By Dr. Alfredo Suarez-Sarmiento,Jr.  Men’s Health Expert | Perito Urology

When even Dwayne “The Rock” Johnson is making headlines about testicular health, it’s probably time we began a conversation about men’s health.

The recent news story surrounding Dwayne Johnson’s experience with epididymitis caught my attention—not because it’s rare, but because it’s actually one of the more common causes of testicular pain we see as urologists.

To be blunt: If there’s one body part men are remarkably good at ignoring until it’s impossible to ignore, it’s the nuts.

What Is Epididymitis?

The epididymis is a small, coiled tube that sits behind each testicle. Think of it as the storage and maturation center for sperm before they head out on their big adventure.

When that structure becomes inflamed or infected, it’s called epididymitis.

Symptoms often include:

• Pain or tenderness in one testicle
• Swelling of the scrotum
• Warmth or redness
• Pain that gradually worsens over hours to days
• Burning with urination
• Urinary frequency or urgency
• Fever

In younger men, it can sometimes be related to sexually transmitted infections like chlamydia or gonorrhea. In older men, it’s more commonly associated with urinary tract bacteria, enlarged prostate issues, or bladder emptying problems.

The good news is that most cases improve with appropriate treatment.

Not All Testicular Pain Is Created Equal

While epididymitis is common…testicular torsion is an emergency.

Torsion occurs when the blood supply to the testicle twists off, not unlike a garden hose being kinked. When this occurs, the testicle loses oxygen. Treating it quickly is essential: Time matters.

Torsion Red Flags:

• Sudden, severe pain
• Nausea or vomiting
• High-riding testicle
• Pain that wakes you from sleep
• Rapid onset over minutes

If that happens:

Go to the emergency room immediately. The chances of saving the testicle drop dramatically after several hours.

“Why Do My Balls Hurt?” Other Common Causes:

1. Epididymitis: Gradual onset. Often treatable with antibiotics and anti-inflammatory measures.

2. Testicular Torsion: Sudden onset. Surgical emergency.

3. Kidney Stones: Pain can radiate down into the testicle and groin.

4. Inguinal Hernia: A small bulge in the groin can create pressure and discomfort extending into the scrotum.

5. Varicocele: Enlarged veins around the testicle. Patients often describe it as “feeling like a bag of worms.” While not the most elegant description, it’s surprisingly accurate.

6. Trauma: Whether from sports, the gym, or an unfortunate encounter with your toddler’s flying knee. We’ve all seen it.

When Should You See a Urologist?

If you have:

• Pain lasting more than a day
• Swelling
• Fever
• Burning with urination
• A new lump
• Recurrent episodes of discomfort
• Sudden severe pain

…it’s worth getting checked out.

Most of the time, it’s something manageable. But sometimes, catching an issue early makes all the difference.

A Quick Word About Testicular Cancer

The overwhelming majority of testicular cancers do NOT present with pain.

Instead, men often notice:

• A painless lump
• Firmness in the testicle
• A change in size
• A feeling of heaviness

The silver lining is that testicular cancer is highly curable, especially when detected early.

So if something feels different, don’t ignore it.

The Bottom Line

Men will routinely:

• Drive on bald tires,
• Ignore the check engine light,
• And convince themselves that the strange noise in the attic is “probably nothing.”

Please don’t apply that same strategy to your testicles: Your body is usually trying to tell you something.

Most causes of testicular pain are treatable, and some are urgent. All of them deserve more attention than the typical male response of:

“Eh… let’s see if it’s still there tomorrow.”

Because when it comes to your health… it’s okay to have the stones to get your stones checked.

About the Author

Dr. Alfredo Suarez-Sarmiento is a urologist at Perito Urology specializing in men’s health, sexual medicine, penile prosthetics, and cosmetic urology. He believes that the best medicine combines expertise, education, and a little bit of humor—especially when talking about subjects that most men would rather avoid.

If you’re experiencing testicular pain or have concerns about your urologic health, schedule an evaluation with a qualified urologist. Early answers provide peace of mind—and sometimes, they protect much more than that.