transmitted disease.
• Viral infections: Mumps, chickenpox, and other viral infections can affect the testicles.
• Kidney stones: If a stone travels down the ureter, it can cause severe pain in the testicle.
• Testicular abscess: This is a pocket of infection, usually from an injury with a break in the skin.

Rare and unusual pain in one testicle causes

The following, although possible, are the least likely to cause pain in one testicle.

• Torsion that has no apparent cause: However, torsion may follow an injury to the testicle.
• Congenital abnormality: It's possible to be born with a condition that causes the testicles to move freely within the scrotum, instead of being anchored down. This condition can lead to torsion.
• Inguinal hernia: An inguinal hernia is when a loop of small intestine protrudes into the scrotum.
• Post-vasectomy pain: This pain is from granulated or coarsely healing tissue that may form at the site of the surgery and may occur months or years later.
• Sexual arousal without release: This occurrence can cause pain in one or both testicles, particularly in young men.
• Tumor within the scrotum: Pain and swelling will be gradual in onset.

This list does not constitute medical advice and may not accurately represent what you have.

Intermittent testicular torsion

Intermittent testicular torsion is also called ITT or chronic testicular torsion. Torsion refers to an abnormal twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.

In intermittent cases, the testicle becomes untwisted on its own and the symptoms spontaneously resolve. The condition nearly always returns, however, and may continue to come and go.

The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.

Symptoms include sudden, severe groin and testicular pain with nausea and vomiting, followed by spontaneous relief of symptoms even without treatment.

Eventually, testicular torsion can result in loss of circulation followed by tissue death and loss of the testicle. Any type of testicular torsion is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and sometimes ultrasound.

Treatment involves emergency surgery to untwist the spermatic cord and anchor the testicle in its proper place within the scrotum.

Rarity: Rare

Top Symptoms: nausea, testicle pain that comes and goes, vomiting, pain in one testicle, testicular swelling

Symptoms that always occur with intermittent testicular torsion: testicle pain that comes and goes

Urgency: Primary care doctor

Urinary tract infection

A urinary tract infection, or UTI, can involve any or all parts of the urinary system but most often affects the bladder and urethra.

Bacteria from the gastrointestinal tract – especially Escherichia coli (E. coli) – are the most common cause of UTIs. These bacteria spread from the anus to the urethra. Sexual activity can do this, but a UTI is not considered a sexually transmitted disease.

Women are more at risk for UTI than men. Due to female anatomy, the urethral opening is a short distance from the anus. Anyone who uses catheters to urinate is also prone to UTIs.

Common symptoms of less-serious UTIs include lower abdominal discomfort and pressure; burning or discomfort on urination; and cloudy or discolored urine.

Left untreated, the infection could spread to the kidneys and cause a medical emergency.

Diagnosis is made by having the patient describe the symptoms and by testing a urine sample for bacteria.

UTIs are caused by bacteria and so can be treated with antibiotics.

Prevention involves good hygiene and drinking plenty of water.

Testicular torsion

Testicular torsion is also called ATT or acute testicular infarction. It is a twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.

The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.

Most susceptible are infant boys and boys just reaching puberty. Torsion may occur in older boys after an injury and/or an athletic workout.

Symptoms include sudden, severe, one-sided testicular pain and swelling, with nausea and vomiting.

Acute testicular torsion is a medical emergency. If not corrected immediately, the loss of blood flow can lead to infertility and loss of the testicle. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and sometimes ultrasound.

Treatment involves first attempting to manually rotate the testicle back into place. If unsuccessful, surgery will be done to either correct the torsion or to remove the testicle if the damage is not reversible.

Painful bladder syndrome (interstitial cystitis)

Painful bladder syndrome, also called interstitial cystitis or IC, is a chronic condition of pain and discomfort in the urinary system.

The cause is unknown. It may be an autoimmune disorder and is often found with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, or vulvodynia (pain in the outer female organs.) Some researchers feel the condition may be linked to a history of abuse.

Painful bladder syndrome is more common in women than in men, but can happen to anyone.

Symptoms vary and may include pressure and discomfort in the lower abdomen; pain during sexual intercourse; bladder pain; and a frequent urge to urinate.

A medical provider should be seen for these symptoms, because painful bladder syndrome can interfere with quality of life and lead to depression.

Diagnosis is made through patient history; physical examination; blood and urine tests; and sometimes cystoscopy. Women may have a pelvic examination and men may have a digital rectal examination.

There is no cure specifically for painful bladder syndrome, so treatment involves addressing the symptoms and making lifestyle changes.

