Scrotal pain could be the result of a variety of conditions and is a common complaint in emergency rooms and doctor’s offices. But did you know that scrotal pain could be the result of a potentially serious condition?
Testicular torsion occurs when the spermatic cord, which supports the testes and houses the tube that carries sperm, becomes twisted around itself, cutting off blood flow. If not treated as soon as possible, this can result in the death of part or all of the affected testicle.
Epididymitis, on the other hand, happens when the epididymis, which connects the testicle to the vas deferens (tube that carries sperm from the testes), becomes swollen, often due to some sort of infection or inflammation. Sexually transmitted infections (STIs), most commonly gonorrhea and chlamydia, and bacteria like E. coli can travel through the urethra and into the reproductive organs to cause epididymitis. If it is not treated effectively, then it could spread to the testes, resulting in a more severe infection.
Similarities
Both of these scrotal pain diagnoses have very similar symptoms, so they may be confused quite easily by the average joe. Scrotal pain is usually just on one side. Those affected may also experience swelling on the one testicle or a lump nearby.
Differences
Because they present so similarly, it’s important to be able to recognize the differences, so that action can be taken immediately in the case of testicular torsion.
The main difference is that testicular torsion typically feels like immediate and severe pain in one testicle, while with epididymitis the pain tends to intensify more gradually. While many search engines may tell you testicular torsion causes one testicle to ride higher than the other, this is not all that reliable. Meaning, it is important to seek medical advice for any significant scrotal pain, and to avoid trying to self-diagnose.
Lastly, the biggest difference is in the way each is treated. Epididymitis requires antibiotics and often anti-inflammatory medications (ibuprofen, naproxen, etc.) for any underlying infection and inflammation. Testicular torsion, if not treated within the first 6-8 hours can result in severe damage to the testicle, with each additional hour adding more risk. Typically, testicular torsion requires surgery to untwist the spermatic cord and attach the testicle to tissue in the scrotum to keep it from happening again. Despite all efforts, some testicles may not be salvageable after prolonged torsion and may need to be removed.
Key Points
- Both conditions may seem similar upon first glance, with symptoms like swelling and scrotal pain.
- Testicular torsion is a serious condition and should be treated as soon as possible to avoid permanent damage.
- If epididymitis is left untreated, the infection may spread to the testes, which could progress to a more severe infection.
- If epididymitis is caused by an STI, you may be spreading that infection. It’s important to treat STIs and practice safe sex with barrier contraceptive methods (like condoms) to prevent infections altogether.
- It’s important to speak with a medical professional as soon as any significant scrotal pain is felt to avoid adverse effects.
References:
Gordhan, C. G., & Sadeghi-Nejad, H. (2015). Scrotal pain: Evaluation and management. Korean Journal of Urology, 56(1), 3–11. https://doi.org/10.4111/kju.2015.56.1.3
Rupp, T. J. (2023, July 17). Epididymitis. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK430814/
Schick, M. A. (2023, June 12). Testicular torsion. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK448199/
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