My Balls Took a Hit — Should I Be Worried?

Today, Dr. Natalya Lopushnyan joins us to discuss testicular trauma. Testicles are critical for both sperm production and hormone regulation, but are susceptible to injuries because they hang outside the body in the scrotum and lack the muscles and bones that other organs have to protect them.

As always, the following is meant to be educational and not used as medical advice. Please contact your medical provider with questions about your specific healthcare needs. 

Without further ado, here’s Dr. L.

Let’s talk about testicular trauma…

Let’s set the scene.

You’re playing pickup basketball. You go up for the rebound, and someone’s knee goes up for your groin.

Bam.

You double over. Maybe you cry. Every man within a 5-mile radius flinched in spiritual solidarity.

But then the question creeps in…
“Did something explode?”
“Should I go to the ER?”
“Will I ever father children again?”

As your friendly neighborhood urologist, I’m here to walk you through what’s normal, what’s not, and when to seek help for testicular trauma. Yes, we’re talking about ball injuries. Let’s do this.

What is testicular trauma?

Testicular trauma is any blow, kick, or unexpected smackdown to your testicles. The testicles are suspended in a loose sack (aka scrotum) and don’t have much bony protection. They're delicate little powerhouses producing testosterone and sperm — and they are not built for contact sports.

When you’re probably fine

Here’s when you can breathe (gently) and maybe just apply ice:

• Pain that improves within an hour or two: It hurts like hell, then eases up? Good sign.
• No swelling or mild swelling: A little puffiness is okay. It’s when you’re seeing grapefruit-level inflation that we worry.
• No bruising, or minor bruising: A little discoloration can happen. But if it’s turning all the colors of the rainbow, that’s a red flag.
• You can still walk and pee normally: If you’re moving okay and the plumbing still works, that’s reassuring.

Tip: Use ice packs, compression shorts, and ibuprofen. Skip the “I’m fine” macho act. Rest. Don’t ride bicycles. 

When to seek medical attention

Okay, tough guy — here’s when you drop the ego and get checked ASAP:

1. Swelling keeps growing or is severe: If your testicle looks like it’s auditioning to be a melon, get it seen.
2. Persistent or worsening pain: Pain that doesn’t ease or gets worse over a few hours? Bad news.
3. Bruising that spreads to the scrotum, groin, or thighs: This could mean internal bleeding.
4. You feel a "pop" at the moment of injury: That is not a good sound down there. Could be a rupture.
5. Blood in your urine or trouble peeing: The urinary system may be involved.
6. One testicle is now higher than the other with a lot of pain on the higher side (plus/minus nausea/vomiting): This could signal a torsion, which is a true emergency. You should head to the ER
7. Nausea or vomiting after the hit: Your body is telling you this was not just a tap.
   
   

What might happen at the doctor’s office?

We may:

• Do an ultrasound (gentle, non-invasive, no worries)
• Check for rupture, hematoma, or torsion
• Prescribe meds or even recommend surgery in severe cases (rare, but it happens)

Trust me, we’ve seen it all. You will not shock us. (Well, unless you come in with a testicle tattoo. Then maybe.)

How to protect the goods in the future

• Wear a cup if you play contact sports.
• Communicate boundaries in the bedroom — some folks are... enthusiastic.
• Don’t ignore small trauma — little hits can still cause internal damage.

Final thoughts from your friendly urologist

You only get two testicles. They deserve respect, protection, and attention when things go wrong.
If you're even slightly unsure whether something is serious, see your local urologist. You’d rather be told it’s nothing than show up too late with a ruptured nut.

Because one thing’s for sure — ignoring ball pain is a real pain in the balls.