Testicular swelling - causes and therapy

Swollen testicles

Testicular swelling is not an independent disease, but a symptom that can have various causes. It is important to diagnose the responsible urological underlying disease promptly. Sufferers should therefore consult with a testicular swelling necessarily a doctor. Diseases associated with swelling of the testicles are testicular torsion, epididymal inflammation, hydrocele, testicular trauma, testicular tumor or testicular inflammation.

contents

• Swollen testicles
• definition
• causes
• Summary

definition

A testicular swelling is caused by a fluid accumulation in the area of ​​the testicles or epididymis, which affects one or both testes simultaneously. The latter are enlarged, which can be accompanied by pain, but can also be painless. The skin of the scrotum is usually tense, possibly red and hot.

Swollen testicles can be associated with serious illness and should be organized as soon as possible. (Image: GordonGrand / fotolia.com)

causes

Testicular swelling may be due to various urological causes. In order to find out, it is urgently necessary to go to a urologist.

Twisted testes (testicular torsion)
A testicular torsion, also called testicular torsion, is a urological emergency: testicles and spermatic cord rotate around their own axis. This creates a highly acute clinical picture, with the rotation of the blood supply to the testis is partially or completely pinched off. The blood builds up in the veins - the testes are swollen, red and extremely sensitive to pressure. In addition, there are sudden, massive testicular pains that radiate into the lower abdomen, as well as nausea and vomiting. In the worst case, the testes may die due to insufficient blood supply. If a testicular torsion is suspected, the patient must go to a clinic as soon as possible. In case of a diagnosed testicular torsion, the affected person must be operated at the latest four to six hours after the onset of the first symptoms. The faster an operation, the sooner the testicle can be saved.

This disease mainly occurs in infants, toddlers and adolescents and young men until the end of puberty. Testicular torsion is possible later, but the likelihood decreases with age.

Epididymitis (epididymitis)
The epididymis lies on the back of the testicle. There the seeds are stored. An epididymitis is usually one-sided. This causes intense pain that radiate into the inguinal canal, fever and general malaise. This is accompanied by a testicular swelling and redness. The disease is usually preceded by symptoms reminiscent of a urinary tract infection: urinary urgency with frequent emptying of the bladder and burning on urination. If chills are added, there is a suspicion of abscess formation.

The epididymitis can develop from a urinary tract infection. But also pathogens of a sexually transmitted disease, such as chlamydia or gonococci, can lead to it. The non-bacterial form may be caused by viruses, fungi or parasites. Another possible cause is an already existing urinary drainage disorder, as is the case, for example, with a prostate enlargement or a urethral narrowing.

In the case of epididymitis the way to the doctor is unavoidable. The patient needs bed rest, cooling and elevation of the scrotum, anti-inflammatory drugs and possibly antibiotics. If the pain is severe, prolonged local anesthesia of the spermatic cord can help. An epididymitis must necessarily be completely cured, as there is a risk of chronicity and associated fertility disorder.

In a hydrocele fluid accumulates in the scrotum, which is accompanied by a significant swelling. (Image: joshya / fotolia.com)

hydrocele
A hydrocele is also called a water break. This results in a usually painless testicular swelling, which can occur for no reason or as a result of testicular disease, such as testicular torsion. If the hydrocele is very large, there is a feeling of pressure and tension.

Before or soon after birth, the testes migrate from the abdominal cavity into the scrotum. This leaves a small gap in the peritoneum, which usually closes until the end of the first year of life. If this does not happen, fluid can accumulate in this gap and create a hydrocele. This can occur both on one side and on both sides and usually forms spontaneously back again. If the gap is not closed, there is a risk of inguinal hernia.
Other possible causes of hydrocele are testicular inflammation, epididymitis or trauma. A water break is actually harmless, but if it persists, it should be operated on.

testicular trauma
Testicular traumas are usually caused by blunt force, in connection with fighting, kicks, sports injuries or traffic accidents. In addition to massive pain is also often a testicular swelling noted. A testicular trauma can lead to a rupture of the testicular sheaths. This causes massive hematomas (bruises). Often an operation is necessary here.
Testicular cancer is also a possible cause of swelling in the testes area. However, the chances of a successful treatment are relatively good these days. (Image: joshya / fotolia.com)

Malignant testicular tumors
Testicular tumors can be good or malignant, although the benign ones are very rare. The most striking symptom of a testicular tumor is a painless testicular swelling. When you touch a hardening on. Those affected also report heaviness and pain, blood in the sperm or swelling of the mammary glands (by the hormone change). All this may indicate a malignant testicular tumor. For testicular cancer, however, the chances of recovery are now very good. The earlier the treatment is started, the better the chances of success. If a testicular tumor is suspected, a doctor should be consulted promptly.

Hodenentzündung
An inflammation of the testicles, known in the jargon as orchitis, usually has a viral cause. Bacteria as triggers are possible, but are less common. Also, an orchitis may be traumatized, e.g. in the context of an accident.

In the case of viral diseases, such as mumps, glandular fever, chickenpox, syphilis and even malaria, testicular inflammation may be a concomitant disease. The bacterial form develops from urethral or prostate inflammation.

The affected suffer from a testicular swelling, hypersensitivity of the testicles, severe redness of the scrotum (scrotum), a strong feeling of illness and high fever. The disease requires bed rest, high storage and cooling of the testicles. In addition, the patients get pain-relieving and anti-inflammatory drugs. Bacterial infestation requires antibiotics. Frequently, an epididymitis occurs simultaneously with the testicle inflammation.

Since the orchitis can lead to a fertility disorder, vaccination against mumps should be considered in small boys. This is usually done with the combination vaccine measles mumps rubella.

Summary

In summary, testicular swelling, even without pain and with no other concomitant symptoms, needs to be clarified as quickly as possible to a urologist. Eventually, the disease can become chronic, lead to a fertility disorder or in the worst case a malignant tumor can be overlooked. (Sw)