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There are several possible causes of testicular pain. The most worrisome cause of testicular pain is due to a twisting of the testicle, referred to as testicular torsion. The twisting will interfere with the blood supply, so it becomes a surgical emergency. The pain of testicular torsion usually is a sudden, severe pain, rather than an intermittent pain over 1½ weeks. Testicular pain can be due to an infection of the testicle, referred to as an orchitis. It also can be due to an infection of the epididymis, the tube that lies over and drains the testicle, referred to as epididymitis. There also are sacs that can form around the testicles, and if there is an increase in fluid in the sac can cause pain or swelling. It is also possible that some problems in the lower abdomen may cause pain that radiates down into the scrotum, such as kidney stones or an inguinal hernia. Ultimately, it would require an appropriate evaluation to determine the underlying cause. If the pain is severe, then it should be evaluated quickly. Otherwise, it does not require immediate evaluation. It may help ease symptoms to apply ice to the scrotum or take Tylenol for the pain.
The primary symptom of testicular cancer usually is a lump or swelling that may have a dull ache, but would not typically present as only intermittent pain of short duration.