If the penis is erect for a long time, the testicles will hurt.

Prolonged penile erection may cause testicular pain, often related to factors such as local congestion, inflammation, or varicocele. Prolonged erection will increase the pressure in the scrotum, affect the normal blood circulation of the testicles, and cause swelling or referred pain. If the pain persists or is accompanied by redness, swelling and heat, you need to be alert to emergencies such as epididymitis and testicular torsion.

Physiological factors are mostly caused by sexual stimulation lasting too long. During erection, the congestion and expansion of the corpus cavernosum may compress the spermatic blood vessels, causing temporary ischemia of the testicles. Discomfort can be relieved by changing position, applying cold compresses, or moderate massage. Pathological factors include chronic prostatitis. The inflammation may spread to the epididymis through the vas deferens, manifesting as dull testicular pain after ejaculation, accompanied by frequent urination and urgency. In patients with varicocele, the obstruction of venous return is more obvious during erection. The pain worsens after standing for a long time or after exertion, and vermiform varicose veins can be seen on the surface of the scrotum. Testicular torsion is a urological emergency. It involves sudden severe pain and the elevated position of the affected testicle. It requires surgical reduction within 6 hours to avoid necrosis. Hydrocele may also induce dull pain due to pressure changes during erection, and a positive light transmission test can assist in diagnosis.

In daily life, excessive sexual stimulation or prolonged abstinence should be avoided, and breathable underwear should be chosen to reduce the increase in scrotal temperature. In case of acute pain, you can lie down on your side with your knees bent to reduce the traction, and apply cold compresses for no more than 20 minutes each time within 48 hours. If the pain does not relieve for more than 2 hours or nausea and vomiting occur, you must seek medical attention immediately to rule out testicular torsion. Patients with varicocele can do daily levator ani exercises to improve circulation and avoid weight-bearing and long-term cycling. Patients with chronic prostatitis need to use levofloxacin tablets, tamsulosin hydrochloride sustained-release capsules and other drugs as directed by their doctor, along with warm water sitz baths to promote the absorption of inflammation.