Testicular swelling in one or both testicles occurs every now and then in men. However, they are not an independent disease, but a symptom that can have various causes. Therefore, it is important to diagnose the actual underlying disease for successful treatment.
What is testicular swelling?
One of the most common causes of testicular swelling is testicular torsion, the technical term is testicular torsion. Testicular torsion usually affects only one testicle. Testicular swelling is an enlargement of one or both testicles. It may be accompanied by pain or be painless. The skin of the scrotum is taut, and it may be red and feel hot. Fever also occurs at times. Swelling is caused by fluid retention in the testicles or epididymis. Because various diseases of the urologic tract can be considered as causes, clarification by a physician (usually a urologist) is recommended as soon as possible.
Causes
One of the most common causes of testicular swelling is testicular torsion, the technical term is testicular torsion. Testicular torsion usually affects only one testicle, is painful, and is considered an absolute emergency. A hydrocele or inguinal hernia can also cause testicular swelling. Such a hernia can be present at birth, but can also occur at a later age. Because the inguinal canal is not completely closed, fluid collects in the scrotum and leads to a swelling that is usually painless. In the case of an inguinal hernia, the physician speaks of a hernia, and in the case of a hydrocele. Epididymitis is caused by bacteria or viruses that travel up through the urethra. Testicular inflammation often occurs as a result of an infectious disease, such as mumps, chickenpox, or mononucleosis. In very rare cases, a testicular tumor is the cause of the swelling. Testicular swelling and bruising can also occur after a testicular injury from an accident.
Diseases with this symptom
- Epididymitis
- Testicular cancer
- Mumps
- Hydrocele
- Herniated disc
- Hernia
- Undescended testicle
- Chickenpox
- Testicular inflammation
- Testicular torsion
- Acute scrotum
- Pfeiffer’s glandular fever
Diagnosis and course
The doctor can usually make a thorough diagnosis very quickly. After a preliminary consultation, he will look at the testicle and carefully palpate it. Already with this palpation, it can be seen whether it is a testicular torsion or an inflammation. In the case of testicular inflammation, lifting the testicles will relieve the pain; in the case of testicular torsion, lifting will increase the pain. In the case of inflammation, analysis of blood and urine in the laboratory supports the diagnosis. With the help of an ultrasound examination, further details can be determined, for example, whether abscesses have formed as a result of inflammation or whether a tumor is present. Testicular torsion is also clearly detected in the ultrasound image. In most cases, subsequent treatment is necessary to positively influence the further course of the disease.
Complications
An example of the development of testicular swelling is the accumulation of fluid in the scrotum (hydrocele) due to an open connection of the testicle with the abdominal cavity. Usually, this is easily recognized and can be well operated. However, if left untreated, water can continue to accumulate, causing uncomfortable feelings of tightness and pressure. In addition, there is an increased likelihood of testicular torsion, i.e. the rotation of the testicle around itself. This cuts off the blood supply to the testicle and causes severe pain. Moreover, it also affects sperm quality and possibly causes infertility. In addition to testicular torsion, due to the open connection to the abdomen, a loop of intestine can enter through the inguinal canal in a simplified manner, causing an Indirect Inguinal Hernia. In addition to water retention, inflammation of the testis (orchitis) or epididymis (epididymitis) can also cause swelling. If left untreated, serious complications can arise. For example, bacteria can enter the bloodstream, causing a systemic infection (sepsis). These are life-threatening if left untreated and can lead to the death of the patient in 60 percent of cases.Tumors or cysts also produce swelling in the testicular area. The complications they entail vary depending on the size and type of disease and, again, primarily affect the patient’s fertility.
When should you see a doctor?
