Scrotal swelling

Alternative names
Swelling of the scrotum; Testicular enlargement

Scrotal swelling is abnormal enlargement of the scrotum, the sac that surrounds the testicles.

Scrotal swelling can occur in males of any age and may or may not be accompanied by pain. It can occur on one or both sides, the testes and the penis may or may not be involved.

Testicular torsion is a serious emergency in which the testicle become twisted in the scrotum and loses its blood supply. If this twisting is not relieved quickly, the testicle may be lost permanently. Immediate evaluation is required.

See also Testicle lump.

Common Causes

  • Injury  
  • Hernia  
  • Congestive heart failure  
  • Hydrocele  
  • Orchitis  
  • Testicular torsion  
  • Varicocele  
  • Certain medical treatments  
  • Surgery in the genital area

Home Care
Ice packs applied to the scrotum are recommended for the first 24 hours, followed by sitz baths to decrease swelling.

If the pain is severe, a rolled-up towel placed between the legs just under the scrotum may help relieve the pain and reduce the swelling. Wearing a loose-fitting athletic supporter is also recommended for performing daily activities. However, avoid excessive activity until the swelling resolves.

Call your health care provider if

Call your health care provider if you notice any unexplained scrotal swelling or if the swelling is painful.

What to expect at your health care provider’s office
The health care provider will perform a physical examination and will obtain a medical history. Medical history questions documenting the scrotal swelling in detail may include the following:

  • When did the swelling develop?  
  • Did it develop suddenly?  
  • Is it getting worse?  
  • How big is the swelling (try to describe in terms such as “twice normal size” or “the size of a golfball”)?  
  • Does the swelling appear to be fluid?  
  • Can you feel tissue in the swollen area (possible hernia)?  
  • Is the swelling only in one part of the scrotum, or the entire scrotum?  
  • Is it the same on both sides (sometimes what appears to be a swollen scrotum is actually an enlarged testicle, a testicular lump, or a swollen duct such as the vas deferens)?  
  • Have you had a surgery on the genital area?  
  • Have you had an injury or trauma to the genitals?  
  • Have you had a recent genital infection?  
  • Does the swelling decrease after you rest in bed?  
  • What other symptoms are also present?  
  • Is there any pain in the scrotal area?

The physical examination will probably include detailed examination of the scrotum, testicles, and penis. Diagnostic tests will be determined from the history and physical examination findings.

Antibiotics and pain medications may be prescribed.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.