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As a parent, few things are more concerning than hearing your son say he has pain “down there.” Whether it’s a young boy or a teenager, testicular or groin pain can be alarming. While some causes are minor and resolve on their own, others may signal a serious medical issue that requires immediate attention. Knowing when to consult a urologist is essential for protecting your son’s health and future fertility.

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Common Causes of Pain

Pain in the testicular or groin area can stem from various causes, ranging from mild to urgent. Some of the more common conditions include:

• Trauma or Injury: Active boys may experience testicular pain from sports injuries, rough play, or accidental bumps. Most injuries are minor, but any severe pain, swelling, or bruising should be assessed by a doctor.
• Infections: Conditions such as epididymitis (inflammation of the tube behind the testicle) or orchitis (testicle inflammation) often present with swelling, redness, and fever. These may require antibiotics and follow-up care.
• Hernias: An inguinal hernia, where abdominal tissue bulges into the groin, can cause discomfort or visible swelling. If the hernia becomes trapped (incarcerated), it can become a medical emergency.
• Testicular Torsion: This is the most urgent condition. It occurs when the spermatic cord twists, cutting off blood supply to the testicle. Torsion causes sudden, severe pain and swelling. It typically affects teenage boys but can happen at any age. It requires emergency surgery to save the testicle.

When to See a Urologist

You should consult a pediatric urologist if your son experiences:

• Persistent or severe testicular pain
• Swelling or lumps in the scrotum
• Pain that comes and goes regularly
• Pain during urination or unusual urinary symptoms
• A history of undescended testicles or testicular abnormalities

Some issues, like varicoceles (enlarged veins in the scrotum), may not cause pain but can affect fertility in the long term. A urologist can evaluate these conditions with an ultrasound and suggest treatment if necessary.

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Emergency Signs

Take your son to the emergency room immediately if he experiences:

• Sudden, intense testicular pain
• Nausea or vomiting with scrotal pain
• A swollen, red, or firm testicle
• Loss of consciousness or severe discomfort

Delaying care in conditions like testicular torsion can result in the loss of a testicle in as little as six hours.

Don’t Hesitate to Ask Questions

Talking about testicular health can be awkward—for both you and your son. However, open communication helps identify problems early. Encourage your son to report any discomfort or changes in his genital area. Assure him that it’s a normal part of growing up and that doctors are there to help, not judge.

Conclusion

While not every case of “pain down there” is serious, some are true urological emergencies. Trust your instincts as a parent. If something seems off, it’s better to seek medical advice than to risk complications. A pediatric urologist can provide expert care and peace of mind for both you and your son.

This article has been fact-checked by Dr Chong Kian Tai, urologist at Surgi-TEN Specialists, Farrer Park Hospital, Singapore.

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