Testicular swelling, also known as scrotal swelling, indicates an enlargement or noticeable lump in one or both testicles or the surrounding scrotal sac. It can range from a minor issue to a serious health problem, necessitating prompt medical evaluation.
Understanding Testicular Swelling
Testicular swelling can appear as a visible enlargement of the scrotum or a distinct lump within the testicle. It can also cause a feeling of heaviness or pressure.
Symptoms vary, including pain that can be dull, sharp, constant, or intermittent. Tenderness, redness, or warmth of the scrotal skin may also occur. Swelling can sometimes be painless, but still requires medical assessment.
Potential Causes of Testicular Swelling
Epididymitis is inflammation or infection of the epididymis, a coiled tube at the back of the testicle that stores and carries sperm. Orchitis is inflammation of the testicle itself, often caused by bacterial or viral infections, including STIs or mumps. Both can cause pain, tenderness, swelling, fever, nausea, or a heavy feeling in the testicle.
A hydrocele occurs when fluid accumulates around the testicle, leading to scrotal swelling. This condition is typically painless, though a large hydrocele can cause discomfort or a heavy sensation. Similarly, a spermatocele, also known as an epididymal cyst, is a fluid-filled sac that forms near the epididymis. These cysts are benign and usually do not cause pain, but they can be felt as a lump or cause a feeling of heaviness.
Varicocele involves the enlargement of veins within the scrotum, often described as feeling like a “bag of worms.” This condition commonly affects the left side of the scrotum and may lead to a dull ache or discomfort, which can sometimes improve when lying down. An inguinal hernia occurs when a portion of the intestine or other abdominal tissue pushes through a weak spot into the groin, potentially extending into the scrotum. This can cause pain and swelling in the testicle, and surgery is often required for correction.
Testicular torsion is a medical emergency where the spermatic cord, which supplies blood to the testicle, twists, cutting off the blood supply. It presents with sudden, severe pain, rapid swelling, and can also involve nausea, vomiting, or a testicle that appears higher than normal. Prompt medical attention within hours is necessary to prevent permanent damage or loss of the testicle.
Testicular cancer, though relatively uncommon, is a serious cause of testicular swelling. It often presents as a painless lump or swelling in one testicle, which may feel firm or hard. While pain is rare with testicular cancer itself, a dull ache or heavy sensation in the scrotum or lower abdomen can occur.
Trauma or injury to the testicles, such as a direct impact, can also result in swelling, bruising, and severe pain. The extent of swelling and pain depends on the severity of the injury, and significant trauma may require surgical intervention.
When to Seek Medical Care
Any new, unexplained swelling or lump in the testicles requires evaluation by a healthcare provider. This is true even if the swelling is painless, as serious conditions like testicular cancer can present without discomfort.
Immediate emergency medical attention is necessary if you experience sudden, severe pain in the testicle, especially with rapid swelling. Other emergency symptoms include nausea, vomiting, or fever alongside testicular swelling. Swelling after a scrotal injury also warrants urgent medical evaluation to assess for damage and ensure blood supply.
If pain is mild or swelling develops gradually, a prompt doctor’s appointment is advisable. Persistent pain or swelling that does not resolve, or any noticeable change in testicle size, shape, or feel, should be discussed with a healthcare professional. Delaying evaluation can sometimes lead to more severe complications.
What to Expect at the Doctor’s Office
The doctor will take a detailed medical history, asking about the swelling’s onset, duration, and associated symptoms. They will also inquire about recent injuries, infections, or other relevant health conditions. A physical examination will follow, including a careful assessment of the scrotum, testicles, and surrounding areas while standing and lying down.
To determine the underlying cause of the swelling, several diagnostic tests may be ordered. A scrotal ultrasound is a common imaging technique that uses sound waves to create detailed images of the inside of the scrotum, helping to identify fluid collections, masses, or issues with blood flow. Urine tests may be conducted to check for infections, such as bacterial or viral causes, or to detect the presence of blood or pus. Blood tests can also be performed to identify signs of infection or to check for specific markers that might indicate testicular cancer.
Treatment for testicular swelling depends entirely on the diagnosed cause. If an infection like epididymitis or orchitis is identified, antibiotics will typically be prescribed for bacterial infections, while viral infections might be managed with rest, ice, and pain relievers. Conditions involving fluid accumulation, such as hydroceles, or enlarged veins, like varicoceles, may be monitored, or surgery might be recommended if they cause significant discomfort or other problems. Testicular torsion requires immediate surgical intervention to restore blood flow and save the testicle. For testicular cancer, treatment usually involves surgical removal of the affected testicle, and further therapy like chemotherapy or radiation may be considered depending on the cancer’s stage.