Table: Some Causes and Features of Scrotal Swelling - Merck Manuals Consumer Version

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Some Causes and Features of Scrotal Swelling

Some Causes and Features of Scrotal Swelling

Cause	Common Features*	Tests
Edema (accumulation of excess fluid in the body)	Swelling that Feels spongy Occurs on both sides throughout the scrotum Remains indented after pressure is applied and removed (called pitting edema); also affects the lower extremities Often in men with swelling in the legs and sometimes abdomen In men with disorders that can cause swelling such as heart failure or a severe liver or kidney disorder	A doctor's examination Sometimes ultrasonography
Hematocele (a collection of blood in the scrotum)	Swelling that Is painful and tender Develops after an injury	A doctor's examination Sometimes ultrasonography
Hydrocele (a collection of fluid in the scrotum)	Swelling that Feels soft Does not disappear when lying down Cannot be pushed back into the abdomen	A doctor's examination Sometimes ultrasonography
Inguinal hernia (a hernia in the groin)	Typically in men who have had a painless bulge in the groin for a long time, often in those already known to have a hernia A bulge that Feels soft and balloon-like Often can also be felt above the scrotum Typically enlarges when men are in an upright position or when pressure within the abdomen increases (for example, when bearing down as if having a bowel movement or when doing heavy lifting) Sometimes disappears when lying down Can sometimes be pushed back into the abdomen Sometimes pain that begins gradually or suddenly, typically when the bulge cannot be pushed back into the abdomen	Only a doctor's examination
Lymphedema (accumulation of lymph fluid)—for example, due to a tropical worm infection called filariasis or present from birth	Rubbery swelling throughout the scrotum No indentations when the area is pressed	A doctor's examination Sometimes ultrasonography
Spermatocele (a cyst in the epididymis)	A lump near the top of the testis	A doctor's examination Sometimes ultrasonography
Testicular cancer	A hard lump attached to or in the testis Possibly dull, aching pain or, if the cancer bleeds, sudden sharp pain	Ultrasonography Blood tests Sometimes CT of the abdomen, pelvis, and chest
Varicocele (widening of the veins that carry blood from a testis)	Swelling that Feels like a bag of worms Usually occurs on the left side Possibly pain and a feeling of fullness when standing Possibly a shrunken testis (testicular atrophy)	Only a doctor's examination
*Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.
CT = computed tomography.