Child and male reproductive health experts have urged parents not to ignore scrotal swelling or pain in their male children, warning that such symptoms could signal serious underlying conditions requiring urgent medical attention.
The specialists explained that while some causes of scrotal swelling may be harmless, others, such as testicular torsion, infections, and hernias, can become medical emergencies if treatment is delayed.
They noted that testicular torsion, in particular, can cut off blood supply to the testicle and may result in permanent damage or loss of the testis if not promptly treated.
Testicles are small, egg-shaped reproductive organs that rest inside the scrotum, which is a thin pouch of skin behind the penis, according to the Cleveland Clinic.
The health website explains that most males have two testicles — one each on the left and right side of their scrotum.
“Testicular pain can affect anyone with testicles (testes) at any age. Testicular pain can be acute or chronic, and the testicles contain many sensitive nerves, which can make testicular pain severe,” the website added.
Speaking exclusively with Healthwise, a Consultant Paediatrician at the Federal Teaching Hospital, Katsina State, Dr Abdurrazzaq Alege, warned parents and caregivers not to ignore scrotal swelling or testicular pain in children.
He said delayed treatment could lead to permanent infertility or loss of a testis.
The child health expert said testicular pain in children could result from several conditions, ranging from infections to life-threatening surgical emergencies that require urgent medical attention.
According to him, the common causes of testicular pain in children include testicular torsion, orchitis, epididymitis, strangulated inguinal hernia, and trauma or injury to the groin or scrotum.
Alege explained that among these conditions, testicular torsion, which involves twisting of the spermatic cord, is the most urgent emergency, followed by a strangulated inguinal hernia.
“Some children may develop testicular swelling, or what we call scrotal swelling, from infancy or shortly after birth. The swelling may occur on one side or both sides and, in many cases, may not initially be painful.
“However, once a child begins to complain of pain, several important conditions must be considered. One of the most common and serious causes of sudden testicular pain is testicular torsion, which is a medical emergency,” the child health expert said.
He noted that while infections such as orchitis and epididymitis could often be managed with medications, including antibiotics and pain relievers, delayed treatment of emergency conditions such as testicular torsion could be dangerous.
The paediatrician also urged parents not to overlook injuries to the groin area, stressing that falls, sports-related accidents, or direct blows to the scrotum during play could result in significant pain and complications.
“Overall, testicular pain in a child should never be ignored. The cause may range from a treatable infection to a surgical emergency, and prompt medical assessment is essential to prevent complications,” he said.
Speaking on warning signs that should prompt an immediate hospital visit, Alege said sudden pain in the testicular area in a previously healthy child should be treated as a medical emergency.
“Typically, the warning signs that should prompt immediate medical attention are when a child who has otherwise been normal suddenly begins to complain of pain in the testicular area or repeatedly points to the testes while expressing discomfort. Once that happens, the child needs urgent evaluation,” he stated.
He added that swelling or redness of the scrotum, whether affecting one or both sides, should never be ignored because such symptoms could indicate a serious underlying condition.
According to him, severe pain may also trigger vomiting, nausea, excessive crying, or restlessness, particularly in younger children who may be unable to clearly communicate what they are experiencing.
The physician further identified fever, difficulty passing urine, painful urination, and the presence of pus or particles in urine as additional warning signs requiring urgent medical attention.
“There may also be more general symptoms. For example, the child may develop a fever, feel unusually hot, or continue pointing to the affected area. Another important concern is difficulty passing urine,” Alege said.
He noted that testicular torsion often presents with sudden, severe, and sharp pain, adding that affected children may roll around in discomfort while repeatedly pointing to the affected area.
The expert explained that the condition may sometimes occur intermittently when the spermatic cord twists and untwists on its own, causing episodes of severe pain that may disappear temporarily.
“Therefore, whenever the child experiences such pain, that is the best time for medical evaluation and examination,” he advised.
On the long-term consequences of untreated testicular torsion, Alege said delayed intervention could result in the loss of a testis and subsequently affect future fertility.
“Testicular torsion can lead to loss of the testis; it can also lead to what we call subfertility or even infertility,” he said.
The paediatrician explained that while fertility may be preserved if only one testis is lost, there could still be some degree of reduced fertility because sperm production would depend solely on the remaining testis.
“If both testes are affected, the consequences can be much more severe and may result in permanent infertility,” he warned.
Alege further noted that other conditions, including inguinal hernias, orchitis, and epididymitis, could also compromise fertility by damaging the spermatic cord, testes, or other structures involved in sperm production and transport.
“Ultimately, anything that damages the testis, the spermatic cord, or the structures attached to the testis has the potential to result in infertility,” he said.
In an earlier interview, a consultant urologist, Dr. Oluwaseun Akinola, said testicular torsion was most common in boys 12-18 years old and in infancy.
“Usually, patients with torsion develop severe, sudden-onset pain in the testicle. It may be associated with nausea and vomiting, and the patient usually has anorexia, which means they don’t want to eat.
“The patient may have had similar episodes that resolved on their own in the past. At the examination, they may notice a swollen scrotum on the involved side, and the testicle may feel like it is higher up in the scrotum than on the other side.
“It is critical that evaluation and correction be undertaken within six hours of onset to prevent loss of the testicle. Delay often leads to loss of the testicle and may result in infertility,” Akinola, a Consultant Urologist at Royan Hospital, said.