How much should I worry about scrotal pain?

Scrotal pain. Scrotal pain should almost always be evaluated by a doctor. The most serious cause is twisting of the blood vessel in the scrotum with extreme pain. Another common cause is infection of the epididymis (part of the testicle) with a bacterium, particularly among younger males who are sexually active or older men. Other causes include hernias, kidney stones, nerve pain, or skin inflammation.