Only in rare cases the testicular "swelling" is due to cancerous conditions; according to various scientific studies, in fact, only 4 cases of swollen testicles out of 100 are the expression of testicular cancer.
The conditions that can most commonly involve testicular swelling are: varicocele, testicular torsion, hydrocele, inguinal hernia, epididymal cyst, epididymitis, orchitis and hematocele.
Being appreciable on palpation, for a definitive diagnosis of testicular swelling, even an accurate physical examination may suffice.
Therapy varies from case to case, depending on what caused the swelling.
Brief reminder of the "male genital system
The male genital system is mainly composed of the following parts:
- Testicles or didymes. They are the male gonads, that is, the main reproductive organs of the male. Contained in the scrotum (or scrotal sac), they are two in number and have the task of producing millions of spermatozoa, or male reproductive cells; they also produce male sex hormones (testosterone), which are fundamental in the development of primary and secondary sexual characteristics and in the control of the genital apparatus.
- Seminal vesicles and prostate. The seminal vesicles are two and produce a viscous liquid similar to seminal fluid. The prostate, on the other hand, is the gland that produces and emits the actual seminal fluid, an essential fluid for nourishing the spermatozoa and constituting, together with the latter, the sperm.
- Epididymus and vas deferens. They are the two small channels that connect a testicle, first, to the seminal vesicles and, then, to the prostate. The spermatozoa flow through the epididymis and the vas deferens of the two testicles, destined to mix with the seminal fluid to form the sperm.
- Urethra. It is a small channel that runs throughout the penis, through which urine and seminal fluid (or sperm, if there are spermatozoa in the seminal fluid) are expelled. The emission of seminal fluid is called ejaculation. To check that urine and seminal fluid do not mix with each other, there is a kind of muscle valve.
- Penis. It is the male reproductive organ and the last tract of the urinary tract. Thanks to its particular anatomical structure, it allows the passage of sperm from man to woman.
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The intent of this article is to clarify the most common conditions that arise at the origin of a swollen teticle.
Readers who are also interested in testicular cancer are advised to consult the article dedicated to this topic, available on the following page.
- Varicocele
- Hydrocele
- Cyst of the epididymis
- Inguinal hernia
- Hematocele
- Epididymitis and / or orchitis
- Testicular torsion
VARICOCELE
Possible Causes of Swollen Testicle: From healthtap.com
Varicocele is the pathological dilation of the testicular (or spermatic) veins, which have the task of draining blood from the testicle. The precise causes of this dilation are currently still unclear; in this regard, the experts have formulated two hypotheses:
- According to one thesis, the varicocele is due to a malfunction of the valve system present on the inner wall of the veins; under normal conditions this system forces the blood to travel in one "single direction: from the testicle to the heart.
- According to the other thesis, the problem would be the consequence of a circulatory block at the level of the abdominal venous vessels. This block would prevent the blood from flowing out of the spermatic veins, which dilate accordingly.
Varicocele is a condition that you can usually live with and that only in very rare cases requires specific treatment.
Epidemiology. Varicocele is a fairly common problem: it affects one in seven men. The most affected subjects are, generally, individuals aged between 15 and 25 years.
HYDROCELE
Hydrocele is an abnormal accumulation of clear fluid in the scrotum, all around the testicle (s).
In infants, it is due to the non-closure of the duct that joins the abdomen to the scrotum (peritoneo-vaginal duct) and which allows the testicles to descend into the scrotal sac. In fact, the patency of the peritoneo-vaginal duct causes the peritoneal fluid to reach freely in the seat where the testicles are housed.
In adults (usually men around the age of 40), hydrocele can be caused by a variety of causes, including:
- A reopening of the peritoneo-vaginal duct;
- An "inflammation of the testicles, secondary to trauma or infection" (eg tuberculosis or syphilis);
- A testicular tumor (rarely).
Epidemiology. According to some statistical studies, neonatal hydrocele has a frequency equal to one case every 10 births (N.B: according to other researches, it is rarer).Usually, in these situations, the problem resolves itself spontaneously at the end of the first year of life.
CYSTS OF THE EPIDIDIMUM
Epididymal cysts are small, spherical, extratesticular formations located in the upper portion of the epididymis. Inside them, there is a transparent liquid.
In a healthy individual, the reasons for the appearance of one or more epididymal cysts are unclear.
Epidemiology. The subjects who most commonly develop one or more epididymal cysts are men in their 40s.
