Testicular Pain or Swelling in Lagos: When It Is an Emergency
Testicular pain that comes on suddenly and is severe is a medical emergency until testicular torsion is excluded. This page explains the causes of testicular pain, the 6-hour window for torsion, and what to do at Mascot Healthcare.
What Causes Testicular Pain?
Testicular pain ranges from a minor infection to a time-critical surgical emergency. The key distinction, torsion vs infection, cannot be made safely by examination alone and needs urgent hospital assessment.
Twisting of the spermatic cord: cuts off blood supply. Sudden, severe pain + swelling + nausea. SURGICAL EMERGENCY. Salvage rate > 90% if operated within 6 hours; < 10% after 24 hours.
Infection of the epididymis and/or testis, gradual-onset pain, swelling, warmth, fever. Often from STI (chlamydia, gonorrhoea) in young men or UTI in older men. Treated with antibiotics.
Dilated veins around the testis: a dull aching discomfort, often described as a "bag of worms" feeling. Associated with male infertility. Not an emergency.
Fluid accumulation around the testis: a smooth, non-tender scrotal swelling that transilluminates. Common in newborns; may develop after infection in adults.
A painless or mildly tender firm scrotal mass, most common in men 15–35. Painless testicular mass requires same-day scan.
Ureteric stone or inguinal hernia can refer pain to the testis without the testis itself being the source.
🚨 Go to hospital or clinic today if you have:
- Sudden severe testicular pain of any duration, come in immediately
- Testicular pain + vomiting: suggests torsion
- Testicular pain in an adolescent or young man, highest torsion risk group
- Painless hard lump in the testis: possible tumour (same-day scan)
- Testicular swelling + fever: epididymo-orchitis (urgent antibiotics)
- Testicular pain after trauma
What Tests Do You Need for Testicular Pain?
Recommended at Mascot Healthcare
Scrotal Ultrasound: checks the testis and epididymis for infection, cysts, swelling and lumps. Sudden severe pain that could be torsion needs a hospital emergency department, not a clinic scan.
Urine Dipstick + Culture: Checks for UTI as source of infection in epididymo-orchitis.
STI Screen (Chlamydia/Gonorrhoea swab test): In sexually active men, epididymitis is commonly STI-related.
Tumour Markers (AFP, hCG, LDH): If a testicular mass is found on scan, tumour markers are measured before any surgical intervention.
What to Do Right Now
Testicular torsion is a 6-hour emergency. Do not wait to see if the pain settles. Come in now.
Applying heat to a potentially torsed testis can worsen tissue damage. Cool compress only if anything.
Epididymo-orchitis requires antibiotics today: delay risks spread of infection and abscess formation.
A painless hard testicular lump requires a scrotal ultrasound the same week, do not delay.
Testicular pain or swelling? This is urgent: get a scrotal scan at Mascot Healthcare today.
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Last updated 18 October 2026.