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Scrotal Pain and Masses

Scrotal pain in young boys and adolescents can be a sign of a real problem that may require immediate medical attention. If you child is in extreme pain, it’s important to contact a doctor right away. Pain in the scrotum or testicle can be brought on suddenly or may start as a swelling in the area that progressively gets worse. Pain in the scrotal area should not be ignored.

Causes of Scrotal Pain

There are several conditions that may be causing your son’s scrotal pain:

  • Testicular Torsion – The spermatic cord becomes twisted, cutting off blood supply to the testicle. The spermatic cord connects the testicle to the reproductive organs and contains blood vessels, muscles, nerves, and the tube that carries sperm. If this cord becomes twisted, blood supply to the testicle will be cut off and can permanently damage the testicle. While not common, testicular torsion causes acute, severe pain and requires immediate medical attention and surgery to repair and untwist the spermatic cord before permanent damage to the testicle is done. Testicular torsion is most common in boys after the onset of puberty. But, it can occur anytime after birth. Any severe scrotal pain that lasts longer than one hour should be examined immediately.
  • Incarcerated Hernia – This type of hernia should be seen by a surgeon familiar with the care of this condition.
  • Orchitis -This is an inflammation of the testicle which can be a cause of testicular discomfort and does not require surgery.
  • Epididymitis – This is a bacterial infection or inflammation of the structure behind the testicle involved in the development of sperm, and treatment is determined by the underlying cause.

Treating Scrotal Pain

A pediatric urologist will prescribe treatments based on the known cause of your child’s pain. For testicular torsion, surgery within four hours of the onset of the pain to untwist the
spermatic cord is vital to saving the testicle and to preserve fertility and function (although fertility can be achieved with one testicle).

For a bacterial infection, your doctor will prescribe an oral antibiotic to clear up the infection. Many conditions resolve on their own over time and are not benefited by specific
treatment other than pain management.

Scrotal Mass

A scrotal mass is a swelling of the scrotum. Any mass or swelling of the scrotum is concerning. Small masses can be found during a routine testicular self exam or, in young boys and
infants, during a physical exam by your child’s doctor. While most masses are benign (non cancerous), masses may require surgery to be removed. Testicular masses occur most often in boys under age five. Testicular cancer is a rare cause of scrotal swelling in children and adolescents.

At Chesapeake Urology for Children, Dr. Adam Kern and the team understands that any health issue with your child is stressful. We will work closely with you in developing a plan of care that best meets your child’s individual needs and are here to answer any questions you may have.