What should you know about testicular pain radiating to the groin?

A painful or swollen testicle can occur with inflammation or infection, including Chlamydia, Gonorrhoea, or Mumps. A bulge that becomes more noticeable with coughing or straining may fit an Inguinal Hernia. Pain can also come from the urinary tract, kidney stones, muscle strain, or testicular torsion. These causes cannot be separated safely from symptoms alone.

Arrange same-day medical assessment for new, persistent, or unexplained pain. Avoid strenuous activity until you have been assessed, and note when the pain began, whether it is one-sided, and whether swelling, discharge, urinary burning, fever, vomiting, or a groin lump is present. Do not use leftover antibiotics. A clinician may need an examination, urine testing, sexual health testing, or imaging.

Go to an emergency department immediately for sudden intense pain, a testicle sitting higher or at an unusual angle, rapid swelling, severe nausea or vomiting, faintness, or pain after an injury. Emergency assessment is also needed if a groin lump is very painful, firm, discoloured, or cannot be gently reduced. Delay can affect treatment options.

Could this be torsion, infection, or a hernia? Do I need urgent ultrasound or urine testing? Should I have tests for sexually transmitted infections? What symptoms mean I should return immediately?