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Testicular Swelling: Causes & Treatment

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Last updated March 22, 2022

Testicular swelling quiz

Take a quiz to find out what's causing your swelling.

A mild swollen testicle after an injury is common and often goes away after a few days. However, large, or sudden swelling should be immediately treated, as it may point to a more serious underlying condition. Read more below to learn 6 possible causes, treatment, and more.

6 most common causes

Testicular Torsion
Chlamydia Infection
Orchitis
Epididymitis
Nephrotic Syndrome
Illustration of a health care worker swabbing an individual.
Non-serious testicle injury

Testicular swelling quiz

Take a quiz to find out what's causing your swelling.

Take testicular swelling quiz

Testicular swelling symptoms

The testicles may seem to be somewhat vulnerable, yet their location also allows any problem to be quickly noted and readily treated.

It is important to have any testicular swelling symptoms treated right away in order to prevent possible loss of fertility. The medical provider will be glad to treat you, or to refer you to someone who can. Testicular swelling is also called scrotal swelling.

Common characteristics of swollen testicles

If you're experiencing swollen testicles, it's also likely to experience:

  • Pain in one testicle or both testicles: This pain may be severe, moderate, or very mild.
  • Pain in the pelvis, groin, lower abdomen, and/or low back
  • Pain during urination: And/or ejaculation
  • A lump in the testicle or scrotum
  • A feeling of heaviness or pressure in the scrotum and/or the groin
  • Redness and heat in the scrotum
  • Visibly enlarged veins on the skin of the scrotum
  • Abnormal discharge from the penis
  • Blood in the semen
  • Fever and chills
  • Enlarged lymph nodes in the groin

Who is most often affected by testicular swelling symptoms?

Testicular swelling happens most often to men who:

  • Are uncircumcised
  • Have unprotected sex
  • Have contracted a sexually transmitted disease
  • Have another bacterial illness that migrates to the reproductive tract
  • Have an enlarged or inflamed prostate
  • Have a chronic cough or chronic constipation, with subsequent straining
  • Are overweight or obese
  • Have recently had a groin injury, urinary tract surgery, or a vasectomy
  • Regularly use a urinary catheter
  • Were born prematurely and/or with abnormalities of the urinary or reproductive tract: Fluid around the testes is most common in infants but can occur in adult men as well.

Are testicular swelling symptoms serious?

The severity of swollen testicles is ultimately dependent on the cause.

  • Not serious: Mild swelling following a minor injury should clear up in just a few days.
  • Moderately serious: Larger swelling in a testicle, along with pain, fever, and sometimes abnormal discharge, can lead to scar tissue and loss of fertility if not treated.
  • Serious: Sudden severe pain and swelling in a testicle will result in loss of fertility if not immediately treated.

What causes testicular swelling?

Many conditions can have testicular swelling as a symptom. The most common are those involving trauma, disease, and structural abnormalities of the urinary and reproductive tracts, as well as tumors.

Most common testicular swelling cause types

The most common causes of testicle swelling includes the following.

  • Trauma: Swelling is normal in any part of the body following a direct hit, especially while doing something like playing sports, falling down, or being involved in a car accident.
  • Disease or illness : Acute inflammation of one or both testes may occur from either bacteria or virus. Inflammation of the epididymis may also lead to swelling, usually in men under 35, typically from a bacterial sexually transmitted disease; however, a urinary tract infection or an infected prostate gland can spread bacteria to the testicle. Superficial inflammation or infection of just the scrotal skin can also lead to swelling.

Less common testicular swelling causes

Less common causes of swollen testicles include the following.

  • Torsion: This is twisting of the testicle on its spermatic cord (the blood supply).
  • Accumulation of fluid in a sac that forms around the testicle: This usually occurs in infants but can happen in adult men as well.
  • Inguinal hernia: With an inguinal hernia, a loop of intestine pushes through a weak spot in the tissue that lines the abdominal wall. The loop drops down into the scrotum, creating pain and what looks like a large swelling.
  • If the veins on and within the scrotum become enlarged: This will interfere with blood supply and can affect fertility.

Allergies

Allergies can result in swollen testicles.

  • Contact allergy: This may occur from something that has directly touched the skin, such as soap, lotions, irritating plants, or an insect bite.
  • Systemic allergy: This may occur from something you have eaten or medications you have taken.

Edema, or fluid retention

Congestive heart failure can lead to system-wide edema.

Testicular swelling quiz

Take a quiz to find out what's causing your swelling.

Take testicular swelling quiz

Rare and unusual testicular swelling causes

The following, although possible, are the least likely causes of swollen testicles.

