Testicular pain in older adults

Overview

Testicular pain in older adults refers to discomfort or pain in one or both testicles. It can range from a dull ache to sharp pain and may be caused by problems in the testicles, the tubes behind them, or other nearby organs.

Testicular pain is not extremely common in older adults, but it does occur. Many cases are linked to prostate issues, hernias, or urinary tract infections.

It affects men over the age of 60, especially those with a history of hernia, prostate problems, or recent infections. Men who lift heavy objects or have long-term health conditions like diabetes may also be at higher risk.

Symptoms

Common symptoms

• Dull ache or sharp pain in one or both testicles
• Swelling or a feeling of heaviness
• Redness or warmth of the skin over the testicle
• Pain that spreads to the lower belly or groin

Symptoms in children

• Testicular pain in children is usually caused by trauma, infection, or testicular torsion. It is less common after puberty, but if it occurs, emergency care is needed.

Symptoms in older adults

• Pain that may come and go or be constant
• Pain when urinating or during a bowel movement
• Lump or swelling in the scrotum
• Discomfort when sitting or moving

Causes

Main causes

• Infection of the epididymis (the tube that stores sperm) – called epididymitis
• Infection of the testicle itself – called orchitis
• Inguinal hernia (part of the intestine pushes into the groin)
• Injury or trauma from a fall or accident
• Fluid buildup (hydrocele) or enlarged veins (varicocele)
• Referred pain from kidney stones, a back problem, or prostate disease
• Testicular torsion – more common in younger men but still possible
• Tumor of the testicle or surrounding tissue – rare but serious

Risk factors

• Age over 60
• Recent urinary tract infection or sexually transmitted infection
• Enlarged prostate (benign prostatic hyperplasia)
• History of hernia or hernia surgery
• Heavy lifting or straining
• Long hours of sitting (like driving or desk work)
• Weakened immune system from conditions like diabetes or cancer treatment

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe testicular pain
• If you have a fever, nausea, or vomiting with the pain
• If you cannot urinate or see blood in your urine
• If you notice a hard, swollen testicle that feels different from before

Book a routine appointment if:

• If you have a dull ache that lasts more than two days
• If you feel a new lump or swelling in your scrotum
• If you have ongoing discomfort during sex or exercise
• If you have symptoms that keep coming back

Diagnosis

A doctor will start by asking about your symptoms and medical history, then perform a physical exam of your testicles, scrotum, and groin area. They may also check your abdomen and prostate gland.

Tests that may be done

• Urine test to check for infection
• Blood tests to look for signs of infection or inflammation
• Ultrasound of the scrotum – a painless scan that shows images of the testicles and surrounding tissue
• Sometimes a CT scan or MRI if the doctor suspects something deeper, like a hernia or kidney stone

What to expect at your appointment

The exam is usually quick and done in the doctor’s office. An ultrasound uses gel on the skin and a small wand – it doesn’t hurt. Most tests give results within a day or two, and your doctor will explain what they mean and what to do next.

Treatment

Treatment depends on the cause of the pain. Most causes can be managed with home care, medication, or a minor procedure. Infections are treated with antibiotics, and hernias may need surgery. Testicular torsion requires emergency surgery to restore blood flow.

Self-care at home

• Rest and avoid heavy lifting or strenuous activity
• Apply a cold pack wrapped in a cloth to the area for 20 minutes at a time
• Wear supportive underwear or an athletic supporter
• Take over-the-counter pain relievers like paracetamol or ibuprofen – check with your doctor first if you have other health conditions

Medical treatments

Doctors may prescribe antibiotics for bacterial infections, or anti-inflammatory medications to reduce swelling. For pain from prostate problems, medications that relax the prostate may help. In some cases, a doctor may drain fluid from a hydrocele or inject medications for varicoceles.

When is surgery considered?

Surgery may be needed for a hernia that does not go back in, a testicular torsion, or to remove a tumor. Surgery for a hernia is usually a same-day procedure, while more serious surgeries may require a short hospital stay.

Living with this condition

You can usually continue most daily activities, but avoid anything that makes the pain worse. Listen to your body and rest when needed. If you have ongoing pain, talk to your doctor about ways to manage it.

Lifestyle tips

• Wear supportive underwear to reduce movement and discomfort
• Avoid sitting for long periods – get up and walk around every hour
• Use a pillow or cushion when sitting if that helps
• Keep up with your regular check-ups to catch any new problems early

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and fibre can help prevent constipation and straining. Light exercise like walking is fine when you feel well. Avoid heavy lifting until your doctor says it’s safe.

Mental health and emotional wellbeing

Testicular pain can be worrying and may cause anxiety about serious conditions like cancer. It can also affect your sex life. Talk to your doctor or a counsellor if you feel stressed or down. If you have thoughts of harming yourself, please contact a crisis helpline or call your local emergency number.

Prevention

You cannot prevent all causes, but you can lower your risk. Use safe sex practices to avoid infections. Treat urinary tract infections early. Avoid heavy lifting or use proper technique. Wear supportive underwear during sports or heavy work.

Vaccines

Vaccines against some infections that can cause orchitis (like mumps) are part of routine childhood immunisation. Adults who are not vaccinated should ask their doctor.

Screening programmes

There is no routine screening test for testicular pain. However, regular check-ups with your doctor can help catch problems like hernias or prostate issues early. Monthly self-exams are not routinely recommended for older adults but may be helpful if you have concerns – ask your doctor.

Complications

If left untreated

• Infection spreading to the other testicle or into the bloodstream (sepsis)
• Abscess – a pocket of pus that may need draining
• Long-term (chronic) pain or discomfort
• Testicular shrinkage or loss of function
• Hernia strangulation – a serious emergency where part of the intestine gets trapped and loses blood supply

Long-term outlook

The outlook is generally very good. Most causes of testicular pain in older adults can be treated effectively. With prompt medical care, even serious problems like testicular torsion or cancer can be managed. You can return to your normal activities after treatment. Your healthcare team will support you every step of the way.

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