Pain doesn't always accompany swollen testicles; the presence or absence of pain depends on the cause of the swelling. Often, swollen testicles are caused by harmless fluid accumulations. However, swollen testicles can also be a symptom of testicular cancer.
Hydrocele is a common cause of swollen testicles in newborns and the elderly, although men can develop hydrocele at any age. Hydrocele occurs when fluid accumulates between the two membranes that cover the testicles. One or both testicles may be swollen. Hydrocele swelling gradually increases over a period of weeks or months.
Hydrocele swelling is usually painless. If the testicles appear to be chronically swollen, medical interventions are available. Surgery can cure hydrocele, or the fluid may be drawn out of the testicular membrane using a fine needle (fine needle aspiration is quite painful, so some men prefer surgical options).
Testicular cysts, also known as spermatocele, are fluid-filled cysts that develop on the epididymis. Spermatocele contain sperm and usually appear on the top portion of the epdidymis. A testicular cyst does not usually cause pain, nor does a cyst typically require treatment. Surgery or needle aspiration may be employed if the spermatocele is large enough to affect the appearance of the scrotum.
Varicocele occurs when blood flow within the spermatic cord veins becomes obstructed, resulting in a swollen scrotum. When standing, the swollen veins in the scrotum may feel like a "bag of worms." The scrotum appears less swollen when the man lies down.
Varicocele is common, affecting fifteen percent of men at some point in their lives. Although varicocele is not dangerous, the condition is associated with 35 percent of male infertility cases. Surgery to correct varicocele is used if fertility is an issue.
Swollen testicles and scrotum are sometimes a symptom of testicular cancer. However, it should be noted that a swollen scrotum is more likely to result from other disorders than cancer. Testicular cancer symptoms may also include pain, hard lumps on the testicles, or even lower back pain. A more detailed description of testicular cancer, its treatment, and its symptoms, is available at Testicular Cancer Symptoms
Secondary diseases can result in swollen testicles. Liver and kidney disorders, and congestive heart disease, cause fluid retention in the abdomen and legs. In some cases, fluid also accumulates in the scrotum or testicles.
Harvard Health Online. (2002, February). The swollen or painful scrotum. Harvard Men's Health Watch. www.health.harvard.edu/medline/Men/N0202b.html.
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