Testicular swelling is an enlargement of one or both testicles or the surrounding scrotal area. While concerning, various factors can cause this condition, from benign issues to serious health problems. A medical evaluation is recommended to diagnose the cause and determine the appropriate course of action.
Inflammation and Infections
Inflammation and infections commonly contribute to testicular swelling. Epididymitis, an inflammation of the epididymis—a coiled tube behind the testicle that stores and carries sperm—is a frequent cause. It is often caused by bacterial infections, including sexually transmitted infections (STIs) or urinary tract infections (UTIs). When the infection spreads to the testicle, it results in orchitis, inflammation of the testicle.
Orchitis can develop as a complication of epididymitis or occur independently, often due to viral infections like the mumps virus. Both conditions cause pain, tenderness, and swelling. Bacterial infections respond to antibiotics, while viral causes are managed with supportive care. Prompt medical attention helps identify the specific infectious agent and guide treatment.
Fluid Accumulation and Vascular Issues
Fluid accumulation and vascular issues can also cause testicular swelling. A hydrocele occurs when fluid collects in the thin sheath surrounding the testicle, causing a noticeable, often painless, scrotal enlargement. It can be present from birth or develop later due to injury, infection, or inflammation. Hydroceles feel smooth and vary in size.
Varicocele is another vascular cause, involving enlarged scrotal veins, similar to leg varicose veins. These enlarged veins may feel like a “bag of worms” above the testicle and cause a dull ache or heaviness, especially after physical activity. Varicoceles are more common on the left side and can sometimes affect sperm production due to increased temperature. While often benign, intervention may be needed if pain is persistent or fertility is a concern.
Structural Abnormalities and Injuries
Structural abnormalities and injuries can cause sudden testicular swelling. Testicular torsion is a medical emergency where the spermatic cord, supplying blood to the testicle, twists. This cuts off blood supply, causing sudden, severe pain, rapid swelling, nausea, and vomiting. Immediate surgery is required to restore blood flow and save the testicle.
An inguinal hernia can also cause scrotal swelling. This occurs when intestine or fatty tissue pushes through a weak abdominal wall spot into the groin or scrotum. The bulge can cause pain or discomfort, especially with coughing, straining, or lifting. Direct trauma, such as from a sports injury or accident, can also cause immediate swelling, bruising, and pain due to internal bleeding or tissue damage.
Serious Medical Conditions
Testicular swelling may indicate a serious medical condition, such as testicular cancer. Though less common, testicular cancer typically presents as a painless lump or enlargement of one testicle. The testicle may feel heavy or firm, with a change in size or consistency. Cancer-related swelling is usually localized to the testicle, not the entire scrotum.
Testicular cancer is highly treatable, especially when detected early. Regular self-examinations are important to identify any new lumps or changes. Any persistent or growing lump, even if painless, warrants prompt medical evaluation. Early diagnosis and treatment significantly improve prognosis.
When to Seek Medical Attention
Knowing when to seek medical attention for testicular swelling is important. Immediate emergency care is necessary if swelling accompanies sudden, severe pain, especially if rapid. This may indicate testicular torsion, requiring urgent surgery to preserve the testicle. Other concerning signs for emergency evaluation include nausea, vomiting, fever, or red, tender scrotal skin.
For swelling that develops gradually, is persistent, or is associated with a new lump or change in testicular consistency, a doctor’s appointment is advisable. Even if painless, it should be evaluated to rule out conditions like hydroceles, varicoceles, or testicular cancer. Any discomfort, heaviness, or scrotal changes causing concern should prompt a medical consultation.