INGUINAL HERNIA
A "hernia is the leakage of a bowel or part of it from the cavity that normally contains it (N.B: bowel is a generic term for an internal organ).
An inguinal hernia arises due to a collapse of the muscular wall that holds the viscera of the lower abdomen. The collapse, in fact, leads to the formation of a hole through which part of an internal abdominal organ comes out.
In the case of a swollen testicle from inguinal hernia, visceral leakage occurs in the close vicinity of the scrotum, therefore apparently altering the normal testicular size.
Epidemiology
From some statistical studies, it has emerged that more than 25 men out of 100 suffer, at least once in their life, from inguinal hernia.
Inguinal hernia is typical of middle-aged adults but can also occur in children and the elderly.
HEMATOCELE
A hematocele is an accumulation of blood in the scrotum, all around one of the two testicles. It is due to the loss of blood from some blood vessel, located in the scrotum.
EPIDIDIMITIS AND / OR ORCHITIS
Epididymitis is inflammation of the epididymis (s), while orchitis is inflammation of the testicles (s).
Both can be the result of a "urinary tract infection or a sexually transmitted infectious disease.
Sometimes, epididymitis and orchitis can take place at the same time: in these cases, we speak of epididymitis-orchitis.
Epidemiology. According to various statistical studies, the subjects who most commonly fall ill with epididymitis or orchitis are individuals aged between 15 and 30 years and the elderly (over 60).
TESTICULAR TORSION
Testicular torsion is the medical term used to indicate the rotation, around its axis, of a testicle.
Episodes of testicular torsion represent medical emergencies to be treated as quickly as possible. A delay in treatment, in fact, can have unpleasant consequences: above all, the atrophy of the testicle.
Epidemiology. Testicular torsion can occur at any age, however it is particularly common among infants and adolescents.
The annual incidence in the US is one case for every 4,000 males.
or nausea.Usually, varicocele, inguinal hernia, hydrocele and epididymal cysts are painless conditions; at most they can cause a slight sense of discomfort and discomfort.
In addition to the swollen testicle, hematocele, epididymitis, orchitis and testicular torsion instead cause additional signs and symptoms.
- Hematocele. The testicle is swollen, painful and red.
- Testicular torsion. The swollen testicle is also very painful. The pain, which generally arises suddenly, can sometimes extend to the abdominal level.
Additionally, testicular torsion can cause nausea, vomiting, mild fever, and a frequent need to urinate. - Epididymitis and orchitis. The swollen testicle (s) are particularly painful and red. In addition, in most cases, patients also experience pain when urinating, fever and general malaise, and emit a foul-smelling liquid from the penis.
WHEN TO SEE THE DOCTOR?
Anyone who notices a swollen testicle (or a parent who notices their child's testicle swelling) should contact their doctor immediately for further information.
For precautionary reasons, timeliness is particularly important; if, in fact, the swelling was linked to a serious condition, a late diagnosis could be at the origin of unpleasant consequences.
SURVEY
Typically, for patients with a swollen testicle, doctors ask the following questions:
- Do you feel pain? If so, where, for how long and what is the intensity of the sensation?
- Do you suffer from other ailments, such as pain when urinating, foul-smelling fluid from the penis, general malaise and / or fever?
- Have you recently suffered trauma to the scrotum or groin?
OBJECTIVE EXAMINATION
During the physical examination, the doctor will:
- Analyze the size of the testicles.
- Assess the location of the testicular bulge.
- Touch the swollen testicle and the exact spot where the swelling resides to see if the patient feels pain or not.
- Assess whether the swollen area has a hard or soft texture.
In most cases, for conditions such as varicocele, inguinal hernia, neonatal hydrocele, and epididymal cyst, the physical examination is more than exhaustive.
ULTRASOUND
Ultrasound is a sufficiently comprehensive and completely harmless diagnostic imaging test.
For its realization, an ultrasound probe is required, which, resting on the patient's skin, projects the internal organs and tissues present in the area under consideration onto a monitor.
In the case of a swollen testicle, the scrotal ultrasound (scrotal ultrasound) is very useful because, in addition to specifying the size of the swelling, it also clarifies its exact internal composition. In this regard, it should be noted that the exclusive presence of liquid could be due to a hydrocele or a cyst of the epididymis, while the presence of an abnormal solid content could be linked to a testicular tumor.
The most severe cases of varicocele, for which there is a real risk of testicular atrophy and infertility, may require surgery.
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