What to Know About Testicle Rupture

The testicles are male reproductive glands surrounded by two layers of tough, fibrous tissue. They’re encased in the scrotum. Despite that protection, testicle rupture is possible, particularly in the event of blunt trauma.

Testicular rupture is a health emergency. Go to your nearest emergency room right away if you suspect testicular rupture.

In the event of serious injury, the usual treatment is surgical repair, followed by a recovery of several weeks and a slow return to daily activities. In the most severe cases, surgical removal of a ruptured testicle may be necessary.

Read on to learn about signs to look for, causes, treatment, and recovery.

Signs of a ruptured testicle

In many cases, a bruised testicle is a painful, but minor injury that can heal on its own.

But if you experience more than localized pain in the scrotum, you may need immediate medical attention. Bruising and swelling of the scrotum may be signs of a ruptured testicle.

Causes

A ruptured testicle is usually the result of some blunt force striking the scrotum.

A 2018 study found that the majority of scrotal injuries were the result of firearms. But sports injuries, including a baseball or a lacrosse ball hitting the scrotum, can also cause testicle bruising or rupture. The same is true for a kick to the scrotum or landing on a hard surface after a fall.

When to seek help

Severe pain and swelling of the scrotum should be treated as a medical emergency, especially if there’s blood in your urine, or if you’re having trouble urinating.

Blood in your urine or having difficulty urinating could suggest an additional injury to the urethra or bladder.

If the scrotum has been penetrated or the bruising and pain are severe, go to an emergency room as soon as possible. Have someone else drive you, or call for an ambulance.

If icing your scrotum and taking an over-the-counter (OTC) pain medication relieves your symptoms, you might not need to go to the emergency room.

But take note of any other changes, such as pain that lingers for a few days or blood in your urine. If you notice such symptoms, contact your primary care doctor. They may refer you to a urologist. If you don’t have a primary care physician, go to an urgent care or walk-in clinic.

If a doctor suspects a testicle rupture, they’ll do a physical examination and a review of what may have caused the injury.

You may be asked to take a urine test to check for signs of infection or other markers of disease. The doctor may perform an ultrasound of the scrotum to view the tissue inside and look at any changes to your blood flow.

Other testicle trauma

Pain and swelling of the scrotum can occur without a blunt or penetrating injury. A few other common causes of symptoms include:

• Epididymitis. Caused by an infection or sexually transmitted infection (STI), epididymitis includes symptoms, like pain, swelling and redness of the scrotum.
• Hydrocele. Sometimes, an injury or infection can cause fluid to build up inside the scrotum, causing swelling and pain. This condition is called a hydrocele.
• Orchitis. Inflammation of the testicles, known as orchitis, can be caused by infection or virus.
• Varicocele. An enlargement of one of the veins in the scrotum is known as varicocele.
• Testicular cancer. While testicular cancer is generally painless, symptoms include an enlarged and firm testicle. Sometimes, a solid nodule can be felt.

If you develop pain and swelling without an obvious cause, try to see a urologist as soon as you can. A primary care physician can do an exam and order tests, and they may also refer you to a specialist.

How is it treated?

Treating a ruptured testicle usually means surgery. If a testicle has been torn, but there’s healthy blood flow, it can typically be repaired through surgery.

Dissolvable stitches are often used. And, in some cases, a plastic tube may be left in the scrotum for several days to drain excess fluid while the testicle heals.

If the injury is too severe, surgical removal of the affected testicle may be necessary.

Recovery

After surgery, you may be given prescription pain medications. However, common OTC anti-inflammatory medications, such as ibuprofen (Advil), may be enough to get you through recovery.

You’ll probably be advised to wear an athletic supporter to help keep the testicles from moving too much after surgery.

Swelling may take at least 2 to 4 weeks to subside. After that time, you may be able to resume daily activities.

However, heavy lifting and other types of extreme physical exertion may have to wait several more weeks. The same is true for contact sports or any sports where injury is possible. Wearing an athletic cup is recommended.

Sexual activity may be appropriate after a few weeks, but be sure to talk with your doctor about any concerns. You may still be feeling considerable discomfort, so allow yourself some time to heal.

Outlook

A ruptured testicle might be uncomfortable just to think about, let alone experience firsthand. Wearing protective gear can help when playing sports, and taking extra precautions when handling firearms is always important.

Mild pain after an injury to the scrotum might not be a sign of a rupture or tearing, but severe pain and swelling or pain that doesn’t go away are signs that you should see a doctor to evaluate your injury.

If a rupture has occurred, surgical repair is often possible. In extreme cases, testicle removal may be necessary. But keep in mind that having one healthy testicle is usually enough for typical fertility.

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