What are complications to getting hit in the scrotum?

Injured scrotum: Injury to the scrotum can cause injury to the testicles such as swelling and bleeding. Aside from terrible pain this can affect your ability to conceive children if it is severe enough.

Scrotal trauma: Everything from skin bruising to testicular rupture. The testis is quite mobile within the scrotum and normally can shift away from blunt force but sometimes it takes a direct hit. If significantly swollen and tender, one should be examined and have an ultrasound of the scrotum to rule out significant testicular injury.