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Scrotal Swelling

Scrotal Swelling-Causes, Diagnosis and its Treatment

 

Introduction:-

Scrotum is part of the male reproductive system. It consists of a sac which houses the testicles and is covered by skin along with a smooth muscle that has two chambers. The swelling in the scrotum can occur at any age.

Causes:-

The swelling in scrotum can be due to an injury or it could be a symptom of an underlying problem. It can also be due to inflammation of testicles or fluid accumulation in the scrotum. Some other causes for the scrotal swelling could be-

  • Varicocele-it is the abnormal enlargement of veins within the scrotum. It is caused by visible enlargement of veins inside the sac that carry the blood to the testicles. A lump is often felt.
  • Testicular torsion- The testicles in the sac get twisted from their axis which stops the blood supply. This condition where the blood supply is cut is called ischemia. It demands immediate surgery or else the ischemia can become irreversible.
  • Hydrocele-it is the enlargement of sac due to fluid accumulation. The swelling in groin area may cause discomfort but generally the condition does not cause pain and also does not cause any threat to testicles. It can be either congenital or may affect males later in life. The congenital hydrocele, in most cases, gets cured by itself within two years of birth. The acquired hydrocele can possibly be caused by injury also. Generally the sac returns to its normal size as the fluids are reabsorbed by the body, but if it does not reduce, surgery may be required. A feeling of heaviness may be experienced by the patient in the morning which decreases as the day progresses.
  • Orchitis-it is the testes inflammation and can be caused by bacterial infection.
  • Hernia
  • Epididymitis-The Epididymis is a long tube that is situated above the testicle. The condition which causes infection and inflammation of epididymis is called epididymitis. In small children Urinary Tract Infection has been linked to this condition, where in young men, it is considered to be sexually transmitted. The enlarged prostrate can also cause epididymitis in older men. It might also be cause by an infection or an injury inflicted to the groin area.
  • Congestive heart failure can cause buildup of fluid in the lower body and scrotal swelling may occur, though in this case testicles are not affected.

 

Symptoms:-

The symptoms of scrotal swelling caused by various factors above can be-

  • Severe sharp pain in the scrotum.
  • Tenderness and pain in the epididymis that progressively becomes worse.
  • Discharge from penis.
  • Chills or high body temperature.
  • Visibly twisted veins in the scrotum (varicocele).
  • Nausea and vomiting typically linked to testicular torsion are often accompanied by fever and onset of severe pain.

Diagnosis:-

Physical examination of the scrotum is done in almost every case followed by an ultrasound and urinalysis in case a bacterial infection is suspected. The ultrasound can aid in measuring the size of spermatic veins and hence can give a clearer picture of the condition.Sometimes a test of sample of discharge from penis is done to check for infection. Blood test is done to check the presence of white blood cells along with ultrasound to check for testicle torsion. In case of varicocele, physical exam is done both lying down and standing up as sometimes it goes undetected if the patient is lying down.

 

Treatment for Scrotal Swelling

The swelling of scrotum can be either painful or painless. Painful swelling calls for immediate treatment. The treatment depends on the condition causing it. If the swelling is caused by infection it can be cured by antibiotics. In cases of hydrocele and testicular torsion, surgery may be required. In case of testicular torsion, the treatment has to be given within six hours or else there is a risk of permanent loss of blood flow to the testicles. It can also be treated manually. The chances of curing testicular torsion reduce to half within twelve hours of injury.

 

Generally, in case of mild swelling, home treatments can also be effective. Application of ice pack on scrotum can provide relief from swelling. Also taking over the counter medicines for infection may reduce inflammation.  Medicines like ibuprofen or acetaminophen may help.

Wearing supporting athletic briefs and taking rest with elevating the lower body can ease the discomfort to a large extent.  Vigorous exercising should be avoided to prevent scrotum swelling.

 

In case a surgery is performed, it is advisable to not indulge in any strenuous exercise           for at least four weeks. The pain associated generally reduces gradually but pain relieving medications can also be given in case acute pain is experienced. The surgery for scrotal swelling is generally non invasive and does not require the patient to be in the hospital for very long.