Funiculitis is the inflammation of the spermatic cord, a structure that begins in the abdominal wall and extends down to the testis within the scrotum. This cord contains the vas deferens, which transports sperm, along with the blood vessels, nerves, and lymphatic vessels that service the testicles. Inflammation of this cord can lead to swelling and pain in the scrotum and surrounding areas.
Symptoms and Causes of Funiculitis
The primary symptoms of funiculitis include pain and tenderness in the scrotum, which can radiate to the groin or abdomen. This is often accompanied by visible swelling or a lump along the spermatic cord. The overlying scrotal skin may appear red and warm, and if an infection is present, fever and chills can develop.
The origins of funiculitis are categorized as infectious or non-infectious. Infectious cases are most commonly caused by bacteria from urinary tract infections (UTIs) or sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Bacteria travel from the urethra or bladder and spread to the spermatic cord, leading to an inflammatory response.
Non-infectious causes are less common and include physical trauma to the scrotal area. Funiculitis can also occur as a post-surgical complication, sometimes seen after a vasectomy. This happens when manipulation of the cord leads to an inflammatory reaction as the body heals.
The Diagnostic Process
Diagnosis begins with a physical examination of the scrotum and a review of the patient’s medical and sexual history. The physician will assess the location and severity of the pain and swelling to guide further testing.
To identify a bacterial cause, a healthcare provider may order a urinalysis and a urine culture to detect bacteria or white blood cells. If a sexually transmitted infection is suspected based on the patient’s history, screening for common STIs will also be performed.
A Doppler ultrasound uses sound waves to create images of the spermatic cord and testicles, allowing the physician to see signs of inflammation like a thickened cord or increased blood flow. The ultrasound is also used to assess blood flow to the testicle. This is necessary to rule out testicular torsion, a medical emergency with similar symptoms where the spermatic cord twists and cuts off blood supply.
Treating Funiculitis
If a bacterial infection is identified, a course of antibiotics is the standard treatment. It is important to complete the entire prescribed regimen, even if symptoms improve, to ensure the infection is fully eradicated. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also often recommended to manage pain and inflammation.
Supportive home care measures can also help alleviate discomfort. Getting adequate rest allows the body to recover, and wearing a scrotal support, such as an athletic supporter, can relieve pressure by elevating the testicles. Applying cold packs constricts blood vessels, which helps reduce swelling and numb the area for temporary pain relief.