Testicular pain (synonyms: orchialgia; scrotal pain, scrotal pain; testalgia (chronic testicular pain); English orchialgia; ICD-10-GM 50.8: Other specified diseases of the male genital organs) can have many different causes.
The most common cause of acute testicular pain is viral infection – accompanied by orchitis (inflammation of the testis) – or, in a child or adolescent (10-20 years of age), testicular torsion (acute stem rotation of the testis and epididymis with interruption of blood circulation and hemorrhagic infarction). Untreated testicular torsion leads to testicular necrosis (death of the testis) in a few hours! The ischemia time (time of reduced blood flow) of the testis in infancy is maximum 6-8 hours, for newborns or infants this period is even much shorter.
Chronic testicular pain (CTP) is defined as pain in one or both testicles that persists for at least 3 months, intermittently or constantly. The daily life activities of the affected person are usually restricted as a result.
Chronic testicular pain can be the result of varicoceles (varicose veins in the testicular veins), hydrocele (hydrocele of the testicle; excessive accumulation of fluid in the scrotum), spermatoceles (cyst of the epididymis), trauma (injury), tumors, and previous surgical procedures (e.g., condition following vasectomy (male sterilization; post-vasectomy pain syndrome).
The most common causes of testicular pain without reference to one of the testicles, can also come from the groin, kidney/ureter, muscles, spine, or hip joints.
Testicular pain can be a symptom of many conditions (see under “Differential Diagnoses”).
Peak prevalence: chronic testicular pain occurs predominantly after the age of 45.
The lifetime prevalence (incidence of disease throughout life) for testicular pain is estimated to be 50% of men (in Germany).
Course and prognosis: Testicular pain can be unilateral or bilateral and permanent (permanent) or intermittent (intermittent). Often, the pain also radiates to the inguinal region (groin), the peritoneum (peritoneum), or even to the inner thigh. The course and prognosis of acute testicular pain depend on its cause. In 20-25% of cases, testicular torsion (twisting of the testicular vessels) is the cause. This causes the blood supply to be interrupted. Irreversible damage to the testicular parenchyma (testicular tissue) due to ischemia (reduced blood supply) occurs after only 4 hours! The ischemia time in children is a maximum of 6-8 hours, for newborns or infants this period is much shorter. Medical clarification is required immediately (emergency!).Course and prognosis of chronic testicular pain is also dependent on its cause.
