acute groin and scrotal pain

Last reviewed 01/2018

Causes include:

• strangulated hernia, inguinal or femoral - tender, painful, irreducible groin lump. May present as intestinal obstruction or abdominal pain
• torsion of the testis - a sudden onset unilateral scrotal pain. There may be an associated poorly-localised abdominal pain. In an early presentation the testis lies high in the scrotum, is exquisitely tender and the spermatic cord is thickened. The opposite testis may lie horizontally - bell-clapper testis
• torsion of the hydatid of Morgagni - again this is a sudden onset unilateral scrotal pain. However in this case there is only tenderness at the upper pole of the testis, and the testis hangs normally
• acute epididymitis - moderate or severe scrotal pain and tenderness; also marked redness and oedema. There is often a history indicative of a previous urinary tract infection
• haematocoele - eg following trauma or scrotal surgery for vasectomy
• appendicitis: the appendix has the same visceral afferent nerve supply (T10) as the testes and this can cause referred pain