About the Scrotum
The testes are two oval shaped male reproductive glands that produce sperm and the male hormone testosterone. The testes are contained within a sac below the penis called the scrotum.
The sperm produced in the testis drains into a long, convoluted tube at the back of the testis called the epididymis, which then drains into another tube in the scrotum called the vas or ductus deferens.
The vas deferens then passes through groin into the pelvis and drains into the urethra at the level of the prostate gland. Semen is expelled from the urethra, which opens on the end of the penis, during ejaculation.
What is Scrotal Swelling?
Scrotal swelling is an enlargement of the scrotal sac. Sometimes, scrotal swelling may affect the entire scrotum. At other times, there may be swollen lumps on one or both sides of the scrotum.
Scrotal swelling can occur due to injury or an underlying medical condition that cause 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.
While scrotal swelling can be alarming, most causes are benign and highly treatable. In very rare cases, scrotal swelling may indicate cancer. It is therefore essential to have any swelling checked out by a doctor.
Causes of Scrotal Swelling
There are a number of conditions that can be related to scrotal swelling, these include:
- testicular cancer,
- testicular torsion,
- abnormally enlarged veins in the scrotum (varicocoele),
- acute inflammation of the testes, called orchitis,
- inflammation or infection in the epididymis, called epididymitis,
- swelling due to increased fluid, called hydrocele,
- congestive heart failure
Types of Scrotal Swelling
A cyst is a small, enclosed collection of fluid. It may feel similar to a pimple deep beneath the skin or in the scrotum. Some cysts are around the size of a pea, while others can grow large enough to put pressure on the scrotum.
Sometimes, a cyst can develop in the epididymis. This is a tube that connects the testicles to a gland called the vas deferens. Doctors refer to these cysts as epididymal cysts, or spermatocoeles.
They can sometimes develop following an injury or infection. However, in most cases, doctors are unable to determine a specific cause.
A varicocele is a swollen collection of veins in the scrotum. If a varicocele develops during puberty, it may slow the growth of one of the testicles.
Most varicoceles do not cause any symptoms. However, some males report pain or swelling. In some cases, males with a varicocele can also experience reproductive difficulties.
A hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle.
- Hydrocele is common in newborns and usually disappears without treatment by age 1.
- Older boys and adult men can develop a hydrocele due to inflammation or injury within the scrotum.
- Adult men can experience discomfort that can increase with the size of the inflammation. Sometimes, the swollen area might be smaller in the morning and larger later in the day.
A hydrocele usually isn’t painful or harmful and might not need any treatment. But if you have scrotal swelling, see your doctor to rule out other causes.
A hydrocele typically isn’t dangerous and usually doesn’t affect fertility. But a hydrocele might be associated with an underlying testicular condition that can cause serious complications, including:
- Infection or tumour. Either might reduce sperm production or function.
- Inguinal hernia. The loop of intestine trapped in the abdominal wall can lead to life-threatening complications.
Also referred to as Idiopathic swelling is swelling with an unidentified cause. This is more common among children, but it can affect males of any age. This type of swelling may appear suddenly. It is painless and usually goes away on its own within a week.
Treatments 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.
Treatment of an underlying medical condition that is linked to your symptoms is important in your recovery.
Procedure may be required if the cause is of the swelling is
- hernia, or
- hydrocoele or epididymal cyst resulting in discomfort.
In case of Testicular Cancer it requires an Urgent Urologist Review it 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.
Hydrocelectomy (Hydrocoele repair)
The removal of a hydrocoele may be required for a hydrocele that doesn’t disappear on its own and results in discomfort.
This is typically a day case outpatient procedure and can be done under general or regional anaesthesia.
An incision is made in the scrotum or lower abdomen to remove the hydrocele. If a hydrocele is found during surgery to repair an inguinal hernia, the surgeon might remove the hydrocele even if it’s causing no discomfort.