Testicular swelling refers to an enlargement or lump in one or both testicles or the surrounding scrotal sac. It may appear as an increase in size, redness, or a shiny appearance. While often concerning, it does not always indicate a grave medical issue. However, any unexplained swelling warrants prompt medical evaluation to determine its cause and ensure appropriate care.
Non-Infectious Benign Conditions
Fluid accumulation around the testicle can lead to a hydrocele, a common cause of scrotal swelling. Fluid collects in the thin sac surrounding a testicle, often presenting as a painless enlargement. While common in newborns and often resolving on its own, hydroceles can also develop in adults due to injury or inflammation. The swelling may feel like a water balloon and cause a sensation of heaviness.
A spermatocele, also known as an epididymal cyst, is a fluid-filled sac that forms in the epididymis, the coiled tube behind the testicle responsible for storing and transporting sperm. These cysts are typically non-cancerous and often do not cause symptoms. However, a larger spermatocele might lead to a feeling of fullness, heaviness, or mild discomfort. It may be linked to a blockage in the sperm-carrying tubes.
Enlarged veins within the scrotum characterize a varicocele, frequently described as feeling like a “bag of worms.” These veins usually appear above one testicle, more often the left, and can cause mild symptoms such as aching pain or scrotal swelling. While often painless, discomfort might worsen with standing or physical exertion and typically improves when lying down. Varicoceles develop when valves in the scrotal veins do not function properly, causing blood to pool.
An inguinal hernia occurs when a portion of the intestine or fatty tissue protrudes through a weak spot in the abdominal wall and descends into the scrotum. This can result in a noticeable bulge or swelling in the groin area. The swelling might become more prominent with straining, coughing, or standing.
Direct impact or injury to the testicles can cause swelling. Trauma, such as a kick or accident, can lead to severe pain, and the scrotum may become red or swollen. In some cases, injury can result in a collection of blood within the scrotum, known as a hematocele.
Inflammatory and Infectious Causes
Inflammation of the epididymis, the tube at the back of the testicle that stores and transports sperm, is known as epididymitis. This condition typically causes pain and swelling in the testicle, often accompanied by redness, warmth, and tenderness. It commonly arises from bacterial infections, including sexually transmitted infections (STIs) such as chlamydia or gonorrhea, or from urinary tract infections.
Orchitis involves inflammation of the testicle itself, leading to pain and swelling in one or both testicles. Viral infections, particularly the mumps virus, are a common cause, developing several days after mumps symptoms begin. Bacterial infections, including those spreading from epididymitis (epididymo-orchitis), can also lead to orchitis.
Urgent and Potentially Serious Conditions
Testicular torsion is a medical emergency. It occurs when the spermatic cord, which supplies blood to the testicle, twists, cutting off blood flow. This causes sudden, severe pain in the scrotum, rapid swelling, and can also lead to nausea and vomiting. Without prompt surgical intervention, typically within hours, the lack of blood supply can permanently damage the testicle, potentially leading to its loss.
Testicular cancer can manifest as a growth or lump on the testicle. While often painless, it can sometimes cause swelling, a feeling of heaviness, or a dull ache in the groin or lower abdomen. It is most common in men aged 15 to 35. Early detection through self-examination and medical evaluation is important, as the condition is highly treatable when identified early.
When to Seek Medical Attention
Any unexplained testicular swelling warrants a visit to a healthcare professional. Several “red flag” symptoms indicate immediate medical attention. These include sudden, severe pain in the testicles, especially if accompanied by nausea, vomiting, or abdominal pain. Rapid swelling, a new lump, or swelling alongside fever or bruising also require urgent evaluation.
A healthcare provider will conduct a physical examination to assess the swelling and may use a light to check for fluid accumulation. Further diagnostic steps could involve an ultrasound or urine and blood tests to identify the cause. Delaying medical consultation for testicular swelling can lead to more serious complications, particularly for conditions requiring prompt treatment.