Testicular trauma refers to damage to the testicles, which hang outside of your body and are vulnerable to being hurt. Your scrotum is the tissue that covers your testicles, but there’s no other protection from muscles or bones.
Much of the time, testicles can absorb the shock that comes from an injury without serious damage. At other times, you may need to seek medical attention for treatment. Trauma can hurt your scrotum and your testicles, even tearing the protective tissue or causing the testicles to split open.
Your testicles make sperm and hormones. Testicular trauma can harm those functions and interfere with blood flow.
Testicular trauma can affect anyone with one or two testicles. They are outside the body and have little protection.
There are several types of testicular trauma, including:
. Contusion: This is a bruise or a hematoma, a collection of blood beneath tissues.
. Testicular torsion: This means that the spermatic cord inside the testicle becomes twisted. Because the cord also has blood vessels, it must be untwisted before lack of blood flow leads to tissue death.
. Rupture: This type of event, also called a fracture, causes the testicle covering to be torn. Without the tough covering, there’s no protection and the testicle contents can spill out.
. Degloving: This happens when some type of accident removes the skin covering the testicles.
. Dislocation: This can happen when something forces your testicle out of position.
. Detaching: In some cases, the testicle has been detached.
After one of these events, you can have infections or inflammation. Epididymitis, swelling of the tube at the back of the scrotum, can turn into an infection.
Strains usually happen to muscles. Your testicles don’t have muscles. You can strain your groin.
Symptoms of testicular trauma may include:
. Severe pain in your scrotum (the sac that holds your testicles).
. Bruising in your scrotum.
. Swelling in your scrotum.
. Pain and discomfort in your lower abdomen.
. Nausea and/or vomiting.
. Fever after injury.
. Blood in your pee (hematuria).
. Pain while peeing (dysuria).
Many types of events can cause testicular trauma, including:
. Penetration by weapons like knives or bullets.
. Blunt force, such as kicks or punches, or things that you can throw (like baseballs).
. Automobile, motorcycle or bicycle accidents.
. Machinery accidents.
. Bites from animals.
These types of events can cause minor injuries, like scraped skin, or major problems, like tearing the protective covering over the testicles and causing blood to pool.
Your provider will begin by asking you questions and doing a physical examination. They will be able to feel your epididymis, which is a tube at the back of the testicle that carries sperm. Your provider will be able to tell if your testicle and the surrounding structures feel normal.
They may order an ultrasound test, which is a noninvasive method of giving your provider a picture of what is going on inside your scrotum.
In other cases that are more severe from the beginning, or that haven’t improved after 48 hours, you may need surgery to diagnose the injury completely.
Complications of testicular trauma can include:
. Low testosterone.
. Urologic problems.
No. There’s no evidence that testicular injury causes cancer.
Injury to your testicles can be a factor in erectile dysfunction, especially if the injury isn’t treated. Epididymitis, a swelling that can happen after trauma, can cause ED if the inflammation is chronic. Other types of injuries, such as those related to surgeries, can cause at least temporary problems with sexual performance.
One way that you can reduce your risk is to wear athletic supporters when you participate in contact sports. You can also make every effort to be safe when you’re driving, riding bikes or motorcycles or operating machinery.
Your provider may treat testicular trauma in different ways. For mild cases, your healthcare provider is likely that you rest, take over-the-counter pain relievers and put ice on the affected area. They may also suggest you use some type of scrotal support and may prescribe antibiotics if needed.
If you haven’t improved after 48 hours, you should contact your provider or return to see them.
There are certain types of trauma to the testicles that your provider will want to treat immediately. These types include any that have penetrated the scrotum and testicles, removed a large amount of skin, or that show signs of twisting or blood supply interruptions.
Your provider may do surgery to treat testicular trauma by:
. Untwisting the testicle and fixing it into position to prevent future twisting.
. Repairing a ruptured testicle and sewing the covering back together.
. Washing the wound out to minimize the risk of infection.
. Moving a dislocated testicle if attempts to manipulate it back into place don’t work.
. Reattaching a detached testicle, if possible.
. Skin grafts for degloving injuries.
. Surgery to remove a damaged testicle (orchiectomy). Your provider may suggest freezing sperm if they have to remove one or both testicles.
You should probably rest for 24 to 48 hours if you have a mild injury. If things get worse, or if you aren’t better, you should see your provider.
If you have a more severe trauma, you should go back to your provider one to two weeks later. If you have a more severe injury or you’re recovering from surgery, swelling may last up to a month.
Many testicular injuries are mild and people recover relatively quickly. Most people with testicular trauma do recover.
It’s probably always appropriate to call or visit your healthcare provider if you have a testicular injury, just to be safe. However, make an appointment if you have:
. Severe swelling of your testicles with pain and bruising.
. A fever after injury.
. Pain that doesn’t stop or gets worse.
. Blood in your pee that doesn’t stop or gets worse.
. Trouble peeing.
. Any symptom that worries you.