When a man discovers that one or both of his testicles, or testes, is swollen and his scrotum has become enlarged, he might become extremely concerned. Several problems can cause testicular or scrotal swelling. Fortunately, most of these conditions can be successfully treated, especially if diagnosed early. If you experience testicular swelling or have any questions about this condition, talk with your family doctor or a urology specialist.
Infection can develop in the testis itself or the epididymis -- a duct that connects the testis with the urine tube, or urethra -- and spread to the testis. These problems, called orchitis and epididymitis, respectively, often cause testicular swelling and scrotal pain. You may also have a fever. Orchitis and epididymitis occur most often in males between the ages of 14 and 35, according to a paper in the April 2009 issue of "American Family Physician." The infections are often caused by the same bacteria responsible for the sexually transmitted infections chlamydia and gonorrhea 2. Infection with the mumps virus can also cause orchitis, a problem that can cause infertility when it occurs in adults. According to a study published in the April 2010 issue of "British Journal of Urology International," cases of mumps orchitis among adults have increased, likely due to reduced vaccination of children against mumps in the 1990s 3.
- Infection can develop in the testis itself or the epididymis -- a duct that connects the testis with the urine tube, or urethra -- and spread to the testis.
- Orchitis and epididymitis occur most often in males between the ages of 14 and 35, according to a paper in the April 2009 issue of "American Family Physician.
Causes of Lower Abdominal & Testicular Pain
Although the testis is located in the scrotum, it gets its blood supply from an artery that originates in the abdomen. The artery courses through the groin as part of a structure called the spermatic cord to reach the testis. In a rare but potentially serious condition called testicular torsion, the testis twists around the spermatic cord. This twisting cuts off the blood supply to the testicle, causing swelling and pain. Testicular torsion can happen because of an injury or because of a congenitally loose attachment of the testicle to the scrotum. A rare problem that occurs in about 1 in 4,000 men under age 25, torsion can be an emergency and requires immediate medical evaluation. Emergency surgery is often needed to restore blood flow and prevent testicular injury.
- Although the testis is located in the scrotum, it gets its blood supply from an artery that originates in the abdomen.
- In a rare but potentially serious condition called testicular torsion, the testis twists around the spermatic cord.
Testicular cancer can also cause swelling of the testis 4. Swelling is usually -- but not always -- limited to one side. A cancerous tumor might cause a noticeable lump on the testis, but it can also lead to generalized swelling, sometimes accompanied by pain or discomfort. Testicular cancer is relatively rare cancer, typically affecting males 15 to 34, although it can develop at any age 4. It is more common in Caucasian men than men of other ethnicities. Fortunately, testicular cancer is usually a highly treatable cancer, especially when detected early through regular self-exams 4.
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A problem called varicocele can also cause testicular swelling, or enlargement of the entire scrotum. The veins that carry blood from the testis back to the heart form a network in the spermatic cord. Sometimes, veins in this network enlarge and function poorly. This causes blood to pool or flow too slowly, leading to backup of blood in the testis and swelling. Varicocele usually develops slowly and is most common in young men. Because of the architecture of the testicular blood supply, it tends to develop most often on the left side and can usually be treated with surgery or other procedures. Another disorder called spermatocele can also cause testicular swelling. This noncancerous condition arises when a fluid-filled cyst develops in the testis or epididymis. It might cause no symptoms but may lead to noticeable swelling of the testis.
- A problem called varicocele can also cause testicular swelling, or enlargement of the entire scrotum.
- This causes blood to pool or flow too slowly, leading to backup of blood in the testis and swelling.
Causes of Lower Abdominal & Testicular Pain
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- Yen and Jaffe's Reproductive Endocrinology; J. Strauss and R. Barbieri
- American Family Physician: Epididymitis and Orchitis -- An Overview
- British Journal of Urology International: The Increasing Incidence of Mumps Orchitis -- A Comprehensive Review
- American Cancer Society: Testicular Cancer
- Facts About Testicular Cancer: Testicular Cancer Statistics. American Cancer Society. May 17, 2018.
- Light DE, Leslie SW. Testicular Seminoma. StatPearls Publishing LLC.; 2019.
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- Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835-41. doi:10.1056/NEJMoa067588
- Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH. Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520-32. doi:10.1002/cncr.25231
- Goedert JJ, Purdue MP, Mcneel TS, Mcglynn KA, Engels EA. Risk of germ cell tumors among men with HIV/acquired immunodeficiency syndrome. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1266-9. doi:10.1158/1055-9965.EPI-07-0042
- Srivastava A, Kreiger N. Cigarette smoking and testicular cancer. Cancer Epidemiol Biomarkers Prev. 2004;13(1):49-54. doi:10.1158/1055-9965.EPI-03-0133
- Gurney J, Shaw C, Stanley J, Signal V, Sarfati D. Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:897. doi:10.1186/s12885-015-1905-6
- Markt SC, Miller R, Odonnell E, et al. BMI at diagnosis and adverse outcomes among men with malignant testicular germ cell tumors. Journal of Clinical Oncology. 2015;33(7_suppl):400-400. doi:10.1200/jco.2015.33.7_suppl.400
- Huang S, Signal V, Sarfati D, et al. Physical activity and risk of testicular cancer: a systematic review. BMC Cancer. 2018;18(1):189. doi:10.1186/s12885-018-4093-3
- Riggin AJ, Siddiqui MM. Development of intermediate and high-risk prostate cancer after testicular cancer. Journal of Clinical Oncology. 2015;33(7_suppl):177-177. doi:10.1200/jco.2015.33.7_suppl.177
- Accardo, G.; Vallone, G.; Esposito, D. et al. Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients. Asian J Androl. 2015; 17(1):154-8. DOI: 10.4103/1008-682X.128514.
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- Gurney, J.; Shaw, C.; Stanley, J. et al. Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015; 15:897. DOI: 10.1186/s12885-015-1905-6.
- Kier, M.; Lauritson, J.; Almstrup, K. et al. Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer: a population-based study. Annal Oncology. 2015; 26(4):737-42. DOI: 10.1093/annonc/mdu585.
- Lerro, A.; McGlynn, K.; and Cook, M. A systematic review and meta-analysis of the relationship between body size and testicular cancer. Brit J Cancer. 2010; 103:1467-74. DOI: 10.1039/sj.bjc.6605934.
- Litchfield, K.; Thomson, H.; Mitchell, J. et al. Quantifying the heritability of testicular germ cell tumour using both population-based and genomic approaches. Scientific Reports. 2015; 5:13889. DOI: 10.1038/srep13889.
- Markt, S.; Miller, R.; O'Donnell, E. BMI at diagnosis and adverse outcomes among men with malignant testicular germ cell tumors. J Clin Oncology. 2015; 33(Suppl 7):400. DOI: 10.1200/jco.2015.33.7-suppl.400.
- Riggins, A. and Siddiqui, M. Development of intermediate and high-risk prostate cancer after testicular cancer. J Clin Oncology. 2015; 33(Suppl 7):177. DOI: 10.1200/jco.2015:33.7_suppl.177.
Joanne Marie began writing professionally in 1981. Her work has appeared in health, medical and scientific publications such as Endocrinology and Journal of Cell Biology. She has also published in hobbyist offerings such as The Hobstarand The Bagpiper. Marie is a certified master gardener and has a Ph.D. in anatomy from Temple University School of Medicine.