Scrotal Swelling: Causes, Concerns, and Cancer Risks - Urology

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Hello! Thank you for reaching out with your concerns regarding scrotal swelling. It’s important to address these symptoms promptly, as they can be indicative of various conditions, some of which may require medical intervention. Let’s break down your questions:
1. What could be the cause of the scrotal swelling?
Scrotal swelling can be caused by several factors. The most common causes include:
- Hydrocele: This is a fluid-filled sac surrounding a testicle, leading to swelling. It is usually painless and can occur due to injury or inflammation.

- Varicocele: This is an enlargement of the veins within the scrotum, often described as feeling like a "bag of worms." It can cause discomfort but is usually not painful.

- Epididymitis: Inflammation of the epididymis, often due to infection, can cause swelling and pain.

- Testicular torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. It usually presents with sudden, severe pain and swelling.

- Hernia: An inguinal hernia can cause swelling in the scrotum if abdominal contents protrude into the scrotal sac.

- Tumors: While less common, tumors of the testicle can also present as swelling.

2. Could this be testicular cancer?
While testicular cancer is a possibility, especially in younger men, it is essential to consider the context. Testicular cancer typically presents as a firm, painless lump in the testicle rather than generalized swelling of the scrotum. However, any new swelling or mass in the scrotum should be evaluated by a healthcare professional.
3. What other symptoms might accompany testicular cancer?
If testicular cancer is present, symptoms may include:
- A lump or swelling in one testicle
- A feeling of heaviness in the scrotum
- Dull ache in the lower abdomen or groin
- Changes in the size or shape of the testicle
- Back pain (in advanced cases)
It’s important to note that many of these symptoms can also be associated with benign conditions.

4. Will surgery affect sexual function?
The impact of surgery on sexual function largely depends on the type of surgery performed and the underlying condition. In cases where a tumor is removed, the surgeon will aim to preserve the surrounding structures, including nerves and blood vessels, to maintain sexual function. However, some men may experience changes in sexual function or fertility after surgery, particularly if one or both testicles are removed (orchiectomy). It’s crucial to discuss these concerns with your surgeon, who can provide tailored advice based on your specific situation.

In conclusion, while scrotal swelling can be caused by various conditions, it is essential to seek medical evaluation to determine the underlying cause. A healthcare provider may perform a physical examination, ultrasound, and possibly blood tests (such as tumor markers) to arrive at a diagnosis. Early detection and treatment are key to managing any potential issues effectively. Please consider scheduling an appointment with a urologist to discuss your symptoms and receive appropriate care. Take care!