Testicle Swelling

On This Page: Symptoms | Causes | Diagnosis | Treatment | Takeaways

What is Testicle Swelling?

Testicle swelling is an enlargement of one or both testicles. You may notice swelling when there is local inflammation of the testicle specifically, or more general swelling of the scrotum (the pouch of skin which holds the testicles), and the other structures inside. Testicle swelling or scrotal swelling can be caused by injury or various medical conditions and diseases, including fluid buildup and infections like sexually transmitted diseases (STDs).¹

Signs and Symptoms of Swollen Testicles

Testicle swelling can develop quickly or over time. It can be painless, or it can occur with different levels of testicular pain and other symptoms. If you have testicular swelling along with pain that is sudden and severe, you should seek immediate medical attention because it may be a sign of testicular torsion, a medical emergency that can cause serious damage or even loss of the affected testicle.

Symptoms that may accompany swollen testicles include:

• Swelling, redness, and tenderness of the testicles and scrotum
• Abdominal or groin pain
• Nausea and vomiting
• Fever
• Painful urination
• Penile discharge
• Pain during sexual intercourse or ejaculation
• Blood in the urine or semen

Can STD Cause Swelling on Testicles

Causes of Swollen Testicles Include:

• Infection – Orchitis (inflammation of the testicle) can be caused by bacterial and viral diseases such as the STDs chlamydia and gonorrhea, and the mumps virus.
• Epididymitis – An inflammation of the epididymis, the tube that stores sperm and connects the testicles to the vas deferens. Epididymitis can also be caused by STDs and infection, and can lead to swelling in the testicles (epididymo-orchitis).²
• Trauma – Because the testicles hang from the body, they are vulnerable to harm, which can lead to swelling.³
• Testicular torsion – When a testicle twists inside the scrotum, twisting the spermatic cord that carries blood to it and interrupting blood flow. This can cause sudden and severe pain and may lead to serious damage or even the loss of a testicle and infertility. Testicular torsion is a medical emergency that requires immediate medical attention.⁴
• Hydrocele –  When fluid builds up in the scrotum, which can cause the scrotum to feel heavy, like a water-filled balloon.⁵
• Varicocele – A lumpy area caused by swollen veins in the testicles, which are similar to varicose veins that occur elsewhere on the body. Their appearance is often described as “a bag of worms.”⁶
• Spermatocele – Spermatic cysts are fluid-filled and often painless and benign (non-cancerous). They are found behind the testicle, near the top and are separate from the testicle itself. Although they often cause no symptoms, they can cause a feeling of heaviness and a dull pain.⁷
• Inguinal hernia –  When fatty tissue or a part of your bowel (your intestines) pokes through a weakness in the abdominal wall muscles and into your scrotum or groin. It can cause enlargement of the scrotum, or appear as swelling or a lump in your groin.⁸
• Congestive heart failure – When your heart’s pumping power is inadequate to meet your body’s needs, which can result in fluid buildup in the lower extremities and scrotum.⁹
• Testicular cancer –  The most common sign is a painless lump in the testicle. While testicular cancer is rare, it’s the most common cancer in American males ages 15-35.¹⁰

Should You Be Concerned?

In general, if you notice swelling in your testicles and it worries you, it’s a good idea to get a physical examination by a doctor and get tested accordingly. If the swelling doesn’t go away or if it is uncomfortable or painful, it can be a sign that you have something that may require medical attention. Even if you feel no pain, it can still be an issue. A firm, swollen testicle accompanied by no pain can be a warning sign of cancer.

Diagnosis

To determine the root of testicular swelling, a doctor examines your testicles for size and positioning, and checks for swelling and tenderness. They may shine a light (transillumination) to check for solid masses, which block light, unlike fluid-filled masses. They may ask questions about your symptoms and your medical and sexual history, and order blood and urine tests or imaging tests, such as a testicular ultrasound.

If you notice testicle swelling and believe you may have been exposed to an STD— especially after an unprotected and/or risky sexual encounter—getting tested helps you know for sure where your sexual health stands. You can get tested quickly and easily without the hassle of a doctor’s appointment by ordering STD testing online and visiting one of our convenient lab locations.

Treatment

Treatment of testicle swelling or scrotal swelling depends on the underlying cause. While certain conditions that cause testicle swelling may not require treatment, others call for extensive treatment.

Depending on the cause as determined examination, testing, or imaging, treatment may consist of:

• Antibiotics – With infections, doctors usually prescribe oral antibiotics or may inject intramuscular antibiotics to fight the infection. If you test positive for an STD through STDcheck.com, we’re here to help. Our doctors offer a phone consultation and can prescribe oral antibiotics for you to pick up at a pharmacy near you.
• Surgery – Testicular torsion usually requires emergency surgery to save the testicle. Surgery may also be needed for a severe testicular injury and inguinal hernias that trap a part of the intestine in the scrotum.
• Surveillance and other treatments – For conditions like hydroceles and mild trauma, no treatment may be needed. Many conditions can be watched to see if they clear up on their own or need treatment. While hydroceles and varicoceles often don’t require treatment, surgery may be needed for hydroceles that grow too large, and varicoceles that cause pain or issues with infertility.
• Cancer treatments – There are various treatment options for cancer. Depending on the severity of the cancer, whether it’s spread, and how long it’s been undetected, cancer treatment may consist of chemotherapy, radiation therapy, and surgery.
• Additional home care – In addition to medical care, a doctor may also prescribe medicine for pain management and may recommend home treatments to ease scrotal pain and swelling, such as taking a sitz bath just up to the hips, using ice, or wearing a supportive garment to elevate the scrotum.

Takeaway

Ignoring testicular swelling can lead to health complications. Depending on the cause, untreated swollen testicles could impact your ability to make normal levels of testosterone, or lower fertility, making it harder to father children. Routinely performing self-exams and paying attention to the look and feel of your testicles can help you notice subtle changes, which can alert you to potential testicular problems.

For testicular or scrotal swelling, it’s important to seek medical advice as needed. If you notice something is amiss, don’t brush it off. Get real answers and support by talking to your doctor. If you think you have been exposed to an STD, get tested to verify your health status, either to identify infection or rule it out as a cause of testicular swelling. With early diagnosis and the right treatment, many causes of swelling in the scrotum or testicles have a generally good outlook.

Medically Reviewed by Julie Hutchinson, MD on February 24, 2022