  • Rare parasitic worms which can migrate into the scrotum: Especially in third-world countries.
  • Tumor or other abnormal growths: Either benign or malignant [3,4]

This list does not constitute medical advice and may not accurately represent what you have.

Intermittent testicular torsion

Intermittent testicular torsion is also called ITT or chronic testicular torsion. Torsion refers to an abnormal twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.

In intermittent cases, the testicle becomes untwisted on its own and the symptoms spontaneously resolve. The condition nearly always returns, however, and may continue to come and go.

The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.

Symptoms include sudden, severe groin and testicular pain with nausea and vomiting, followed by spontaneous relief of symptoms even without treatment.

Eventually, testicular torsion can result in loss of circulation followed by tissue death and loss of the testicle. Any type of testicular torsion is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and sometimes ultrasound.

Treatment involves emergency surgery to untwist the spermatic cord and anchor the testicle in its proper place within the scrotum.

Rarity: Rare

Top Symptoms: nausea, testicle pain that comes and goes, vomiting, pain in one testicle, testicular swelling

Symptoms that always occur with intermittent testicular torsion: testicle pain that comes and goes

Urgency: Primary care doctor

Testicular torsion

Testicular torsion is also called ATT or acute testicular infarction. It is a twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.

The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.

Most susceptible are infant boys and boys just reaching puberty. Torsion may occur in older boys after an injury and/or an athletic workout.

Symptoms include sudden, severe, one-sided testicular pain and swelling, with nausea and vomiting.

Acute testicular torsion is a medical emergency. If not corrected immediately, the loss of blood flow can lead to infertility and loss of the testicle. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and sometimes ultrasound.

Treatment involves first attempting to manually rotate the testicle back into place. If unsuccessful, surgery will be done to either correct the torsion or to remove the testicle if the damage is not reversible.

Testicular cancer

Testicular cancer is a condition where cells inside the testicle begin to grow out of control, forming a lump (called a tumor). These cells may spread (metastasize) to other parts of the body.

You should visit your primary care physician who will coordinate care with a cancer surgery specialist (surgical oncologist). Testicular cancer responds well to surgical treatment.

Orchitis

Orchitis occurs when one or both testicles are inflamed. This is often caused by sexually transmitted infections like gonorrhea or chlamydia. More rarely, orchitis is caused by a virus.

Antibiotics are needed to treat bacterial orchitis. If the cause is viral, ibuprofen, acetaminophen, and ice packs may be used to treat symptoms.

Rarity: Rare

Top Symptoms: spontaneous testicle pain, fever, tender testicular swelling, muscle aches, new headache

Urgency: Primary care doctor

Non-serious testicle injury

Being struck in the testicles is very common, and despite the intense pain that follows, rarely requires professional medical care.

You can treat your painful scrotal injury with rest and optional application of ice. Be careful not to ice your scrotum for more than a couple minutes at a time.

Rarity: Rare

Top Symptoms: testicle pain from an injury, testicle injury

Symptoms that always occur with non-serious testicle injury: testicle injury

Urgency: Self-treatment

Nephrotic syndrome

Nephrotic syndrome is a symptom of damage from other disease, not a disease in itself. This damage prevents proper filtering of the blood. Protein which should remain in the blood plasma instead leaks out into the urine.

The loss of normal protein in the blood causes swelling, especially in the legs and around the eyes, and it may spread to other parts of the body. Urine may appear foamy. There may be weight gain due to retained fluid.

Most susceptible are those with diabetes, lupus, heart failure, or another form of kidney or liver disease.

Nephrotic syndrome can lead to increased risk of infections and blood clots, as well as to further kidney damage and possible kidney failure.

Diagnosis involves finding the underlying disease that is causing the nephrotic syndrome, and begins with urine tests and blood tests. Sometimes kidney biopsy is done.

Treatment depends upon the underlying illness, and so will be different for different patients. Most cases are additionally treated with blood pressure control, diuretics, and improved diet.

Epididymitis

The epididymis is a coiled tube which stores sperm inside each testicle. Epididymitis is an inflammation of one or both of these tubes.

It is caused by a bacterial infection, most often from sexually transmitted diseases (STDs) such as chlamydia and gonorrhea. Epididymitis can also be caused by a urinary tract or prostate infection, or by trauma due to injury or heavy lifting.

Males of any age can be affected, though men engaging in unprotected sex are most susceptible.

Symptoms include redness, swelling, and pain in the testicle; pain on urination or ejaculation; discharge from the penis; and blood in the semen.

Any of these symptoms should be treated by a medical provider as soon as possible in order to prevent abscess or permanent damage.

Diagnosis is made through physical examination; penile swab for STD tests; urine and blood tests; and sometimes ultrasound of the testicles.

