Three differential diagnoses for scrotal pain Scrotal pain is also referred to as testicle pain or testicular pain and it occurs when pain is felt in or around one or both testicles.
Epididymitis: Inflammation of the Epididymis
Epididymitis is an inflammation of the epididymis, a curved structure at the back of the testicle in which sperm matures and is stored (Uphold & Graham, 2013). When the pain occurs as an acute condition, the symptoms can last up to six weeks (Uphold & Graham, 2013). This condition is mostly the cause of acute testicular pain in post-pubertal pain and usually occurs in those that have a history of sexual activity. Approximately half of those who suffer from this condition develop fevers; however, nausea and vomiting are not common (Uphold & Graham, 2013). The condition is also typically associated with asymptomatic urethritis when it is transmitted sexually and may eventually lead to a gradual unset of testicular pain, tenderness, dysuria and urethral discharge (Uphold & Graham, 2013). Chronic epididymitis is characterized by symptoms lasting for greater than six weeks (Uphold & Graham, 2013).
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If a diagnosis is not obtainable, urinalysis and urine culture should be considered. C-reactive protein levels or erythrocyte sedimentation rate are also tests that can be used to differentiate from torsion (Uphold & Graham, 2013). Intravenous pyelography can be used to detect bladder obstruction in older men. When the patient has sexually transmitted infection (STI), a gram-stained smear of urethral exudate or intraurethral swab specimen tests should be