What Causes Swelling of Scrotum?

Medically reviewed by George Krucik, MD, MBA

Scrotal swelling is an enlargement of the scrotal sac. The scrotal sac, or scrotum, houses the testicles. Scrotal swelling can occur due to injury or an underlying medical condition. It may be caused by an accumulation of fluid, inflammation, or... Read More

Scrotal swelling is an enlargement of the scrotal sac. The scrotal sac, or scrotum, houses the testicles. Scrotal swelling can occur due to injury or an underlying medical condition. It may be caused by an accumulation of fluid, inflammation, or an abnormal growth within the scrotum.

The swelling may be painless or very painful. If the swelling is painful you should 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.

What causes scrotal swelling?

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.

Signs of scrotum 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.

Identifying the cause

Mention to your doctor any symptoms you are 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.

Treatment options for scrotal swelling

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 do not 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 hydrococele.

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

Home treatment

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. 

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Medically reviewed by Graham Rogers, MD on May 25, 2016Written by April Kahn

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This feature is for informational purposes only and should not be used to diagnose. Please consult a healthcare professional if you have health concerns.

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