Although the aforementioned symptoms are most common among victims of assaults involving testicular abuse, far more harmful health issues have been linked with the act.
Rupturing of the tunica albuginea (the hard covering of the testis). Can occur when a testis is exposed to a force equal to or above 50 kilograms.  The affected tissue must be surgically removed (debridement). 
Torsion of the testes. The spermatic cord twists around on itself, restricting blood flow to the testis it supplies. Failure to correct the torsion within 24 to 48 hours usually results in the death of the testis.  
Irreparable damage to the seminiferous tubules and Leydig cells, causing infertility and a decline in testosterone production, respectively. Over 97% of a man's testosterone is produced by the Leydig cells in his testes. Low testosterone levels in men have been linked with coronary disease, osteoporosis, decline in muscle mass, gain in body fat, impaired cognitive ability, mood swings, lower sex drive, depression and the development of a withdrawn disposition.  
Death via neurogenic shock. A few cases involving men dying from neurogenic shock after sustaining a violent assault to their testes have been reported by the print media.  The Cossiah women of India have used their knowledge of the testes' sensitivity to cold-bloodedly murder their husbands by squeezing their testes. 
The second most common cause of testicular injury is a kick to the groin.
Victims of testicular abuse are more likely than non-victims to develop post-traumatic and depressive illnesses.
Knowledge on the hypersensitivity of the testes and their low threshold for pain is widespread, but few people are aware of the long-term ramifications associated with trauma to the testes. Much of this is due to the media's portrayal of testicular trauma (non-violent forms of trauma) and testicular abuse, respectively, as a harmless form of Schadenfreude (pleasure derived from other people's suffering) and socially accepted means of enacting revenge upon a man/boy for a wrongdoing: it's the only form of severe torture/violence that is marginalised in today's politically correct climate.
There's a misconception among the public, especially among the younger generation, that the extreme pain associated with testicular trauma is the only side-effect it can cause. This misconception has led to people arguing that testicular abuse should not be treated as severely as other forms of violence. Disturbed members of society, such as the sub-group of paraphiliacs who are aroused by testicular abuse, argue that testicular abuse is acceptable and should never be punished. Persons who are envious of men, such as the bitter and immature pockets of the female populace, revel in seeing men sustain an injury to their testes because it symbolises an embarrassing attack on male sexuality. The use of testicular trauma as a theme in slapstick comedy does little to curb these attitudes.
Awareness-raising media coverage on testicular abuse and testicular trauma has been very scarce, though it has improved since 2009. Indianapolis broadcasting network WTHR investigated testicular abuse among adolescents on 06 Nov. 2009 after a schoolboy told them about his experience at school. The investigation included testimonies from North Putnam Middle School's school nurse Bev Richardson and paediatric urologist from Indiana's Riley Hospital, Martin Kaefer. Richardson said she treated at least four boys each week for testicular injuries caused by during a violent game called "ball-tapping". The boys told Rirchardson that the abuse was happening all of the time. One of the students she treated needed to be taken to hospital. Dr Martin Kaefer told WTHR that a boy he treated needed to have one of his testes excised. The most common cause of injury for the boys he treated involved the perpetrators snapping the back of their hands against their victims' testes. Among the children brought into Riley hospital for treatment included a 5-year-old boy -- a victim of testicular abuse -- who required an operation on his testes. 
"If you fracture the testicle and literally rupture it, that results in pretty significant short-term and long-term problems, and we've seen this at Riley Hospital. It's really quite devastating." Paediatric Urologist, Dr Martin Kaefer.
Reportage on the issue peaked when schoolboy David Gibbons sustained a ruptured testis during an unprovoked assault midway through 2010.  The assault gained headlines because it was not performed out of malice or anger, but for its ties to a violent game that is popular among adolescents and young adults. The name of this violent game is "sack-tapping". Sack-tapping encompasses boys and girls hitting boys in the testes. It is undoubtedly a by-product of the media's glorification of testicular abuse and marginalisation of testicular trauma. Like David, many boys who are included in this game are unwilling participants who never gave their consent to be hit in the testes. The injury to David Gibbons' testis led to its amputation. 
The surgeon who amputated David's testicle at St. Joseph's Hospital, urologist Dr Scott Wheeler, said he performs up to 3 or 4 operations on boys who've injured their testes after being punched during a "sack-tapping" encounter. Dozens of cases involving less severe injuries are also treated at St. Joseph's Hospital. 
According to Dr Anthony Atala, a paediatric urologist and department chairman of Wake Forest University School of Medicine and spokesman for the American Urological Association, the incidence rate for testicular injuries has risen. 
Urologist Dr Steve Hodges, who also works at Wake Forest University Baptist Medical Center, told Fox News that testicles are "not particularly hardy organs," and that it "doesn't take much force to compress them and cause rupture." 
The Consumer product Safety Commission has found testicular injuries among 10-20 year olds have increased each year since 2007. This statistic was cited by JoNel Aleccia's article, Groin-punch ‘game’ harms more boys in a few media outlets.
The various state and federal law systems in Australia, Canada, New Zealand, U.K. and U.S. do not differentiate testicular abuse from violence directed towards the other regions of the human anatomy.
Queensland Legislation: Criminal Code Act 1899
Chapter 30 Assaults
335 Common assault
Any person who unlawfully assaults another is guilty of a misdemeanour, and is liable, if no greater punishment is provided, to imprisonment for 3 years.
339 Assaults occasioning bodily harm
(1) Any person who unlawfully assaults another and thereby does the other person bodily harm is guilty of a crime, and is liable to imprisonment for 7 years.
(3) If the offender does bodily harm, and is or pretends to be armed with any dangerous or offensive weapon or instrument or is in company with 1 or more other person or persons, the offender is liable to imprisonment for 10 years.
This policy endangers all men and boys and denies justice to victims of testicular abuse:
The unique physiology of the testes elevates their sensitivity and vulnerability [to physical trauma] to an unprecedented level. The bulk of the Human anatomy is covered by thick layers of skin, muscle and bone. The testes are one of the few areas that do not fall under this category -- the only barrier between the testes and the outside world is the thin sac of skin they're enclosed within, the scrotum and the thin Dartos and Cremaster muscles that control their movement.
Unlike many of the other vulnerable areas of the human anatomy (IE. throat, knee) the testes are far more hypersensitive and are less equipped to recover from severe structural damage. A testis can rupture when it is exposed to a kick, punch, blow or is squeezed. The affected area of a ruptured testis has to be surgically removed (debridement) and cannot regenerate, thus meaning it is lost forever. This can have a serious impact on the two bodily functions that the testes regulate: the production of the male gamete and the primary androgen, testosterone. A fractured bone or a non-fatal stab wound to the torso cannot cause this sort of devastation.
A man's external genitalia represent his sexuality. Attacking the most intimate, sensitive and vulnerable area of a man's anatomy -- his external genitalia -- is an attack on his sexuality. The potential it has to damage the functionality of his testes makes it very traumatic experience that holds no comparison. The trauma can vary from functional damage to severe psychological illness. The only form of violence that comes close to resembling the side-effects of testicular abuse is rape.
A spiteful person can commit testicular abuse with the knowledge it will have a far more devastating effect than a blow to any other region of the male anatomy, yet walk away with the same punishment they'd receive for performing a milder form of assault on their victim.