Testicular Swelling – Swollen Testicles

Testicular swelling (also called swollen testicles or enlarged scrotum) is a medical condition where the testicle (either one or both) gets enlarged due to an infection or accumulation of fluids or due to cysts or tumour. The swelling can be caused due testicular trauma or for no actual known reason. When you touch your testicles, you can feel the enlargement or if there are any cysts present, you will be able to feel them on your scrotum.  Some people may even feel tenderness and pain when their swollen testicles are touched. 

Along with testicular swelling, you may also feel that the testicles are bruised (if you have had an injury in the recent past), difficulty peeing, pain, nausea or even discharge may be seen.

Why do testicles swell?

Well, there are a number of reasons why the testicles of a person swell. Here are some most common reasons for scrotal swelling:

1. Injury to testicles or in the groin area.  Obviously you will have pain when the scrotum is hit by an object in case of an accident. The scrotum can then become red and start swelling. It is important that you see a good doctor immediately when your testicles are hurt in an accident because, if the blood supply gets cut off to the testicles during the accident, they may die off.  You should also see a good sexologist or a sex specialist when you see inflamed testicles, blood in urine or have fever after the accident or injury.
2. Hydrocele – The condition when scrotum gets filled with fluids. There are two types of hydrocele – communicating and non-communicating depending on whether there is a communication between the abdominal area to the testicles through the inguinal canal. (Inguinal canal is an opening in the abdomen through which the testicles descend at the time of birth. In some, the canal may remain open allowing fluids (and intestines) to flow into the groin / scrotum causing it to swell).
3. Epididymitis – Epididymis is a tube that runs in the back of testicles and carries sperm outside the body during ejaculation. Swelling or inflammation of epididymis is called epididymitis. You will have severe pain along with swelling in the scrotum. Epididymitis can develop due to an infection that can be sexually transmitted or regular bacterial or viral infection. 
4. Inguinal hernia – As said earlier, the inguinal canal remains open even after the testicles descend into the scrotum. In such cases, fluids tend to flow into the scrotum resulting in faster swelling of testicles. For some people, even the intestines start descending and a bulge can appear in the groin in the scrotum. This condition is called ‘Inguinal Hernia’.
5. Varicocele – Varicocele is a condition when the veins on the scrotum become bulged. This happens when the valves inside the veins are damaged or don’t function well and restrict the free flow of blood. Most often varicocele is seen in the left testicle but less frequently, the right or both testicles might get affected. 
6. Orchitis – An infection caused by bacteria, virus or any other STI that leads to scrotal swelling is called Orchitis. If only one testicle is swollen, there are chances that the other testicle will also get infected (when left unattended).
7. Oedema – build up of fluids. Oedema in scrotum may be a sign of congestive heart failure. However, congestive heart failure can also lead to swelling of other parts of the body as the body starts retaining fluids. 
8. Spermatocele – It is referred to as a condition when cysts start forming in the scrotum. These can usually be above or behind the testicles. Spermatocele is sometimes referred to as spermatic cysts or epidydimal cysts. This is a benign condition and may not bother you much but if you feel uncomfortable with the cysts formation, get in touch with your doctor.
9. Testicular torsion – This is caused due to twisting of spermatic cord in the testicles. When these get twisted, the blood flow to testicles is cut off. The condition needs to be considered as an emergency situation. You may not find any possible cause of the problem.
10. Testicular cancer – Rare but possible scenario that you may develop a tumour in your scrotum that is cancerous. Initially, a lump-like formation may be seen and eventually it can start to grow. This can lead to severe pain and discomfort.
11. Tuberculosis – A bacterial infection that may very rarely lead to swelling of testicles. In most of the cases, only the lungs of a person are affected but in rare cases, the testicles are swollen.

Treatment for swollen testicles

Treatment for inflamed testicles depends on the actual cause of the problem. Your doctor will conduct a physical examination to understand the cause of the issue. Some tests including blood and urine tests may be required along with some imaging tests to get to the root cause of the problem.

If your doctor thinks that the swelling could be due to infection of any kind, you may be put on antibiotics for a few days to see progress. In some cases, removing the fluids from testicles through a minor outpatient surgery might be needed while in other cases, a little longer surgery might be the only option. 

Does swollen testicles affect fertility?

That is an interesting question and the answer is, yes, possible. When the blood flow is cut off to the testicle (testicle torsion or for any other reason) or when blood doesn’t flow through the veins, testicles will be deprived of oxygen and stop functioning properly. As a result, they stop producing male hormones and sperms leading to infertility.