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Quick reference medical handouts used by Pediatric offices


My 11 1/2 year old son is complaining of pain in his testicles. It is intermittent and is described as a sharp or pinching pain. His pediatrician says not to worry . . . this is typical in boys going through puberty. I have not been able to find any information on your site or any other concerning this condition as a symptom of puberty. Should I be concerned?
    

Pain in the scrotum or testicles can be due either to problems within the testicle itself or to a problem in another part of the body. Testicular aches and pains are not usually cause for alarm unless the pain is severe and of sudden onset. Then it is a medical emergency. Testicular cancer is usually painless. However, any testicle lump should be evaluated by the health care provider whether or not there is testicle pain.

Common causes of testicular pain include:

  • injury or trauma
  • varicocele (dilated vein within the sac)
  • hernia into the scrotum
  • epididymitis (the ducts through which the sperm leaves the testicle can become inflamed and painful) Epididymitis is pretty rare before puberty. It is an acute inflammation or infection of the epididymis, a structure that lies along the spermatic cord in the scrotum. It presents as sudden painful scrotal swelling. There usually is pus in the urine. The major problem with epididymitis lies in the fact that differentiation from torsion of the testicle can be very difficult. If the problem is just infection, bed rest and antibiotics are curative.
  • testicular torsion (the cord that suspends the testicle becomes twisted, cutting off the blood supply to the testicle) It is caused by a congenital abnormality of the covering of the testis that allows the testis to twist within its sac. This twisting can cut off the blood supply to the testis, with prompt and dramatic effect. There is sudden pain and swelling of the scrotum. The testis becomes exquisitely painful and is difficult to examine. Swelling is usually absent above the testis in the area of an inguinal hernia.
  • torsion of the appendix testicle. This condition is most common between ages 7 and 12. The appendix of the testis, a vestigial structure of membranes attached to some testes, may likewise undergo painful twisting. Torsion of the appendix of the testis is also painful, but not as dramatically so.
  • testicular infection (orchitis) due to a variety of agents including the mumps virus.

You did not mention in your question whether or not your son was seen by the doctor or this simply was an answer to a telephone question. If he was checked by the physician, then we would recommend observing your son for another day or two. If the pain is still present, have him rechecked by the doctor. Shour the pain become suddenly worse, have him seen immediately in the doctor's office or an emergency room.  If your son has not been examined, then we would suggest that you call the doctor's office and request that your son be examined, just to be on the safe side.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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