Should You Worry If Your Son Complains of Testicle Pain?

While you might be amazed at how often your son talks about genitals, he may be less forthcoming if he’s experiencing scrotum pain.

Pain there is not uncommon, especially from bumps and bangs. “When kids are playing sports or messing around, they get hit down there quite often,” says pediatric urologist Audrey Rhee, MD.

But persistent pain after a kick or hit can signal trauma that requires urgent medical treatment. Scrotum pain can also be a sign of infections or other medical conditions.

Here’s what you should know about testicular pain — and how to talk about your son’s sore testicles without anyone dying of embarrassment.

Causes of testicle pain in children

Trauma, infection and other medical problems can all lead to pain in a boy’s scrotum, says Dr. Rhee. The most common causes of testicle pain in children include:

• Testicular torsion: This is an emergency condition in which the testicle becomes twisted, losing its blood supply. It’s most common in men and boys under 25, especially between the ages of 12 and 18. It happens suddenly, for no obvious reason, and it causes severe pain in one testicle. If torsion isn’t treated within 6 to 12 hours, the testicle can be lost.
• Testicular trauma: There’s a good reason male athletes wear cups. Strikes to the testicles can cause bruising, swelling and significant pain. In rare cases, trauma can cause a testicle to rupture — a serious condition that requires surgery.
• Infections: A number of bacterial or viral infections can cause swelling in the testicles or in the epididymis (the coiled tubes that link the testicles to the vas deferens, which carry sperm). In sexually active teens, infections such as chlamydia or gonorrhea can cause swelling and pain. There are also other, non-sexually transmitted infections that can cause discomfort. In boys under 10, for example, the mumps virus is a surprisingly common cause of infection in the testicles.
• Spermatoceles, hydroceles and varicoceles: Fluid-filled cysts (spermatoceles), fluid around the testicle (hydroceles) and clusters of enlarged veins (varicoceles) can all cause genital discomfort.
• Hernias. An inguinal hernia occurs when fatty tissue or part of the intestine protrudes through muscles in the groin. It can cause pain or aching and often appears as a bulge in the groin or scrotum.

When should you call a doctor?

It can be hard for kids or parents to figure out the cause of scrotum pain, so if your son is complaining of pain, limping or acting uncomfortable, call your doctor for advice, Dr. Rhee advises.

And if the pain is severe and doesn’t let up, head to urgent care or the emergency room — timely care is crucial for testicular torsion or rupture.

Talking about testicles

Unfortunately, not all boys are upfront about their pain.

“Young boys are usually pretty quick to say it hurts down there. But as they get older, they’ll often say their leg hurts or their belly hurts,” Dr. Rhee says. “They tend to be vague.”

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She recommends treating scrotum injuries just like any other injury: Be matter-of-fact. “A lot of people are uncomfortable talking about genitals, but it’s no different from talking about pain in your child’s arm or leg,” she says. “Don’t be afraid to look for redness or swelling in his groin area, and ask your son to point to the spot where it hurts.”

The sooner you start talking frankly with your son about his genitals, the better, she says. “When kids are young, teach them that if it hurts down there, they need to let you know,” she says. “It might seem uncomfortable to talk about this at first. But it’s the right thing to do and will help your son learn to take care of his body.”