Testicular swelling, or scrotal swelling, is an enlargement or lump in one or both testicles or within the scrotum. It can appear as a larger testicle, sometimes with redness or shiny skin. This common condition affects males of all ages. Due to various potential causes, some requiring immediate medical attention, prompt medical evaluation for any new or concerning testicular swelling is important.
Inflammation and Infection
Inflammation and infection are common causes of testicular swelling, often with distinct symptoms. Epididymitis and orchitis are two primary conditions in this category. They can occur together, known as epididymo-orchitis.
Epididymitis is inflammation of the epididymis, a coiled tube behind the testicle that stores and transports sperm. It causes pain and swelling in the affected testicle. Bacterial infections, including STIs like chlamydia or gonorrhea, and non-sexually transmitted bacteria from UTIs, are common causes. Non-infectious causes can also occur.
Orchitis is inflammation of the testicle itself. While bacterial infections can cause orchitis, often as a complication of epididymitis, viruses are also culprits. The mumps virus is a known cause, especially in unvaccinated individuals. Symptoms include pain and swelling in one or both testicles, nausea, and fever.
Orchitis can occur without epididymitis, and vice versa, though co-occurrence is common. Medical professionals distinguish these conditions through examination and tests, as both present with similar scrotal discomfort and enlargement. Untreated infections can lead to complications like fertility issues or testicular damage.
Fluid Buildup and Growths
Testicular swelling can also result from fluid accumulation or benign growths within the scrotum. These conditions often present with less acute pain than infectious causes. Recognizing these distinctions helps identify the swelling’s nature.
A common cause is a hydrocele, a fluid collection around the testicle. This fluid buildup typically causes painless scrotal swelling, though some may feel heaviness. Hydroceles can be primary (no clear cause) or secondary (from injury, infection, or inflammation). They are common in infants but can also occur in adults.
Another swelling type is a spermatocele, or epididymal cyst. This benign, fluid-filled sac forms within the epididymis, often containing milky fluid and sperm. Spermatoceles are usually harmless and painless, though larger cysts might cause discomfort or fullness. Both hydroceles and spermatoceles are benign, but medical evaluation is important to confirm diagnosis and rule out other causes.
Structural and Vascular Conditions
Testicular swelling can stem from structural issues, blood vessel problems, or direct scrotal injury. These conditions vary in presentation and urgency, some requiring immediate medical intervention. Recognizing their signs is crucial for timely management.
An inguinal hernia occurs when intestine or fatty tissue pushes through a weak abdominal wall spot into the scrotum. This protrusion causes swelling and discomfort in the groin or scrotum, often more noticeable with straining or standing. Though not directly testicular, it can mimic testicular swelling.
A varicocele is enlarged veins within the scrotum, often described as a “bag of worms.” These veins develop above the testicle, more common on the left. Varicoceles are usually benign and asymptomatic, but can cause a dull ache, heaviness, or affect fertility.
Testicular torsion is a medical emergency. The spermatic cord, supplying blood to the testicle, twists, cutting off blood supply. Symptoms are sudden and severe: intense testicular pain, rapid swelling, nausea, or vomiting. Without prompt surgical intervention, lack of blood flow can lead to permanent damage and testicle loss.
Direct trauma or injury to the scrotum causes immediate swelling, bruising, and pain. While minor injuries resolve, significant trauma requires medical evaluation for internal damage or compromised blood supply. Any injury causing persistent pain or swelling warrants professional assessment.
Testicular Cancer
Testicular cancer, though less common, is a serious condition that can cause testicular swelling. Recognizing its presentation and the importance of early detection is crucial for successful treatment. This cancer primarily affects younger to middle-aged men.
It often presents as a painless lump or overall enlargement of one testicle. While pain is not typical, some may feel a dull ache in the groin or lower abdomen, or scrotal heaviness. A sudden fluid collection around the testicle (hydrocele) can also be an associated symptom.
The lump is typically firm and felt on the testicle. Any new or unexplained lump or swelling warrants prompt medical evaluation, even if painless. Early detection through self-examination and professional assessment is crucial, as testicular cancer is highly treatable in its initial stages.
Inflammation and Infection
Inflammation and infection are common causes of testicular swelling. These conditions often present with symptoms beyond just swelling, such as pain, redness, warmth, or fever. The onset can be sudden or gradual, depending on the underlying cause.
Diagnosis typically involves a physical examination, where a doctor assesses the swelling, tenderness, and any associated symptoms. Urine tests are often performed to check for bacterial infections, especially STIs or urinary tract infections. In some cases, imaging studies like an ultrasound may be used to differentiate between various causes and rule out other serious conditions.
Treatment for inflammatory or infectious causes usually involves antibiotics for bacterial infections. Pain relief and anti-inflammatory medications are also commonly prescribed to manage symptoms. Rest, scrotal support, and ice packs can help reduce discomfort and swelling. It is important to complete the full course of antibiotics to prevent recurrence or complications. Untreated infections can lead to chronic pain or fertility issues.
Fluid Buildup and Growths
Fluid buildup and benign growths are common causes of testicular swelling that often present without significant pain. These conditions are generally not harmful, but medical evaluation is important to confirm their benign nature and distinguish them from more serious issues.
Diagnosis typically involves a physical examination, where a doctor can often feel the characteristics of the swelling. Transillumination, shining a light through the scrotum, can help identify fluid-filled sacs like hydroceles, as light passes through them. An ultrasound is frequently used to confirm the diagnosis, visualize the fluid or growth, and rule out other causes of scrotal enlargement.
Management for hydroceles and spermatoceles often involves observation, especially if they are small and asymptomatic. If they cause discomfort, become very large, or are cosmetically bothersome, surgical removal may be considered. These procedures are generally straightforward and have good outcomes. It is important to remember that while benign, any new scrotal swelling should be evaluated by a healthcare professional.
Structural and Vascular Conditions
Structural issues, blood vessel problems, and direct injury can cause testicular swelling, with varying degrees of urgency. Some conditions, like testicular torsion, require immediate medical attention to prevent permanent damage.
Diagnosis often relies on a thorough physical examination and patient history. For conditions like inguinal hernias, the swelling may be reducible or change with position. Varicoceles are often diagnosed by palpation, feeling for the characteristic “bag of worms” sensation, especially when standing. Doppler ultrasound is a key diagnostic tool for assessing blood flow, crucial for diagnosing torsion and evaluating varicoceles.
Management varies widely. Inguinal hernias often require surgical repair. Varicoceles may be observed if asymptomatic, or treated surgically if causing pain or fertility concerns.
Testicular torsion is a surgical emergency requiring immediate intervention. Scrotal trauma management depends on severity, ranging from rest and ice to surgical exploration for significant injuries. Prompt medical assessment is crucial for all structural and vascular causes of swelling.
Testicular Cancer
Testicular cancer is a serious but highly treatable cause of testicular swelling, especially when detected early. While the exact cause is unknown, several risk factors increase the likelihood of developing it.
Risk factors include a history of undescended testicle (cryptorchidism), even if surgically corrected, and a family history of testicular cancer. Previous testicular cancer in one testicle also increases the risk of developing it in the other. Age is also a factor, with most cases occurring in men between 15 and 45.
Regular self-examinations are important for early detection. Men should check their testicles monthly for any new lumps, changes in size or shape, or feelings of heaviness. Any suspicious findings should be reported to a doctor immediately. Professional medical assessment, including physical examination and ultrasound, is essential for diagnosis. Early detection significantly improves treatment outcomes and survival rates for testicular cancer.