Urology  |  Acute testicular pain


Acute testicular pain


  • Urological Emergency and requires surgical correction within 6 hours.

  • Features of torsion:

    • Sudden onset of severe pain radiating to the groin.
    • Associated nausea, vomiting.
    • Difficult to examine due to pain.
    • Testis high, abnormal alignment.
    • Testis tender and swollen when compared to other side.


  • Features of epididymo-orchitis:

    MSU required:

    • Usually more gradual onset than torsion.
    • Tender swollen epididymis, testis less tender.

  • If young, screen for STI. If older, usually related to BPH.
  • Treat infection with a 4 week course of antibiotics; Doxycycline if younger than 35yrs. Norfloxacin if older than 35yrs.
  • Note that it takes days for the pain to settle and weeks for the swelling to settle.
  • Refer if septic, or if no improvement on oral antibiotics.

Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016

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