Published on: 4/7/2025
Treatment depends on what is causing the swollen and painful testicle.
When a testicle becomes swollen and painful, a doctor first needs to identify the cause. One cause could be testicular torsion, where the testicle twists and cuts off its blood flow. This is very serious and usually needs emergency surgery to untwist the testicle and keep it in place so that it does not twist again. An infection of the testicle or epididymis (epididymitis) is another possible cause that usually needs antibiotics. The doctor may prescribe oral antibiotics and recommend using cold compresses and over-the-counter pain relievers to help manage discomfort while the infection clears. Sometimes a hernia in the groin (inguinal hernia) can also cause testicular swelling and pain. These hernias usually need surgery to fix them, but the exact timing depends on how severe the symptoms are. Your doctor will examine you carefully to determine if this could be causing your symptoms. An injury or trauma to the testicle can also cause swelling and pain. In these cases, treatment usually involves rest, ice packs to reduce swelling, and over-the-counter pain medication. Sometimes, if there is severe trauma, a doctor might need to do imaging tests to check for internal damage. A varicocele or hydrocele can also cause swelling and discomfort in the testicles. A varicocele is when veins in the scrotum become enlarged, while a hydrocele is a fluid-filled sac around the testicle. Treatment for these conditions varies - some may need surgery while others can be managed with supportive care and monitoring. It is important to be evaluated by a doctor if you have these symptoms; appropriate care will depend on their findings.
(References)
Lavallee ME, Cash J. Testicular torsion: evaluation and management. Curr Sports Med Rep. 2005 Apr;4(2):102-4. doi: 10.1097/01.csmr.0000306081.13064.a2. PMID: 15763047.
Kowalik K, Narożnicki P, Modrzejewski A. Spermatic vein thrombosis as a rare cause of testicular pain - review of the literature. Cent European J Urol. 2023;76(3):251-255. doi: 10.5173/ceju.2023.13. Epub 2023 Jul 14. PMID: 38045772; PMCID: PMC10690383.
Velasquez J, Boniface MP, Mohseni M. Acute Scrotum Pain. 2023 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29262236.
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