| Trauma | Testicular trauma may cause torsion, testicular rupture or haematoma which should be referred to a urologist or surgeon for a specialist opinion and possible intervention. |
| Inguinal Hernias | May have a history of fluctuant testicular swelling. These have the potential to become irreducible and incarcerated causing pain and discomfort. |
| Fourniers Gangrene | This is necrotising fasciitis of the perineum and is a urological emergency. It is more common in diabetes and vasculopaths. Presents with severe pain and rapidly spreading necrotic cellulitis. |
| Malignancy | Testicular cancers typically present in men aged 15-40 years with a small hard lump within the testis with/without pain. If any concern an USS may be indicated. |
| Oedema | Peripheral oedema may progress up the legs to the testes causing diffuse swelling and pain; this will require diuretics and medical management. |
| Cysts/Hydroceles | Cyst and hydroceles should be relatively painless, but may cause a heavy or dragging sensation. |
| Referred Pain e.g. Renal Colic, AAA, Appendicitis | Abdominal pain may be referred into the groin and testes. It is important to complete a thorough abdominal examination and consider these differentials, particularly in older patients. |
