Scrotal Pain in Children
What is scrotal pain?
Scrotal pain is pain, discomfort or swelling affecting the scrotum—the pouch of skin that contains the testicles. It can affect boys of any age and may develop suddenly or gradually. While some causes are relatively minor, others require urgent medical treatment, so it is important that new or unexplained scrotal pain is assessed promptly.
Our paediatric surgeons have extensive experience in diagnosing and treating conditions affecting the testicles and scrotum. Following a careful examination, we can identify the cause of your child's symptoms and recommend the most appropriate treatment.
What can cause scrotal pain?
There are several possible causes of scrotal pain in children, including:
- Testicular torsion – where the testicle twists, cutting off its own blood supply. This is a surgical emergency.
- Torsion of a testicular appendage – a less serious condition caused by twisting of a small piece of tissue attached to the testicle.
- Epididymitis or epididymo-orchitis – inflammation or infection affecting the structures around the testicle.
- Inguinal hernia – where part of the bowel passes into the groin or scrotum.
- Hydrocoele – a collection of fluid around the testicle that may occasionally cause discomfort.
- Injury or trauma to the scrotum.
- Less commonly, referred pain from another condition affecting the abdomen or pelvis.
Determining the underlying cause is essential, as treatment varies depending on the diagnosis.
When should I seek urgent medical attention?
Sudden scrotal pain should always be treated as a medical emergency until proven otherwise.
You should take your child to the nearest Emergency Department immediately if they develop:
- Sudden, severe pain in one or both testicles
- Swelling of the scrotum
- Redness or tenderness of the scrotum
- Pain associated with nausea or vomiting
- A testicle that appears to sit higher than normal
- Severe pain following even minor injury
These symptoms may indicate testicular torsion, where the blood supply to the testicle becomes twisted. Urgent surgery is often required, and treatment within a few hours offers the best chance of saving the testicle.
If your child's pain is mild, recurrent or has developed gradually, they should still be assessed by a healthcare professional, but this may not require emergency treatment.
How is scrotal pain diagnosed?
Your child's consultation will begin with a detailed medical history followed by a gentle examination of the groin and scrotum.
Depending on your child's symptoms, investigations may include:
- Physical examination
- Urine tests to check for infection
- Blood tests if required
- Ultrasound scan of the scrotum to assess blood flow and identify underlying conditions
Although ultrasound can be very helpful, it should never delay emergency surgery if testicular torsion is strongly suspected.
What treatment is available?
Treatment depends on the underlying cause of your child's symptoms.
Possible treatments include:
- Emergency surgery for testicular torsion
- Pain relief and observation for torsion of a testicular appendage
- Antibiotics for bacterial infections
- Surgical repair of an inguinal hernia if present
- Treatment of a hydrocoele if it is causing symptoms or persists beyond early childhood
- Rest, supportive underwear and pain relief following minor injury
Your consultant will explain the diagnosis, discuss all available treatment options and answer any questions you may have before treatment begins.
Recovery
Recovery depends on the underlying condition and any treatment required.
Children treated for minor injuries or inflammation often recover within a few days. Following surgery, most children return home the same day or after a short hospital stay, with recovery usually taking one to two weeks depending on the procedure performed.
Your consultant will provide personalised advice regarding pain relief, returning to school, sport and follow-up appointments.