Sudden, severe pain in one testicle
Swelling of the scrotum
One testicle sitting higher than usual
Testicle positioned at an unusual angle
Nausea or vomiting
Lower abdominal pain
Pain that starts suddenly, especially after activity or during sleep
Tenderness of the scrotum
Absence of the cremasteric reflex
Immediate emergency evaluation by a doctor or emergency department
Scrotal ultrasound with Doppler blood flow study
Do not wait for symptoms to improve on their own