Treatment involves antibiotics as well as rest, cold packs to the testicles, wearing an athletic supporter, and refraining from lifting and sexual intercourse until the infection is gone.

Chlamydia (male)

Chlamydia in men is one of the most common sexually transmitted diseases, or STDs. The disease is caused by the Chlamydia trachomatis bacteria.

A man can get chlamydia through having vaginal, anal, or oral sex with an infected partner, either male or female.

Symptoms of chlamydia in men include discharge from the penis; burning sensation on urination; and sometimes pain and swelling in the testicles. The disease can spread to the rectum and cause rectal pain, bleeding, and discharge. It may affect the eyes and cause bacterial conjunctivitis.

It is important to get treatment for these symptoms, as chlamydia in men can lead to sterility. It also leaves a person more susceptible to contracting HIV.

Diagnosis is made through urine test and/or a swab from the end of the penis.

Treatment involves a course of antibiotics, usually by mouth, to kill the bacteria. Be sure to finish all of the medication as directed.

It is possible to be re-infected with chlamydia even after having the disease, so it still very important to practice safe sex.

Testicular swelling quiz

Take a quiz to find out what's causing your swelling.

Take testicular swelling quiz

Testicular swelling treatments and relief

When swollen testicles are an emergency

Seek immediate treatment in the emergency room, or call 911, if you have sudden severe pain and swelling in one or both testicles, along with nausea and vomiting. This is considered a medical emergency because it can result in tissue death and loss of the testicles.

When to see a doctor for swollen testicles

You should schedule an appointment sooner than later for pain, swelling, and fever with burning on urination and abnormal discharge from the penis.

At-home treatments for swollen testicles

For occasional or mild testicular swelling, or to find relief while you wait for your appointment, you can try the following remedies at home.

  • Ice pack: If the pain seems minor, you can use an ice pack to reduce swelling.
  • Pain medication: Take an over-the-counter pain reliever such as ibuprofen (Advil, Motrin) or other NSAIDs.
  • Wear an athletic supporter to help take the pressure off of the testicles
  • Rest and avoid strenuous activities: Especially lifting anything heavy
  • Address overall health: Make lifestyle improvements in diet, exercise, and sleep
  • Always use protection during sexual activity

FAQs about testicular swelling

Can a UTI cause testicular swelling?

Yes, urinary tract infections (UTIs) can cause testicular swelling. Infections from the urethra can travel down the vas deferens to the epididymis or testes to cause an infection. Inflammation and swelling will result from the infection. The bacteria E. Coli and pseudomonas are the most common culprits in older men, while gonorrhea and chlamydia are the most common culprits in men under the age of 35.

Can STDs cause testicular swelling?

Sexually transmitted diseases (STDs, also known as sexually tranmitted infections) can cause testicular swelling in the same way that non-sexually transmitted urinary tract infections can cause testicular swelling. The mechanism involves colonization of the urethra by the organism and then traveling down the vas deferens to the epididymis or testes. Gonorrhea and chlamydia are the most common sexually transmitted causes of testicular swelling.

Can kidney stones cause testicular swelling?

While kidney stones can sometimes cause pain that radiates down to the testicles, they do not cause testicular swelling.

How long does testicular swelling last?

How long testicular swelling lasts depends on the cause. If testicular torsion is the cause, immediate detorsion is required within 48 hours of the onset of testicular swelling and pain. Symptoms should improve immediately after the procedure. In the case of an infection causing swelling, symptoms typically improve within 13 days of antibiotic treatment initiation, but it may take up to 4 weeks for complete resolution.

Why is only one of my testicles swollen?

Unilateral testicular swelling can occur due to the same reasons you may have bilateral testicular swelling torsion, infection, fluid collection, hernia so it is not very helpful in determining the etiology. More useful in evaluating the acute swelling is the nature and timing of the onset of pain, the particular area of the testicle that is swollen, and the presence of fever and lower urinary tract symptoms (e.g. frequency, urgency, painful urination). While a less common cause of swelling, a persistently enlarged testicle should be evaluated to exclude a malignant growth.

Hear what 1 other is saying
Testicular swellingPosted April 16, 2021 by A.
Hi there! in 41 yr old male. Abt 5 days back I had a sexual encounter with my wife and 3 days later I was in the shower shaving my pubes and everything was normal. But that night I started feeling some discomfort. When i touched my testicles I felt as if someone had stuck chewing gum under my left testicle. There is no pain unless I touch it, which is mild. But at times I feel discomfort in the sac. it the 3rd day now. Just waiting for doctor's appointment, which is tomorrow. Any idea wt the reason for the sudden swelling?
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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