Testicular Swelling: Or something else? Differential Diagnosis

Skin and subcutaneous (L00-L99).

  • Epidermal cyst* (epidermal cyst) – bulging elastic skin nodule resulting from retention of horny and sebaceous masses, of various genesis (traumatic, inflammatory, naevoid).

Cardiovascular system (I00-I99).

  • Elephantiasis* – irreversible thickening/hardening of the skin with massive fluid retention.
  • Congestive heart failure or decompensated heart failure* (heart failure).
  • Thrombosis of the inferior vena cava* – formation of a blood clot in the inferior vena cava.
  • Varicocele* /* * (varicocele; synonyms: varicocele testis) – in the area of the plexus pampiniformis formed by the testicular and epididymal veins, a plexus of veins in the spermatic cord (lat. funiculus spermaticus); in a high percentage (75-90%), the varicocele occurs on the left side.Surgical indication: varicocelectomy, if in addition to the varicocele there is also a reduced testis. The threshold is a testicular atrophy index (TAI) of 20%, which means that one testicle is 20% smaller than the other; another factor is a volume difference of at least 2 ml between the two testicles.

Infectious and parasitic diseases (A00-B99).

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Hernia inguinalis* /* * (inguinal hernia; inguinal hernia; inguinal hernia); in case of incarceration (incarceration) accompanied by severe pain* * * – hernia (hernia) in the region of the inguinal canal.

Neoplasms – tumor diseases (C00-D48).

Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99).

  • Ascites* (abdominal dropsy).

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99)

  • Epididymoorchitis* * * – combined inflammation of the testis (orchis) and epididymis.
  • Epididymidis cyst – encapsulated accumulation of fluid in the region of the epididymis.
  • Hematocele* * * /* * / * – bleeding into the testicle.
  • Testicular torsion* * * – acute reduced blood flow to the testis due to sudden rotation of the testis around its vascular pedicle (urological emergency!).
  • Hydatid torsion* * * – rotation (torsion) of small appendages on the testis, epididymis or spermatic cord; the clinical symptoms initially resemble those of acute testicular torsion; thus difficult to distinguish from it.
  • Hydrocele* (water hernia)
  • Idiopathic scrotal edema* – swelling of the scrotal skin, the cause of which is not known and does not require treatment.
  • Mumps orchitis* * – special form of epididymoorchitis; complication of parotitis epidemica (mumps) in about 25% of patients who suffer mumps disease after puberty; can occur unilaterally as well as bilaterally (unilateral as well as bilateral) / in up to 30% bilaterally.
  • Spermatocele* – retention cyst (cyst due to an outflow obstruction) originating from the epididymis (more rarely from the spermatic cord).
  • Varicocele* * – pathological expansion and extension of the pampiniform plexus / venous plexus.

Injuries, poisoning and other consequences of external causes (S00-T98).

  • Injuries, unspecified (e.g., scrotal hematoma/bruise, testicular rupture* * * ).

Other causes

  • Swelling after vasectomy – male sterilization procedure.
  • Sepsis (blood poisoning), especially after surgery, catheterization.

* * * Swelling of the testicles with severe pain * * Swelling of the testicles with minor pain * Swelling of the testicles without pain.