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Scrotal swelling is an enlargement of the scrotal sac, or scrotum, which houses the testicles. It can be caused by injury, an underlying medical condition, a buildup of fluid, inflammation, or an abnormal growth within the scrotum.

The swelling may be painless or very painful. If the swelling is painful, seek emergency treatment. In severe cases and depending on the cause, not receiving timely treatment can result in the loss of your testicles due to the death of tissue.

Scrotal swelling can happen rapidly or slowly over time. One of the main causes of painful scrotal swelling is testicular torsion. This is an injury or an event that causes a testicle in the scrotal sac to twist and cut off blood circulation. This very painful injury could cause tissue death to the scrotum in a matter of hours.

Medical conditions and diseases can also cause the scrotum to swell. These conditions include:

  • trauma
  • testicular cancer
  • abnormally enlarged veins in the scrotum
  • acute inflammation of the testes, called orchitis
  • swelling due to increased fluid, called hydrocele
  • hernia
  • inflammation or infection in the epididymis, called epididymitis
  • congestive heart failure
  • inflammation or infection of the scrotal skin

Other symptoms related to these conditions may be present before scrotal swelling.

In addition to a visible enlargement of the scrotal sac, you may have additional symptoms. The symptoms you experience will depend on the cause of the swelling.

Common symptoms that may be experienced alongside scrotal swelling include a lump in the testicle and pain in the testicles or scrotum.

Contact your doctor if you notice either of these symptoms.

Mention to your doctor any symptoms you’re experiencing with the scrotal swelling. Let them know if your scrotum is painful or contains a lump. After gathering this information, your doctor will perform a physical examination.

The examination will include a physical inspection of the scrotum. At this point, they will ask when you noticed the swelling and what activities you were doing before the swelling.

If necessary, the doctor may perform a scrotal ultrasound to view the inside of the scrotum. This imaging test will let them see if there are any abnormalities within the scrotal sac.

You can book an appointment with a primary care doctor in your area using our Healthline FindCare tool.

Treatment options for scrotal swelling depend on the cause. If an infection caused the swelling, your doctor will prescribe antibiotics to fight the infection. If oral antibiotics don’t work, you may have to receive intramuscular antibiotics or be hospitalized for IV antibiotics.

Treatment of an underlying medical condition that is linked to your symptoms is important in your recovery. Your doctor can prescribe medications to help you manage your pain and may recommend a supportive garment to ease pain and swelling. Surgery may be necessary to correct the condition if the underlying cause is varicocele, hernia, or hydrocele.

Testicular cancer has several treatment options, which will depend on the severity of the cancer. Whether the cancer has spread and how long it went undetected will determine your treatment, which normally consists of the following:

  • chemotherapy
  • radiation therapy
  • surgery, which involves removing cancerous tissue and cancerous tumors from the scrotal sac

In addition to receiving care from your doctor, they may suggest at-home treatment options, including:

  • using ice on the scrotum to relieve swelling, normally within the first 24 hours of noticing the swelling
  • taking an over-the-counter pain reliever
  • wearing athletic support
  • using a sitz or shallow bath to reduce swelling
  • avoiding strenuous activities

The outlook for scrotal swelling varies depending on the severity of the swelling and the cause. Swelling due to injury will generally pass with time, while other causes require extensive treatment. With early diagnosis and proper treatment, the outlook is generally good.