Testicular Trauma

Testicular contusion is a bruised testicle. These male body parts hang outside your body. This puts them at risk of injury. Your pouch-like scrotum covers your testicles. But there aren’t any muscles or bones to protect them.

It’s not common, but you can injure your scrotum and testicles. Most of the time, testicles can absorb the shock from an injury without serious damage. At other times, you may need to seek medical care. For example, testicle bruising may also involve a buildup of blood beneath tissues (hematoma).

In addition to bruises, injury to your testicle may cause:

• Twisting of a spermatic cord inside it (torsion)
• Tearing of your testicle covering (rupture)
• Skin coming off your testicle
• Your testicle moving out of position
• Detachment of a testicle

Your testicles make sperm and hormones. Testicular trauma can get in the way of this task and block blood flow.

Symptoms of testicular contusion

Testicular contusion symptoms may include:

• Severe pain in your scrotum (the sac that holds your testicles)
• Visible bruising (discoloration) in your scrotum
• Swelling in your scrotum
• Pain and discomfort in your lower belly
• Nausea and/or vomiting
• Fever
• Blood in your pee
• Pain while peeing

Testicular contusion causes

Many things can cause testicular contusion or trauma, like:

• Knives or bullets
• Blunt force, like kicks or punches, or things that you can throw (like baseballs)
• Car, motorcycle or bike accidents
• Machinery accidents
• Animal bites

These types of events can cause minor injuries, like scraped skin. They can also cause major problems, like tearing the protective covering over the testicles and causing blood to pool.

Risk factors

Testicular bruises can affect anyone with at least one testicle. You’re at a greater risk of testicular contusion if you ride a motorcycle or play contact sports.

One way to reduce your risk is to wear athletic supporters when you play contact sports. You can also make every effort to be safe when you’re driving, riding bikes or motorcycles, or using machines.

Complications of this condition

Complications of testicular contusion can include:

• Infections
• Inflammation
• Infertility
• Low testosterone
• Urologic problems

Some injuries may lead to short-term issues with sexual performance.

How doctors diagnose this condition

A healthcare provider will start by asking questions about what caused your injury. In a physical exam, they’ll be able to tell if your testicle and the structures around it look and feel normal.

They may order a testicular ultrasound. This is a painless way to give your provider a picture of what’s going on inside your scrotum.

If they don’t see anything wrong in the ultrasound, you probably don’t have a serious injury. The time to worry about a testicle injury is when they see something torn or out of place. A lack of blood flow is another reason for concern.

You may need surgery to diagnose the injury in severe cases, or if you aren’t doing better after 48 hours.

How Do You Treat Testicular Trauma?

For mild testicular bruises, your healthcare provider may tell you to:

• Rest.
• Take over-the-counter pain relievers.
• Put ice on the affected area.
• Use some type of scrotal support.
• Take antibiotics they prescribe if needed.

Your provider will want to treat some types of injuries right away. These types include any that have:

• Gone through your scrotum and testicles
• Removed a large amount of skin
• Shown signs of twisting or blood supply blockage

Your provider may do surgery to repair or reattach your testicle. Rarely, they may need to remove a damaged testicle (orchiectomy). Your provider may suggest sperm banking if they must remove one or both testicles.

Recovery time

You should rest for 24 to 48 hours if you have a mild injury. See your provider if things get worse or you aren’t better in 48 hours.

Swelling from a more severe injury or from surgery may last up to eight weeks.

When should I see my healthcare provider?

It’s a good idea to call or visit a provider if you have a testicular injury, just to be safe. If there’s any question about the severity of your injury, go to your nearest emergency department. See a provider if you have:

• An injury that goes through your scrotum
• Severe swelling of your testicles with pain and bruising
• A fever after injury
• Pain that doesn’t stop or gets worse
• Blood in your pee that doesn’t stop or gets worse
• Trouble peeing
• Any symptom that worries you

You may want to ask your healthcare provider:

• How bad is this injury?
• Will I need surgery?
• How soon would the surgery take place?
• When can I play sports again?

If you’ve had a testicular contusion, you’ll likely have a follow-up visit with a provider in one or two weeks.

What can I expect if I have testicular contusion?

Many testicular injuries are mild. People recover relatively quickly. Most people with testicular bruising do recover.