Swollen Testicals – Causes, Diagnosis & Treatment

Causes:

• Epididymitis: Inflammation of the epididymis (the tube at the back of the testicle), often caused by bacterial infection (including sexually transmitted infections like chlamydia or gonorrhea).
• Orchitis: Inflammation of the testicle itself, sometimes occurring with epididymitis (epididymo-orchitis). Can be caused by bacteria, viruses (like mumps), or injury.
• Testicular Torsion: A medical emergency where the testicle twists, cutting off blood supply. Causes sudden, severe pain and swelling. Requires immediate treatment.
• Hydrocele: Fluid buildup around the testicle, causing painless swelling. Common in newborns but can occur at any age.
• Varicocele: Enlarged veins within the scrotum, similar to varicose veins. Can cause swelling and sometimes discomfort.
• Hernia: A bulge of tissue pushing through a weakness in the abdominal wall can extend into the scrotum, causing swelling.
• Testicular Cancer: A less common but serious cause of testicular swelling, often painless.
• Injury: Trauma to the testicles can cause swelling and pain.
• Other Infections: Less common infections can also cause testicular swelling.

Diagnosis:

• Physical Exam: Careful examination of the scrotum, testicles, and surrounding area, noting swelling, redness, tenderness, and any other abnormalities.
• Patient History: Gathering information about the onset of symptoms, any injuries, other medical conditions, and sexual history.
• Ultrasound: A common imaging test to visualize the testicles and surrounding structures, helping diagnose conditions like torsion, hydrocele, or tumors.
• Urine Tests: May be done to check for infection.
• Blood Tests: May be done to check for infection, tumor markers, or other abnormalities.

Treatment:

• Epididymitis/Orchitis: Antibiotics are prescribed to treat bacterial infections. Pain relievers and scrotal support can also help.
• Testicular Torsion: Requires immediate surgical intervention to untwist the testicle and restore blood flow. Delay can lead to testicle loss.
• Hydrocele: May resolve on its own in infants. In older individuals, surgery may be needed if the hydrocele is large or causing discomfort.
• Varicocele: May not require treatment if asymptomatic. If painful or affecting fertility, surgery or embolization (a procedure to block the affected veins) may be considered.
• Hernia: Surgery is typically required to repair a hernia.
• Testicular Cancer: Treatment depends on the type and stage of cancer and may involve surgery, radiation therapy, or chemotherapy.
• Injury: Treatment depends on the severity of the injury and may involve rest, ice, pain relievers, or surgery in severe cases.

Important Considerations:

• Seek immediate medical attention if you experience sudden, severe testicular pain and swelling. This could be a sign of testicular torsion, a medical emergency.
• Consult a healthcare professional for any testicular swelling, even if it is not painful. Early diagnosis is crucial, especially for conditions like testicular cancer.
• Do not attempt to self-treat testicular swelling. Proper diagnosis is essential for effective treatment.