Rarity: Rare

Top Symptoms: fatigue, abdominal cramps (stomach cramps), depressed mood, pelvis pain, arthralgias or myalgias

Urgency: Primary care doctor

Orchitis

Orchitis occurs when one or both testicles are inflamed. This is often caused by sexually transmitted infections like gonorrhea or chlamydia. More rarely, orchitis is caused by a virus.

Antibiotics are needed to treat bacterial orchitis. If the cause is viral, ibuprofen, acetaminophen, and ice packs may be used to treat symptoms.

Rarity: Rare

Top Symptoms: spontaneous testicle pain, fever, tender testicular swelling, muscle aches, new headache

Urgency: Primary care doctor

Non-serious testicle injury

Being struck in the testicles is very common, and despite the intense pain that follows, rarely requires professional medical care.

You can treat your painful scrotal injury with rest and optional application of ice. Be careful not to ice your scrotum for more than a couple minutes at a time.

Rarity: Rare

Top Symptoms: testicle pain from an injury, testicle injury

Symptoms that always occur with non-serious testicle injury: testicle injury

Urgency: Self-treatment

Groin nerve irritation

There are several nerves supplying the groin, inner thigh and genital region. Entrapment or irritation of one of these nerves can result in pain or numbness in this area. This is often caused by surgery in this area but can happen without a specific cause as well.

You should discuss your symptoms with your primary care physician. Sometimes a referral to a specialist is needed. Treatment often includes an injection with a local anesthetic.

Rarity: Rare

Top Symptoms: thigh numbness, groin numbness, testicle numbness, sharp testicle or scrotum pain, sharp groin pain

Urgency: Primary care doctor

Groin hernia

A groin hernia, also called an inguinal hernia, means that a structure in the lower abdomen – a loop of intestine or a section of fat – has pushed through the muscles of the abdominal wall. This creates a bulge, or hernia, that can be seen and felt in the groin.

A hernia is caused by a weak spot in the abdominal wall muscles, which can separate under heavy lifting or repeated straining. The weakness may be inherited or may be from previous surgery, injury, or pregnancy.

Symptoms include a bulge low down in the abdomen, most visible when the person stands; and pain in the bulge with any strain on the abdominal muscles, such as lifting a heavy object or bending over.

A hernia will not heal on its own. There is the risk of serious complications if the blood supply to the herniated organ becomes reduced or cut off.

Diagnosis is made through physical examination and x-ray or CT scan.

A small hernia may need no treatment. A larger one can be repaired with surgery.

Rarity: Uncommon

Top Symptoms: pain in the lower right abdomen, pain in the lower left abdomen, groin pain, testicle pain, groin lump

Urgency: Primary care doctor

Epididymitis

The epididymis is a coiled tube which stores sperm inside each testicle. Epididymitis is an inflammation of one or both of these tubes.

It is caused by a bacterial infection, most often from sexually transmitted diseases (STDs) such as chlamydia and gonorrhea. Epididymitis can also be caused by a urinary tract or prostate infection, or by trauma due to injury or heavy lifting.

Males of any age can be affected, though men engaging in unprotected sex are most susceptible.

Symptoms include redness, swelling, and pain in the testicle; pain on urination or ejaculation; discharge from the penis; and blood in the semen.

Any of these symptoms should be treated by a medical provider as soon as possible in order to prevent abscess or permanent damage.

Diagnosis is made through physical examination; penile swab for STD tests; urine and blood tests; and sometimes ultrasound of the testicles.

Treatment involves antibiotics as well as rest, cold packs to the testicles, wearing an athletic supporter, and refraining from lifting and sexual intercourse until the infection is gone.

Chronic prostatitis

Chronic prostatitis is an ongoing inflammation or infection of the prostate gland, the small, walnut-shaped organ just below the bladder in men.

Prostatitis is most often due to common bacteria in the urine causing infection. It may also be caused by surgery or other trauma setting up an inflammation. In some cases, the cause remains unknown.

Men of all ages are susceptible. Risk factors include a past urinary tract infection; using a catheter for urination; or pelvic trauma from bike riding or horseback riding.

Symptoms include pain in the abdomen, low back, groin, and genitals; frequent need to urinate; pain, burning, and difficulty when urinating; urine that is cloudy or bloody; and painful ejaculation.

A medical provider should be seen for these symptoms, since a bacterial infection can spread and lead to scarring, pain, and infertility.

Diagnosis is made through urine tests, blood tests, and ultrasound or CT scan.

Treatment involves antibiotics for bacterial prostatitis, though if all the bacteria are not destroyed the disease can become chronic. Nonsteroidal anti-inflammatory drugs are also helpful.

Questions your doctor may ask about pain in one testicle

• Do you feel pain when you urinate?
• Are you sexually active?
• Do you notice anything going on with your testicles or scrotum?
• Have you experienced any nausea?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.