Testicular swelling without pain

Testicular swelling that occurs without pain is much less common. If varicose veins develop in the scrotum, a so-called varicocele, this can occur with or without pain. This is a dilatation of the veins in the testicles due to a disorder in the drainage of blood.

This leads to blood congestion, which causes the vessels to dilate and varicose veins to form. Often these varicose veins are painless and show no other symptoms apart from a slight swelling, so that they are only noticed by chance. However, some patients experience severe pain and a tension in the scrotum in addition to the swelling of the testicles.

A cyst in the epididymis can also lead to a painless swelling of the testis. This is a benign enlargement which lies against the epididymis and is filled with a fluid. Since it usually does not cause any symptoms, this is also usually a random diagnosis, which is discovered as a secondary finding during a normal ultrasound examination. In the case of a water or inguinal hernia, a massive painless swelling can develop if there is an accumulation of fluid due to a leak in the inguinal canal. In some cases, swelling can also result from a tumorous change in the area of the testicles.

Testicular swelling in children

Testicular swelling, which manifests itself in childhood, most often occurs as a result of testicular torsion (torsion of the testis). In most cases, children and adolescents are affected. In small children testicular torsion is the most common cause of acute and severe pain in the testicular area.

A torsion of the testicle and the spermatic cord interrupts the blood supply to the testicles. Twisting of the testicle can occur as a result of unusual movements during sports, accidents or injuries. In many patients there is a congenital defect in the development of the spermatic cord and the testicular sheath, which can promote testicular torsion.

This can lead to a torsion of the testicle in small children, even while sleeping. Due to the interrupted blood supply the testicle dies within a relatively short time. Therefore immediate emergency medical treatment is urgently indicated.

Patients are presented with severe, sudden onset of pain, redness of the scrotum, nausea and vomiting. After the diagnosis has been made, immediate surgery must be performed to save the damaged testicle. In babies and toddlers, swelling of the testicles often occurs in the context of a hydrocele. Infectious diseases such as mumps or chickenpox can also cause swelling of the testicles, especially in small boys.Testicular swelling, which is associated with infectious childhood diseases, should not be underestimated, as a transfer of the infection to the testicles and local inflammation and in the worst case infertility can result.