Testicular pain: What to know

Written by: Mr Nkwam Michael Nkwam
Published: | Updated: 07/09/2023
Edited by: Sophie Kennedy

Testicular pain can be a sign of various issues and requires immediate medical attention. In this informative guide, highly respected consultant urological surgeon Mr Nkwam Micheal Nkwam shares a key case in point of what to do when testicular pain occurs and explains the importance of seeing a doctor promptly.

Can testicular pain be a sign of something serious?

It has always been well-documented that finding cancers earlier improves the likelihood of cure so seeing your doctor quickly if you have blood in your urine for example, is always the right thing to do. But what about testicular pain?

As we say in the trade, "Time is testicle!", so make sure you seek urgent medical attention as soon as possible! Although testicular cancer can present with a painful testicle it is far from the most likely cause. The most important diagnosis to rule out is twisting of the testicle on its cord - this is called testicular torsion.


A case in point: What to do when testicular pain strikes

It is 3pm on Monday afternoon and 14-year-old Johnny is in the middle of his favourite session of double maths at school when all of a sudden, he develops a severe pain in his right testicle (although either testicle can be affected). He is sent to see the school nurse for review. The pain gets worse and the nurse quite sensibly advises he be sent to A&E immediately to review. Johnny’s parents are informed and come to pick him up within the hour to take him to the nearest hospital.

It is now 4:30pm and Johnny is seen straight away by the urology team. There is no history of injury to testicle for example, while playing sport, and Johnny had been totally well all week with nothing to suggest a urine infection either. His testicle was still painful but now also red and swollen so the doctors explained to Johnny and his parents that they are concerned this may be a case of testicular torsion! There is no scan which can tell doctors one hundred per cent that there is no torsion - so the only way to confirm the diagnosis and treat it in one go is with immediate surgical exploration in theatre.


“Time is testicle”

Testicular torsion occurs when the testis rotates on its cord cutting off the blood supply to the testis – this is a medical emergency.

Truth be told, testicular torsion can occur at any age but is most common between the ages of 12 and 18 years. If left twisted, the testicle will eventually die but if it is untwisted, it can be brought back to life and this is time-dependent. Over 80 per cent of testes are saved when the testis is untwisted within 6 hours of the onset of pain. However, the salvage rate falls to about 50 per cent at 10 hours, 10 per cent at 12 hours and a lowly 5 per cent or less at 24 hours. Hence, the saying “time is testicle!”


What about Johnny?

Luckily for Johnny, he got to theatre 2 hours after his pain started and his testicle was twisted. So, the surgeons untwisted it thus saving the testicle and put stitches in as well to stop it from happening again. For good measure his other testicle was also stitched to prevent the same. Both Johnny and his testicles went on to make a full recovery and he was back in double maths again the following week!

The take home message is; in the event of sudden onset testicular pain make sure you seek medical attention immediately.




Mr Nkwam Micheal Nkwam is one of the UK’s leading consultant urological surgeons. To schedule a consultation with Mr Nkwam, visit his Top Doctors profile today.

By Mr Nkwam Michael Nkwam
Urology

Mr Nkwam Michael Nkwam is a highly respected consultant urological surgeon based in London. He is renowned for his expertise in benign prostate hyperplasia (enlargement), prostate cancer diagnostics and Holmium laser (HoLEP). He additionally specialises in kidney stones, haematuria (blood in the urine) and vasectomy.

After obtaining a bachelor’s degree with honours, Mr Nkwam qualified in medicine from St. George’s, University of London in 2007. He completed his further surgical training in the West Midlands and was awarded membership of the Royal College of Surgeons of England in 2010. Mr Nkwam undertook specialist higher surgical training in urology in the East Midlands training programme and was appointed as a Fellow of the Royal College of Surgeons’ Urology section in 2017. Following this, he completed a twelve-month fellowship based at Luton and Dunstable University Hospital NHS Trust specialising in Holmium laser enucleation of the prostate (HoLEP) and endourology. Having gained invaluable insight into this form of treatment, he successfully performed the first HoLEP procedure at King’s College Hospital, London in 2020. With wide ranging expertise and experience in endourology, general urology and urological oncology, Mr Nkwam is regarded as a leading surgeon in his field. He sees private patients at HCA UK at The Shard, Chelsfield Park Hospital, the Shirley Oaks Hospital and the London Circumcision Centre.

Additional to his clinical responsibilities, Mr Nkwam provides essential training for GPs on a range of important areas of urology, including updates in the management of kidney stones, benign prostate hyperplasia and men’s health, amongst others. His numerous academic papers are published in revered peer-reviewed journals and he has presented his work at various key national and international conferences in his field.

Throughout his esteemed career, the excellence of Mr Nkwam’s work has been recognised with numerous awards, including ‘Best Poster in Session’ prizes, awarded by the European Association of Urologists in 2017 and the British Association of Urological Surgeons in 2018. That same year, Mr Nkwam was also the Ian McCallum Research Prize winner. He is a member of a number of key professional bodies, including British Urology Researchers in Surgical Training (BURST) and the British Association of Urological Surgeons (BAUS).

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