Pain in left scrotum

  A few days ago, aproximately 4 or 5.  I woke up with an erection and a pain in my left scrotum.  The pain wasn't that servere so I didn't think much of it.  The pain has not gone away since.  I can feel no lumps on my testicles, but the tube that runs from my left testicle seems to be a little swollen, but I'm not sure.  I was wondering if you could tell me what might be the problem and what I should do.
  Thanks...  
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Dear Jim
Thanks for your question.
This is a typical presentation for epididymitis.  You should see a doctor for a urinalysis and urine culture to confirm the diagnosis.  Antibiotics is the cure.  Sexually transmitted forms of epididymitis is treated with different antibiotics and your partner needs treatment also.     Pain should greatly improve over the next 3-5 days after antibiotics but the swelling may last a month or so.  Epididymitis drops way down the differential  diagnosis if one has had a vasectomy.
A testicular torsion occurs mostly in males less than 22 years of age and is usually associated with acute onset of severe  pain with perhaps  nausea/  vomiting . This is a medical emergency because surgical correction of a twisted cord is needed within six hours to save the testicle.  
A swollen cord can be a varicocele ( a varicose vein of the cord) and be the cause of mild testicular pain.  It is more common on the left side.  Ibuprofen is the treatment for symptomatic pain.  Rarely is surgery needed for pain but is the treatment of choice if associated with infertility and fertility is desired.
More individualized urological care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians