In middle school, I recall a kid getting kicked in the balls so hard he needed to go to the hospital. Even the teachers made comments about how the whole event could affect his ability to have kids someday, a line of thinking that gets repeated just about any time a moving object makes contact with someone’s delicate testes. But is any of that true? Does a hit to the balls do anything to reduce sperm count or production, or is that just a painful superstition?
Actually, if it’s bad enough, a swift bop to the balls can do some real damage. But before you start freaking out about that one time your niece did a cartwheel and accidentally kicked your junk, know this: If your balls were injured enough to cause long-term damage, you’d probably already be aware of it.
It’s pretty normal for a hard kick or hit to the balls to leave the victim in pain for an hour or so. You might need to lay down, take an ibuprofen or put an ice pack on them to help deal with the pain. Some people even throw up! The testes are chock-full of nerve endings, and are honestly kind of poorly designed — for something so precious and necessary for the continued growth of humanity, you’d think they’d be a little better protected. In any case, it can take a bit of time for the pain to subside.
It only really becomes a problem when the pain doesn’t subside. According to Healthline, pain that lasts more than an hour, as well as bruising, fever, persistent nausea, difficulty peeing or blood in your pee are all causes to go to the emergency room ASAP.
Enough damage has potentially occurred that your fertility could be impacted, too. A couple of possible causes include testicular torsion, where the spermatic cord of the testes becomes twisted and cuts off blood flow, and straight-up testicular rupture. Both require surgery, but typically, normal testicular function can be restored if blood supply hasn’t been cut off for too long. It’s also possible for an injury to lead to epididymitis, or inflammation of the epididymis. This is usually a form of infection that can spring up days after the injury. It can be resolved with antibiotics, but if left untreated, the epididymis may no longer be able to store and carry sperm.
A 2019 study published in Case Reports in Emergency Medicine states, “Blunt scrotal trauma is a common occurrence in male athletes, but serious injuries are rare despite the vulnerable position of the testicles.” That said, exact data on testicular injury is hard to come by because people are often hesitant to seek treatment. Per the study, testicular rupture is 80 to 90 percent “salvageable” when surgery occurs within 72 hours of the incident, decreasing to 40 to 50 percent from that point on. This is an improvement from previous decades, though — in a study of eight patients with testicular trauma in 1996, five had atrophied testicles. Most case reports today indicate success in preserving fertility, aided by enhanced ultrasound technology that allows doctors to see what’s happening in the balls before taking a knife to them. Some exceptions include really severe injuries, like being shot in the balls or motorbike accidents.
While none of these problems reduce sperm count per se, they can reduce your body’s capacity to produce sperm overall. Not to mention, any of them could potentially cause one of your testes to die, meaning your sperm production is essentially cut in half. But again, these problems have obvious symptoms — you’d know if something was wrong.
If your balls hurt and it’s been longer than an hour or so since they’ve been kicked or hit, that’s pretty much always a good reason to see a doctor. Even if you don’t care at all about your fertility, the surgery you’ll require from bleeding internally and removing that dead testicle attached to your body will end up being way more expensive than a vasectomy.