Causes of Lower Abdominal & Testicular Pain

Shared nerves carry pain sensations from the lower abdomen and scrotum, which contains the testicles and other male reproductive structures. For this reason, pain originating in either location is often felt in both areas. Similarly, the causes of lower abdominal and testicular or scrotal pain can be due to abnormalities affecting structures in either location. Many conditions can lead to lower abdominal and scrotal pain, some of which can lead to permanent testicular damage if not treated quickly. It's important to see your doctor for an accurate diagnosis and appropriate treatment if you experience lower abdominal and testicular pain.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Testicular Trauma

As any man can attest, a blow to the scrotum typically causes intense testicular pain. With severe trauma, the pain often extends into the lower abdomen and may be accompanied by nausea, vomiting and possibly difficulty urinating. A high-force blow to the scrotum can damage the testicles or cause bleeding within the scrotum. Medical evaluation is needed if there is scrotal swelling, tenderness or bruising. Cold packs and over-the-counter pain relievers generally suffice for minor scrotal trauma.

Groin Hernia

A groin hernia describes protrusion of abdominal contents through a weak area in the groin region of the abdominal wall. Most are inguinal hernias, which form at the site where the spermatic cord passes from the abdomen into the scrotum in men. Most groin hernias develop gradually and initially cause no pain. They often cause a lump in the groin, which may extend into the scrotum. A sudden or large groin hernia can cause aching pain in the lower abdomen and scrotum. The pain often comes and goes, and is typically relieved by lying down. Constant, worsening pain may indicate a groin hernia complication and requires immediate medical evaluation and treatment.

Testicular Torsion

Testicular torsion describes twisting of the spermatic cord within the scrotum. Among other structures, this cord carries the artery that supplies blood to the testicle and other scrotal structures. Twisting of the cord disrupts this blood supply leading to sudden, severe, one-sided testicular pain and swelling. Lower abdominal pain, nausea and vomiting also frequently occur with testicular torsion. Teens going through puberty and men younger than 25 are at the greatest risk for testicular torsion, though the condition can occur in older males. Testicular torsion requires emergency surgical treatment to avoid loss of the affected testicle. Death of the testicle can occur within 4 to 8 hours.

Epididymitis and Orchitis

Epididymitis refers to inflammation of the epididymis, a structure on the back of the testicle that transports sperm. A bacterial infection most commonly causes epididymitis, such as the sexually transmitted diseases chlamydia and gonorrhea. The testicle can also become infected in some cases, a condition known as orchitis. One-sided scrotal pain typically develops gradually with infectious epididymitis, with or without orchitis. This characteristic helps distinguish these conditions from testicular torsion. The pain progresses over days to weeks, along with scrotal tenderness and swelling, burning with urination, increased urinary frequency, painful ejaculation and possibly a low fever. Lower abdominal pain also develops in some men. Noninfectious epididymitis and ochitis can develop due to an enlarged prostate, back flow of urine into the epididymis, or as a side effect of certain prescription medications.

Other Causes

A number of other medical conditions can cause lower abdominal and scrotal pain. Most of these conditions involve abdominal structures with referred pain to the scrotum. For example, a stone or other obstruction of the ureter -- the tube that carries urine from the kidney to the bladder -- can lead to these symptoms. Lower abdominal or pelvic tumors and scar tissue formation in the space behind the abdominal cavity can also sometimes cause lower abdominal and scrotal pain. Appendicitis or a herniated disc in the low spine might be the culprit, although other symptoms usually make these conditions relatively obvious.

When To Seek Medical Care

Although it can be embarrassing to discuss scrotal or testicular pain, it's important to seek medical attention if you experience this symptom -- with or without abdominal pain. Medical evaluation is especially important if your pain develops suddenly, is worsening, or is accompanied by other symptoms.

Reviewed by: Tina M. St. John, M.D.