Men of any age can suffer from infections that cause testicle pain, which can be caused by E. Coli or other bacteria. For older men, benign enlarged prostates can play a major role in developing these infections. The bacteria accumulates when the enlarged prostate prevents the bladder from draining properly. Because of this, E.coli or other gastrointestinal bacterial can back up and cause infection.  Medical treatment for this includes Bactrim DS or a quinolone antibiotic. The course of treatment is around 10 days, unless the prostate is involved, which may be treated longer. Often, the Prehn’s sign will ease symptoms. Ice packs are also helpful. You can reduce pain with Tylenol, Motrin, or even stronger narcotic pain medication for the first few days. Treatment for STIs is antibiotics. Your doctor may prescribe Rocephin followed by a course of zithromax or doxycycline. Improvement in pain should begin in 24 to 48 hours. Ice packs as well as testicular elevation can bring relief while you wait for the antibiotics to work. You can also take over the counter pain medications to help as well, especially during the first few days. Testicular trauma is caused by a twisted testicle not getting enough blood. This typically occurs after many different kinds of trauma, such as slipping off of a bicycle and hitting the groin. Extreme testicular trauma can twist the spermatic cord, which calls for surgical intervention. This condition affects 3.8% of every 100,000 males under the age of 18 every year.  Early recognition of a high-riding testicle and no Cremasteric reflex is sufficient to warrant surgical exploration. This can help prevent an orchiectomy, which is the surgical removal of the testicle. Even trauma that is not severe can cause swelling, tenderness, high fevers, and frequent and urgent need to urinate. The window from injury to surgery is approximately four to eight hours. This will prevent too much damage to the spermatic cord, which has to be untwisted quickly to avoid removal. Despite this rush to take care of it, orchiectomy rates average 42%. Delay in diagnosis may result in orchiectomy and possibly infertility.

Summary:
Deal with bacterial infections. Treat sexually transmitted infections. Deal with testicular trauma.