Ruptured Testicle

A ruptured testicle is when the membrane that covers a testicle breaks. This membrane is the tunica albuginea (TOO-ni-kuh al-buh-JI-nee-uh). It can occur when:

• Something pierces your scrotum
• Your testicle is hit very hard
• Your testicle gets crushed against a bone in your pelvis

Your testicles don’t have muscles or bones around them for protection. This means they’re vulnerable to injury. When a testicle ruptures, the tunica albuginea breaks, and seminiferous tubules stick out. Your seminiferous tubules are the structures in your testicles that make sperm.

Although testicular trauma is common, a ruptured testicle isn’t. It takes a force of 50 pounds or more to rupture a testicle. 

A ruptured testicle is a medical emergency. Seek medical attention quickly if you think you might have a ruptured testicle.

Symptoms of a ruptured testicle

Ruptured testicle symptoms may include:

• Severe testicular pain
• Swollen testicles
• Bruising
• Nausea and vomiting
• Pain and discomfort in your lower abdomen
• Blood in your pee (hematuria)
• Pain while peeing (dysuria)
• Fever after the injury

If you have these symptoms after trauma to your scrotum, get medical treatment.

Ruptured testicle causes

Testicular rupture happens with trauma (injury). It may be blunt force or an injury that pierces your skin (penetrating injury). Examples include:

• Bite
• Gunshot wound
• Impact from a fall or vehicle crash
• Kick or punch to your groin
• An object hitting your testicle at a high speed (like a ball or puck in sports)
• Stab wound

Any male can experience a ruptured testicle. But it’s more common in adolescents and young adults who play sports.

How doctors diagnose it

Visit an emergency department, your primary care provider (PCP) or a urologist to diagnose a ruptured testicle. A healthcare provider will ask you questions about your symptoms and do a physical exam of your testicles and the surrounding area. They may also recommend tests, such as:

• Imaging tests like an ultrasound or MRI
• Pee tests to check for signs of infection or disease

Your provider will want to make sure you don’t have another type of problem with your testicle, like:

• A collection of blood in the space around your testicle (hematocele)
• Infection
• Organs pushing through weak muscle or tissue in your abdomen (hernia)
• Testicular cancer
• Your testicle twisting and cutting off the blood supply (testicular torsion)

How do you repair a ruptured testicle?

Most cases of testicular rupture require surgery to:

• Control bleeding
• Repair tears to your tunica albuginea
• Remove tissue that treatment can’t fix

During surgery, your surgeon will:

1. Give you general anesthesia so you aren’t awake during the surgery
2. Make a cut (incision) in your scrotum
3. Check your testicle and nearby structures
4. Close any tears in your tunica albuginea with dissolvable stitches (sutures)
5. Possibly place a temporary tube to drain blood and other fluids from your scrotum

Can it be saved?

Not always. Sometimes, healthcare providers can’t repair a ruptured testicle. In this case, they must remove your testicle (orchiectomy).

Recovery time

It can take several weeks to a couple of months to recover from a testicular rupture.

After surgery, your incisions will ooze fluid for a few days, and you’ll have swelling in the area. You’ll likely have mild to moderate pain for several days after the procedure. Pain medications can help. Your stitches should dissolve in two to three weeks. Swelling usually goes away after a few weeks.

When should I see my healthcare provider?

Seek medical attention as quickly as possible if you have any symptoms of a ruptured testicle after an injury to your testicles or scrotum.

During your visit, you may wish to ask:

• Will you have to remove my testicle?
• Was anything else damaged?
• Will I need a drainage tube after surgery?
• Will it affect my fertility?
• How long do I have to wait before I can be sexually active?

What can I expect if I have a ruptured testicle?

With fast treatment, the outlook for a ruptured testicle is good. Most people make a full recovery without permanent damage to their testicles.

Is there anything I can do to feel better?

As you recover, healthcare providers typically suggest that you:

• Avoid physical activity, contact sports and sexual activity (including masturbation) for several weeks
• Follow up with a urologist to see how well you’re healing
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) to manage your pain and reduce swelling
• Wear a jockstrap or tight underwear to support and protect your testicles

Can a ruptured testicle be prevented?

To help reduce your risk of rupturing a testicle, you should:

• Wear properly fitting protective equipment (jockstrap and athletic cup) when playing sports
• Drive safely, and always wear a seatbelt
• Be careful when handling guns and knives

Will a ruptured testicle make me infertile?

Not usually. One healthy testicle is often enough for you to make sperm and get a female partner pregnant. If you have infertility problems after a testicular rupture, schedule an appointment with your primary care physician or a urologist. They can do a semen analysis to check the volume and quality of your sperm.