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Things to know about a swollen scrotum

Scrotal swelling refers to scrotum swelling. The scrotum is the skin pocket containing the testicles.

Scrotal swelling can sometimes affect the entire scrotum. At occasions, lumps on one or both sides of the scrotum may be swollen.

Swelling of the scrotum can be painless, or very painful. While it can be troubling, the majority of causes are benign and highly treatable.

Scrotal swelling can, in very rare cases, indicate cancer. Hence, it is important that a doctor checks any swelling.

The article outlines the causes and symptoms of scrotal swelling, and the available treatment options.

Causes and symptoms

The scrotum can swell from various conditions. Some of these potential causes are outlined in the following sections.

Hydroceles and hernias

The most common causes of scrotal swelling are hydroceles and hernias.

A hydrocele is a fluid array formed around a testis. Often, hydrocells occur during early development.

In such cases, the testicles descend into the scrotum and leave an irregular opening behind which is not closing. This opening causes fluid to collect around the testicles and in the scrotum. At birth approximately 10 per cent of males have a hydrocele.

Hydroceles may also occur later in life, due to injury or infection. However, for no apparent reason, many hydroceles do occur.

Hydrocells also have no symptoms. Many males may however find in the scrotum a sense of heaviness or fullness.

Meanwhile, hernias develop when a portion of the intestines passes through the same opening through which a hydrocele can pass. The unexplained swelling is the principal symptom of a hernia.

At birth, approximately 1–5 percent of males have a hernia, and it is especially common in premature infants. Older males may develop a hernia when the bowels drop down due to a weakness in the groin. This risk may increase with frequent straining during bowel movements and lifting.

For males with obesity, hernias are also more likely as the extra weight puts pressure on the groin’s weak spot.


A cyst is a collection of small, enclosed fluids. It may feel like a pimple deep under the skin, or in the scrotum. Several kysts are around a pea’s size, while others may grow big enough to put pressure on the scrotum.

Sometimes in the epididymis a kyst can grow. This is a channel connecting the testicles to a gland called the vas deferens. Doctors call such cysts epidididymal cysts, or spermatoceles.

Sometimes, they may develop after an injury or infection. In most cases, however, physicians are incapable of determining a specific cause.


A varicocele is a set of swollen veins inside the scrotum. If a varicocele develops during puberty, one of the testicles can grow slowly.

The majority of varicoceles have no symptoms at all. Certain males do report pain or swelling, however. Males who have a varicocele may also encounter reproductive problems in some cases.


Sustaining a groin injury can cause swelling, which can feel tender or very painful to the touch.

Swelling that is very painful or lasts longer than one or two days can be a sign of serious injury. Males with such swelling should see a doctor at the earliest opportunity.


A swelling in the scrotum will rarely signify a tumor.

Tumors in the testicles are particularly rare in children under the age of 15, and account for only 2 percent of cancers in men. Testicular cancer is more likely to occur in 20–34 year-old males. Today, however, it is one of the less common cancer types.

It is nonetheless necessary for a doctor to examine any swelling or other changes in the scrotum. Many testicular cancers are curable, even when a doctor identifies them at an advanced stage, according to the National Cancer Institute.

Idiopathic swelling

Idiopathic swelling refers to swelling, for which a doctor could not determine a cause. This is more common among kids but may affect men of any age.

This kind of swelling can all of a sudden appear. It is painless, and usually goes away in about 3–6 days alone.


A doctor will do a physical examination of the testicles and scrotum to diagnose the cause of scrotal swelling. You may also take a complete medical history and inquire about any other problems or injuries in recent years.

An mri or other imaging examination can in some cases help rule out certain causes of scrotal swelling.

If a doctor suspects a tumour, a biopsy or tumor removal may be prescribed. The biopsy or tumor is then examined by a laboratory technician for signs of cancer.


A doctor will in many cases prescribe pain relievers or anti-inflammatory medications to alleviate scrotal swelling and discomfort.

Other scrotal swelling treatments will however depend on the exact cause. The parts below list a variety of potential treatment options by cause.


Hydroceles do not always require care, especially if they grow in a newborn baby or young child. They usually close themselves up.

In some situations, suction fluid from the hydrocele may be prescribed by a doctor. It may still occur however, requiring more treatment.

A pain-inducing hydrocele may require surgical treatment. Many surgical repairs are possible with only local anesthetics on an outpatient basis.


A hernia is not going to go away by itself. Many doctors therefore suggest surgery to repair the hole, especially if the hernia is big or causes symptoms.


Those cysts do not require treatment at all. Nevertheless, a doctor can drain a particularly large or painful cyst.


Varicoceles usually require treatment only in cases where they cause symptoms or affect fertility. There are several different options for surgery which a doctor can recommend to repair the veins.

Until deciding on an approach, it is important to discuss certain options with a doctor.


The treatment options for testicular tumors are dependent on the type and stage of the cancer. Many males only need surgery whereas others need chemotherapy, radiation therapy, or other cancer therapies.

Risks and complications

Many Scrotal Swelling causes are relatively harmless. The main symptoms tend to be pain in the scrotum, or a sense of fullness.

Some causes of scrotal swelling can damage the testicles and cause infertility if a person does not seek treatment. Tumors can spread to other areas of the body and are potentially life-threatening.

It is therefore important for men who experience any symptoms of scrotal swelling to see their doctor for a diagnosis and proper treatment.

It is generally safe to undergo surgery to repair swelling in the scrotum, though all operations carry certain risks. The possible risks and benefits of surgical treatment should be discussed with a doctor or surgeon.

When to see a doctor

If males experience any swelling in the scrotum, they should see a doctor. Scrotal swelling is rarely an emergency, but untreated swelling within the scrotum may damage the testicles, scrotal blood vessels or other essential structures. That may also affect fertility in some cases.

A doctor will refer an urologist to someone who has scrotal swelling. Urologists specialize in treating urinary tract conditions and male reproductive organs. Such healthcare professionals may work with an individual to determine the cause of scrotal swelling and discuss treatment options necessary.


Scrotal swelling may be alarming but often the cause is benign. And seeing a doctor as soon as possible is still best. This is because the testicles and other essential components within the scrotum can be affected by some causes of scrotal swelling.

More serious causes of scrotal swelling, such as cancer, are also important to rule out.

In some cases a doctor may refer an urologist to someone with scrotal swelling. They will work to determine the cause of the swelling and prescribe treatment options necessary.

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