Other causes of testicular or scrotal symptoms

Problems other than cancer may also cause symptoms in the testicles or scrotum. Once again, it is important to see a doctor if you have changes in your testicles.

Torsion of the testicle

In this condition, one of the testicles gets twisted inside the scrotum. This cuts off the blood supply to the testicle, epididymis, and other structures, leading to symptoms of sudden, severe pain in the scrotum along with swelling and redness. Some men also have belly pain or nausea and vomiting. Testicular torsion is an emergency that needs to be treated right away. This condition is diagnosed by ultrasound of the scrotum. Treatment is surgery to untwist the testicle, which restores the blood supply. If the torsion isn't treated right away (within the first 6 hours), the testicle can die and will have to be removed. If it isn’t removed soon enough, it can even cause problems with the other testicle. Testicular torsion occurs most often in teen boys, but may occur later in life.

Injury

Physical injury can cause pain to the area right way, or may cause slowly worsening pain and swelling later on as the scrotum fills with blood (this is known as a hematocele). Sometimes treatment may be needed to stop the bleeding, but the problem may get better on its own. A testicular injury can be very painful, but it does not cause cancer.

Infection

Infections in the scrotal area are usually caused by bacteria or viruses.

Epididymitis is inflammation of the epididymis, the coiled tube next to each testicle that stores sperm. This is most often caused by an infection, such as those which are transmitted through sex, but it can also be caused by other types of infection, as well. Slowly developing pain and swelling on one side of the scrotum are common. The pain may spread to the side or back. Pain when passing urine is also common. You may notice fever and a milky discharge from the penis. If the infection is caused by bacteria, treatment with antibiotics will cause the pain, swelling, and other symptoms to go away completely. If these problems last, you need to go back to the doctor.

Orchitis happens when the testicle(s) becomes inflamed. It can cause painful swelling in one or both testicles. Viral infections (like mumps) are common causes of orchitis. About 1 in 5 men who gets mumps as an adult will have orchitis in one or both testicles, which can lead to problems with fertility. This was much more common before children started getting a vaccine against the mumps virus.

Hydrocele

Sometimes a testicle can become enlarged because fluid has collected around it. This is called a hydrocele. It is usually painless unless it grows too large. Sometimes the pain can spread to the lower belly or back. Hydroceles are usually harmless and rarely need to be treated.

Varicocele

In this condition, the veins within the scrotum can get very large (dilate). This can cause swelling and lumpiness around the testicle. It has been described as the scrotum feeling like a "bag of worms." It is usually painless, but may cause a feeling of heaviness in the scrotum. Varicoceles do not usually need to be treated.

Epididymal cyst/spermatocele

This is a fluid-filled sac much like a hydrocele, but the fluid inside contains sperm cells. It is usually a small, painless lump in the scrotum that is not connected to the testicle. These cysts are very common, and rarely need to be treated.

Inguinal hernia

Hernias are caused by defects in the muscles of the lower belly (the abdominal wall). These defects allow structures in the belly (abdomen), such as a piece of intestine, to enter the scrotum. There may be a slight lump or bulge in the groin or scrotum. The lump from a hernia may be easier to see or feel when the man stands up or lifts something heavy. It is sometimes painful, especially when the man strains to pass urine or have bowel movement.

Most of the time a hernia isn't dangerous, but it becomes more serious if a problem called strangulation develops. This is when a part of the intestine gets trapped in the groin, cutting off its blood supply. This causes severe pain, nausea, and vomiting. Surgery is needed to correct this right away to prevent much more serious problems.

Kidney stones

Kidney stones are small crystals that form in the kidneys and can become lodged in the tubes leading to the bladder (the ureters). They cause severe pain, most often in the back or belly. This pain can extend down to the scrotum. Many men also have nausea and vomiting. Blood is often found in the urine, but it may not be seen with the naked eye. Large stones may need to be removed using surgery or other procedures.

These are the more common causes of testicular symptoms, but they are not the only ones. Because it is hard to figure out the cause based on symptoms alone, it is important to have any testicular or scrotal change looked at by a health care professional.