Testicular swelling, both unilateral and bilateral, is a symptom and not a disease. The question of whether or when someone with testicular swelling should go to the doctor knows only one answer: always and immediately! This is true even if there is no pain. The swelling of the testicles is always caused by a disease of the urological area. An early clarification by a urologist should be made as soon as possible in one’s own interest. The cause of testicular swelling can be an inguinal hernia or a hydrocele, whereby fluid enters the scrotum and collects there. An awkward movement can cause bruising of the testicle with subsequent swelling. Bacterial or viral epididymitis or the formation of an abscess is also conceivable. Notorious are testicular inflammations triggered by infectious diseases such as chicken pox, mumps or Pfeiffer’s glandular fever, which even threaten infertility. In the event of painful testicular torsion, the emergency physician should be called immediately. Rarely, but not to exclude, is also a tumor as the cause of the swelling of the testicle. in the case of a swelling of the testicle, therefore, no one should hesitate to go to the urologist out of excessive shame.
Treatment and therapy
If the testicular swelling is based on testicular torsion, the testicle turns and thus cuts itself off from the blood supply. Therefore, surgery is necessary within a few hours to prevent further damage and possible inability to conceive as a result. The surgeon opens the scrotum, returns the testicle to its normal position and fixes it to prevent it from twisting again. If the operation is performed in time, the testicle recovers within a short time and no secondary damage remains. In case of inflammation, the testicle should be immobilized, cool compresses are also helpful. In case of viral inflammation, the doctor may prescribe anti-inflammatory and analgesic drugs. If there is a bacterial infection, antibiotics tailored to the pathogen are used. Acute testicular inflammation heals completely within a few weeks; only in exceptional cases does it progress to a chronic stage. If a testicular tumor is diagnosed, surgery is performed, followed in some cases by radiation treatment or chemotherapy. The prognosis of this type of cancer is very good even in advanced stages. Inguinal hernias are not dangerous, but they also require surgical treatment. Only in the case of a mild form of hernia in babies, the doctor will wait, because the inguinal canal can still close.
Outlook and prognosis
Testicular swelling does not need to be treated in every case. It is not uncommon for the swelling to disappear again on its own. However, if it occurs over a long period of time or leads to severe pain, a doctor must be consulted. The swelling can have quite a few different causes. Not infrequently, it is an inflammation or the formation of abscesses. In the worst case, a tumor is responsible for the swelling of the testicle and the associated pain. With early treatment, a cure is usually possible. If the swelling of the testicle restricts blood flow, fertility problems may result, with the patient suffering complete infertility in the worst case. Similarly, hernia may occur, which is associated with swelling and severe pain. If the testicular swelling is not treated, it can develop into an infection that spreads throughout the body. Testicular swelling is treated causally, with surgery required in most cases. Antibiotics may also be used if inflammation is present. Tumors are removed surgically, although there is no guarantee of complete recovery in this case.
Prevention
A healthy lifestyle is the best prevention, but if cystitis does occur, it should be treated immediately. Those who prefer high-risk sports with a risk of injury should not do without testicular protection. Vaccinations against mumps, measles and chickenpox can also prevent testicular swelling.
You can do it yourself
In case of overheating, improper positioning of the scrotum and swelling, occasional straightening of the genitals will help. These are brought into a comfortable position and the air circulation around the testicles is improved. Such adjustment is recommended when sitting for long periods of time or when wearing ill-fitting legwear. In case of painful swelling, rapid elevation of the affected organ helps. For on the go, there is the so-called jockstrap, which supports the affected testicle. Another helpful utensil is the so-called testicle support. This is a small support pillow. The scrotum is relieved by the high positioning. The swelling goes down. These two helpful utensils are available in medical supply stores. They can be easily integrated into everyday life in the case of swelling of the testicles. In the phase of acute pain, tight-fitting underwear proves helpful. This is because, in contrast to loose-fitting underwear, it has a supporting function. Compressions with temperate water cool the swollen testicle and relieve the pain. Even a wet washcloth can help. Important: temperate to cool – never ice cold! If symptoms persist, further self-help should be refrained from and a doctor should be consulted urgently.
