Some Causes and Features of Scrotal Pain
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Cause |
Common Features* |
Tests |
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Testicular torsion (twisting of a testis) |
Severe, constant pain that begins suddenly in one testis A testis that may be pulled up closer to the body than the other testis Most often occurring in newborns and boys after puberty but sometimes in adults |
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Torsion of the testicular appendage (twisting of a small piece of tissue attached to the testis) |
Pain that usually develops over several days and that occurs in the top part of the testis Sometimes swelling around the testis Typically occurring in boys aged 7–14 years |
Ultrasonography |
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Epididymitis (inflammation of the epididymis) or epididymo-orchitis (inflammation of an epididymis and testis) |
Pain that begins gradually or suddenly in the epididymis and sometimes the testis Possibly frequent urination or pain or burning during urination Possibly in men who have recently been doing heavy lifting or straining Often swelling of the scrotum Sometimes a discharge from the penis Typically occurring in boys after puberty and in men |
Urinalysis and urine culture Sometimes tests for sexually transmitted diseases |
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Injury |
In men who have had an injury to the genitals Often swelling of the scrotum |
Ultrasonography |
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Inguinal hernia (a hernia in the groin) |
Typically in men who have had painless bulge in the groin for a long time, often in those already known to have a hernia A bulge that Pain that begins gradually or suddenly, typically when the bulge cannot be pushed back into the abdomen |
A doctor's examination |
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Referred pain (for example, pain that comes from an abdominal aortic aneurysm, stones in the urinary tract, pressure on spinal nerve roots in the lower part of the spine, appendicitis, or a tumor or pain that occurs after a hernia is repaired) |
Normal results detected during examination of the scrotum Sometimes abdominal tenderness |
Depends on examination findings and the suspected cause |
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Orchitis (infection of the testis), usually due to a virus, such as the mumps virus |
Pain in the scrotum and abdomen, nausea, and fever Swelling and sometimes redness of the scrotum |
Repeated blood tests to measure antibodies to the virus suspected to be the cause |
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Necrotizing infection of the perineum (the area between the genitals and anus), called Fournier gangrene |
Severe pain, an ill appearance, fever, and sometimes confusion, difficulty breathing, sweating, or dizziness Redness of the scrotum or blistering or dead tissue in the genital area Sometimes in men who have recently had abdominal surgery More common among older men with diabetes, peripheral arterial disease, or both |
Usually only a doctor's examination Sometimes imaging tests |
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*Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. |
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