Genital Injuries and Testicular Trauma in Male Athletes

February 03,2022 |
Two men playing basketball

Most men have experienced some degree of testicular trauma in their lifetime, but male athletes are subject to genital injury far more often than the layperson. When it occurs, it causes others to gasp or cringe in sympathetic pain. The initial shock can be extreme, but pain tends to dull as time goes on. However, in serious occurrences the damages aren’t always quick to fade. Genital injuries and testicular trauma in male athletes can range from mild to severe, sometimes requiring surgery. If left untreated, the more severe cases can even result in the loss of a testicle. Here are some ways to identify, classify, treat, and protect male athletes and the public from genital injuries and testicular trauma.


Signs of Testicular Trauma

Aside from the initial shock that occurs immediately following the injury, some of the common signs of testicular trauma include the following:

  • Scrotal pain
  • Abdominal discomfort
  • Testicular swelling and/or bruising
  • Scrotal swelling and/or bruising
  • Nausea and/or vomiting
  • No pain relief after physically lifting the testicle
  • Absence of cremaster reflex
  • Blood in the urine
  • Fever
  • Difficulty urinating


If you’re experiencing any of the above symptoms or have recently undergone a trauma in sports or in general, it’s always better to be safe and schedule a physical examination with your urologist or a sports medicine physician. While serious genital injuries are rare, they can create long-lasting problems if ignored.


Types of Genital Sports Injuries

There are different types of genital sports injuries, each of which vary in severity and degree. Some of the primary types of genital injuries include epididymitis, hematoma, scrotal or testicular contusion, testicular rupture, dislocation, degloving, and testicular torsion.


  • Epididymitis – the epididymitis is a tube that carries sperm from the testicle, out of the body. This type of injury occurs when the epididymis becomes inflamed or infection following a trauma. If not treated, the infection can spread and become increasingly dangerous. Infection and inflammation can cause disruptions to the functionality of the epididymitis, which can manifest in other symptoms.


  • Hematoma – hematoma is the medical term for a blood clot. In genital injuries, blood clots can occur within the testicle and manifest in the appearance of a bruise. While the appearance of a bruise may seem mild, blood clots can be fatal and should be examined by a medical professional to avoid the chances of developing a pulmonary embolism.


  • Scrotal or Testicular Contusion – a contusion is when the capillaries of injured skin or tissue is damaged, which causes them to rupture. This type of damage also results in a bruise but does not carry the same severity as a hematoma. Since sometimes it can be difficult to distinguish the difference between a bruise caused by a hematoma and a contusion, seeking medical assistance is always encouraged.


  • Testicular Rupture – a rupture occurs when a blood vessel bursts or breaks suddenly, often after contact trauma. When this occurs in the genitals, the blood vessel ruptures within the testicles, which can cause blood and other fluids from the testicles to leak into the scrotum.


  • Dislocation – when there is physical trauma to the genitals, the force can cause the testicles to be pushed out of the scrotum, resulting in dislocation.


  • Degloving – in severe genital trauma, an injury known as degloving can occur. This is when the scrotum is torn away from the body and it requires immediate medical attention to avoid long-lasting damage.


  • Testicular Torsion – another injury that requires immediate attention is testicular torsion. This is when one or both testicles become twisted inside of the scrotum. This can lead to a loss of blood flow and if not addressed, loss of a testicle. Since damage to testicles is often below the surface level, it’s always recommended to seek medical care after any sort of trauma, especially within athletic sports.


    Classifying Different Levels of Testicular Trauma

    If you incur some type of genital sports injury, you’ll need to have it assessed by a medical professional. During this time, you’ll undergo a physical examination to check for any lacerations or bruising, swelling, or more serious problems. To do this, your doctor will gently roll the testicles between their thumb and forefinger. If damage seems severe, or the pain is too great to handle, an ultrasound will be ordered.

    At this time, your doctor will determine how severe the damage is and whether other abnormalities are present. Other urologic tests may be performed for more information on the damage. There are generally three classifications of injury: mild, moderate, and severe.


  • Mild Testicular Trauma – mild testicular damage is the most common type of genital injury in male athletes. This occurs when pain and swelling are present, but both are minimal. Treatments are simple and done at home.


  • Moderate Testicular Trauma – if a male experience moderate levels of pain during an examination and moderate levels of swelling are present, damage could be internal. Further testing is needed to make sure the proper treatment is administered.


  • Severe Testicular Trauma – this severity of damage is often associated with significant levels of pain and scrotal swelling is visually apparent to the naked eye. The examination itself may need to be stopped due to pain levels when the affected area is touched. An ultrasound will need to be performed to further assess damage and make sure that any complications are caught and treated before damage progresses.


    How to Treat Genital Injuries and Testicular Trauma

    The way you treat genital injuries and testicular trauma will depend on the severity of the accident. While minor instances may only require icing and rest, severe cases can lead to surgery and the loss of a testicle.


  • Icing and Rest – in mild cases, all that’s needed is plenty of rest and utilizing ice packs for about 20 to 30 minutes, three to four times per day. Your doctor may recommend icing more or less frequently, depending on the level of damage, and how long icing can be tolerated.


  • Over the Counter Medication – for those who need pain relief, over-the-counter medications are recommended. Ibuprofen and naproxen can be used and if you feel like the pain is too much, your doctor may recommend something stronger. Nonsteroidal anti-inflammatory medications that have been approved by your doctor can be used to help with the swelling.


  • Supportive Underwear – supportive underwear can be used to help keep things in place and minimize discomfort while you’re moving around. This can be as simple as substituting boxers for briefs, or you may require something more substantial.


  • Surgery – in severe cases, surgery may be required to correct testicular torsion or any dislocation. If the damage is too severe, it may result in the loss of a testicle, which is why immediate action is essential. Surgery may require the use of a catheter during recovery.


Preventing Genital Injuries and Testicular Trauma

Although serious injuries and trauma are rare, the potential is a real possibility. While male athletes are at the highest risk for experiencing this type of trauma, it can occur outside of sports. Testicular trauma can be the result of different occurrences, including falls, kicks, collisions, straddle injuries, and even equipment malfunction. While it’s not recommended that you exercise extenuating prevention in the same form of athletes, if your job puts you at risk, it may be beneficial to consider.

Since most sports-related male injuries result from blunt force trauma, injury and trauma can be minimized by wearing protective gear and/or athletic cups. Make sure that the cup is properly fitted so that it stays in place during activity. This is important for both men and boys involved in sports. However, it’s been found that nearly half of young men do not wear a cup during contact sports. While these types of injuries are less common than others, the damage can be severe and long-lasting. Always wear a protective cup during any type of contact sport, regardless of your age. You should also schedule regular check-ups with your urologist to make sure that everything is functioning as it should—especially after an injury.

While male athletes may be eager to return to the field, allowing for complete recovery is the only way to avoid further damage. You should have doctor approval and continue to check-in if you notice any pain or problems that occur after your return. For more information on urology related education, support, or products, Byram Healthcare is here to help.