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“Blue balls” is a widely used colloquialism describing scrotal pain after high, sustained sexual arousal unrelieved because of lack of orgasm and ejaculation. It is remarkable that the medical literature completely lacks acknowledgment of this condition. The case reported here illustrates that a good history may help make the diagnosis, offer the possibility of prompt relief, and avoid any unnecessary evaluation. Clinicians should be aware of this condition and consider it in the differential diagnosis of scrotal pain.
CASE REPORT
A 14-year-old male presented to the emergency department with a history of severe bilateral scrotal pain of 1.5 hours' duration. There was no associated nausea or vomiting. The patient denied fever, chills, or feeling systemically ill. He described the pain as sharp, stabbing, constant, and unaffected by position. There was no history of dysuria, urethral discharge, previous urinary tract infections, trauma, or any history of prior sexual intercourse. The patient was a reluctant historian. …
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