Scrotal swelling is abnormal enlargement of the scrotum. This is the name for the sac surrounding the testicles.
Scrotal swelling can occur in males at any age. The swelling can be on one or both sides, and there may be pain. The testicles and penis may or may not be involved.
In testicular torsion, the testicle becomes twisted in the scrotum and loses its blood supply. It is a serious emergency. If this twisting is not relieved quickly, the testicle may be permanently lost. This condition is extremely painful. Call 911 or see your health care provider immediately. Losing blood supply for just a few hours can cause tissue death and the loss of a testicle.
Things you can do to help this problem include:
- Apply ice packs to the scrotum for the first 24 hours, followed by sitz baths to decrease swelling.
- If the pain is severe, place a rolled-up towel between the legs just under the scrotum to help relieve pain and reduce swelling, but get medical attention to make sure it is not a torsion.
- Wear a loose-fitting athletic supporter for daily activities.
- Avoid excessive activity until the swelling disappears.
When to Contact a Medical Professional
Call your health care provider if:
- You notice any unexplained scrotal swelling.
- The swelling is painful.
- You have a testicle lump.
What to Expect at Your Office Visit
Your health care provider will perform a physical exam and take a medical history, which may include the following questions:
- When did the swelling develop? Did it come on 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 golf ball")?
- Does the swelling appear to be fluid? Can you feel tissue in the swollen area?
- Is the swelling in one part of the scrotum or in the entire scrotum?
- Is the swelling the same on both sides (sometimes a swollen scrotum is actually an enlarged testicle, a testicular lump, or a swollen duct)?
- Have you had surgery, injury, or trauma in the genital area?
- Have you had a recent genital infection?
- Does the swelling go down after you rest in bed?
- Do you have any other symptoms?
- Is there any pain in the area around the scrotum?
The physical exam will most likely include a detailed exam of the scrotum, testicles, and penis. The combination of a physical exam and history will determine whether you need any tests.
Your health care provider may prescribe antibiotics and pain medications, or recommend surgery. A scrotal ultrasound may be done to find where the swelling is occurring.
Swelling of the scrotum; Testicular enlargement
Barthold JS. Abnormalities of the testes and scrotum andtheir surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 132.
Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 539.
Update Date 1/21/2015
Updated by: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.