PAINFUL TESTICLE

If a male complains of a painful testicle, examine both testicles. Look for discoloration or swelling. If a testicle has been injured by a blow, provide support with an improvised jockstrap and apply ice packs. If a testicle suddenly becomes painful, particularly in an adolescent, and appears swollen and/or discolored, usually without a penile discharge, it may be twisted, or torsed. Since this usually happens if the testicle rotates inward (toward the midline) (Figure 175), gently see if you can rotate it outward within the scrotum. If this causes a dramatic relief of pain, you may have saved the testicle. If the maneuver increases the pain and appears to shorten the “hang” of the testicle, you may be worsening the torsion and might attempt rotating the testicle in the opposite direction.

Figure 175 Rotation of the right testicle in a torsion; an inflamed epididymis of the left testicle.