Scrotal swelling is an enlargement of the scrotal sac, the pouch of skin behind the penis that contains the testicles. It can vary in size, pain level, and development speed. Scrotal swelling warrants medical attention to determine its underlying cause.
Common Reasons for Scrotal Swelling
Several conditions can lead to scrotal swelling. A frequent cause is a hydrocele, a collection of fluid in the thin sac surrounding a testicle. This condition can be present from birth or develop later due to injury or inflammation. Hydroceles are typically painless, though larger ones might cause discomfort or a feeling of heaviness.
Epididymitis is another common cause, characterized by inflammation of the epididymis, a coiled tube at the back of the testicle that stores and transports sperm. This inflammation usually results from a bacterial infection. Symptoms include scrotal pain that can spread to the groin, along with tenderness, warmth, and swelling.
Orchitis involves inflammation of the testicle, frequently caused by viral infections like mumps, or bacterial infections. Like epididymitis, it causes pain and swelling, often affecting one testicle but potentially spreading to both. Associated symptoms include fever, nausea, and a general feeling of illness.
A spermatocele, also known as a spermatic cyst, is a benign, fluid-filled sac that forms in the epididymis. These cysts are typically painless and do not cause symptoms unless they grow large enough to cause a noticeable lump or a feeling of fullness. They might be linked to a blockage in the tubes that transport sperm.
Urgent Causes Requiring Immediate Attention
Some causes of scrotal swelling demand immediate medical intervention due to potential serious complications. Testicular torsion is a time-sensitive condition where the spermatic cord, which supplies blood to the testicle, twists. This twisting cuts off blood flow, leading to sudden, severe pain, scrotal swelling, and sometimes nausea or vomiting. Prompt surgical correction within hours is necessary to prevent permanent damage.
An incarcerated hernia can also cause acute scrotal swelling. This occurs when a portion of the intestine or other abdominal tissue pushes through a weak spot in the abdominal wall and becomes trapped in the groin or scrotum. If the trapped tissue’s blood supply is compromised, known as a strangulated hernia, it can cause intense pain and is a medical emergency.
Testicular cancer can present as a lump or swelling in the testicle, sometimes with a feeling of heaviness. While not always an acute emergency like torsion, any new lump or change in the testicle should be evaluated promptly. Early detection significantly improves treatment outcomes.
When to Seek Medical Help
Prompt medical evaluation is important for any unexplained scrotal swelling. Seek immediate medical attention if swelling is accompanied by sudden, severe pain. Symptoms such as fever, nausea, vomiting, or blood in the urine alongside swelling also warrant urgent care.
Consult a doctor if you notice a new lump in the scrotum or if the swelling does not resolve on its own. Any scrotal swelling that feels firm, appears discolored, or is accompanied by a dull ache in the lower abdomen or groin should be evaluated. Relying on self-diagnosis can delay appropriate treatment for potentially serious conditions.
Medical Evaluation and Management
When seeking medical attention for scrotal swelling, a healthcare provider will take a detailed medical history, asking about the onset, duration, and associated symptoms. A physical examination of the scrotum, testicles, and abdomen will follow to assess the swelling’s characteristics, tenderness, and location.
Diagnostic tests may be ordered to identify the cause. A scrotal ultrasound is a common imaging technique to visualize structures within the scrotum and determine if swelling is due to fluid, inflammation, or a mass. Urine tests can detect infections, and blood tests may check for signs of infection or tumor markers.
Management depends on the underlying cause of the swelling. For conditions like epididymitis caused by bacterial infections, antibiotics are prescribed. Pain relief measures, such as over-the-counter medications, applying ice packs, and elevating the scrotum, can alleviate discomfort. Surgical intervention may be necessary for conditions like testicular torsion, incarcerated hernias, or certain cases of hydroceles and spermatoceles.