Merck Manual

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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

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.