Scrotal Swelling (Swelling in One or Both Testicles)
Understanding Scrotal Swelling
Scrotal swelling refers to enlargement, puffiness, or abnormal increase in size of one or both sides of the scrotum. It may develop gradually or suddenly and can be painless or associated with discomfort.
While some causes are harmless, persistent or sudden scrotal swelling should never be ignored, as it may indicate infection, fluid collection, hernia, or rarely a tumor.
Early evaluation ensures accurate diagnosis and appropriate treatment.
What Is Scrotal Swelling?
You may be experiencing scrotal swelling if you notice:
One testicle larger than the other
Increase in scrotal size
Feeling of heaviness in the scrotum
Tight or stretched skin over scrotum
Associated pain or discomfort
Lump or abnormal mass
Swelling may involve the testicle itself or surrounding structures.
Common Causes of Scrotal Swelling
Scrotal swelling is a symptom and may have multiple causes.
Hydrocele
Fluid collection around the testicle.
Common features:
Painless swelling
Gradual increase in size
Feeling of heaviness
Usually not dangerous but may require treatment if large.
Testicular Infection (Orchitis)
Testicular infection causing:
Pain
Swelling
Fever
Often associated with viral or bacterial infections.
Trauma or Injury
Direct injury during sports or accidents can cause swelling and bruising.
Varicocele
Enlargement of veins in the scrotum.
Symptoms:
Dull aching pain
Heaviness
“Bag of worms” feeling
May affect fertility
More common on the left side.
Inguinal Hernia
Part of intestine protrudes into scrotum.
Symptoms:
Groin swelling
Swelling increases on standing or coughing
May be painful
Requires surgical evaluation.
Epididymitis
Infection or inflammation behind the testicle.
Symptoms:
Pain and swelling
Fever in some cases
Burning urination
Requires medical treatment.
Painless lump
Firm swelling
Gradual enlargement
Any new lump should be evaluated immediately.
Sudden Painful Swelling – Emergency 🚨
If swelling is sudden and associated with severe pain, nausea, or vomiting, it may indicate testicular torsion, which requires urgent medical attention.
Symptoms may include:
Sudden intense pain ‼️
Swelling‼️
Nausea or vomiting‼️
One testicle positioned higher than the other‼️
Testicular torsion requires immediate medical attention to prevent permanent damage.
Scrotal Swelling in Children
Common causes:
Hydrocele
Torsion
Hernia
Do not delay consultation in younger patients.
Scrotal Swelling in Adults
Common causes:
Hydrocele
Varicocele
Infection
Tumor
Persistent swelling requires evaluation.
Associated Symptoms
Scrotal swelling may occur with:
Testicular pain
Fever
Burning during urination
Groin discomfort
Blood in urine
Lower abdominal pain
These symptoms help identify the cause.
When should you consult a Urologist?
Seek immediate medical attention if:
Pain is sudden and severe
Swelling develops rapidly
There is nausea or vomiting
One testicle appears higher than the other
There is burning or blood in urine
You should schedule evaluation if:
Swelling persists for more than a few days
Swelling is increasing in size
There is associated pain
You feel a lump
There is fever
How Is Scrotal Swelling Evaluated?
Evaluation may include:
Detailed medical history
Physical examination
Urine tests
Blood tests
Scrotal ultrasound (Doppler study)
Ultrasound helps assess blood flow and identify torsion or infection.
Treatment of Scrotal Swelling
Treatment depends on the cause and severity:
Observation for small, asymptomatic hydrocele
Antibiotics for infection
Surgical correction for large/symptomatic hydrocele or hernia
Varicocele treatment when symptomatic
Early treatment prevents complications.
Can Scrotal Swelling Be Prevented?
Not all causes are preventable, but risk can be reduced by:
Treating infections early
Using protective gear during sports
Seeking prompt medical care for sudden symptoms
Why Scrotal Swelling Should Not Be Ignored
Ignoring scrotal swelling can lead to:
Untreated infection
Fertility issues
Missed diagnosis of tumor
Persistent discomfort
Early diagnosis improves outcomes and reduces anxiety.
Related Symptoms
Scrotal swelling may also be associated with:
Groin swelling
Lower abdominal pain
Evaluating related symptoms helps identify the exact cause.
SCROTAL SWELLING – FAQs
Is scrotal swelling serious?
Scrotal swelling can range from harmless fluid collection (hydrocele) to infection or, rarely, tumor. Sudden painful swelling requires urgent evaluation, while painless swelling should also be assessed to determine the cause.
What is the most common cause of scrotal swelling?
Common causes include hydrocele, varicocele, infection (epididymitis), hernia, and trauma. A scrotal ultrasound helps identify the exact cause.
Is it normal for one testicle to be slightly larger than the other?
Yes. Mild size difference is common. However, new or increasing asymmetry, lump, or swelling should be evaluated by a urologist.
Can scrotal swelling be painless?
Yes. Conditions such as hydrocele or early testicular tumor may cause painless swelling, which is why medical evaluation is important even without pain.
When should I go to the hospital for scrotal swelling?
You should seek immediate medical attention if swelling is:
Sudden and severe
Associated with intense pain
Accompanied by nausea or vomiting
Associated with fever
These may indicate torsion or infection.
Can scrotal swelling affect fertility?
Yes. Certain conditions such as varicocele or untreated infection can affect sperm production and fertility. Early treatment reduces this risk.
How is scrotal swelling diagnosed?
Diagnosis typically includes physical examination and scrotal ultrasound (Doppler study) to assess blood flow and identify hydrocele, varicocele, infection, hernia, or tumor.
Can scrotal swelling go away on its own?
Some mild swelling may reduce, but persistent or increasing swelling should not be ignored. Proper evaluation ensures serious causes are ruled out.
Which doctor should I consult for scrotal swelling ?
A urologist is the appropriate specialist for evaluation of scrotal swelling.
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If you notice scrotal swelling, lump, or change in testicle size, early consultation with a urologist ensures accurate diagnosis and timely treatment.
Do not ignore new swelling—early evaluation makes a difference.
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