Swollen Scrotum Without Pain: Should I Be Concerned?

A swollen scrotum that is not painful may not necessarily be due to excessive blood flow?

Hello Doctor: In early July of this year, while taking a shower, I noticed that the blood vessels on the left side of my scrotum were swollen.
I'm not sure what it is, but after looking online, I suspect it might be a varicocele.
I'm currently in puberty, and I wonder if this is due to increased blood flow.
I don't feel any pain or notice any shrinkage of the testicles; it just feels a bit swollen when I touch the blood vessels.
I'm unsure whether I should go to the hospital for an examination, especially since there is no pain or shrinkage.
Should I see a urologist? I'm just starting my first year of high school and I'm 15 years old.

Youyou, 10~19 year old female. Ask Date: 2015/08/24

Dr. Li Yilun reply Urology

Varicocele is characterized by abnormal twisting and swelling of the testicular veins (i.e., the spermatic veins) within the spermatic cord in males, commonly occurring around puberty.
Approximately 10% of young males have varicocele, while about 30% of males with infertility have this condition.
Varicocele occurs in 90% of cases on the left side, 10% bilaterally, and is rarely isolated to the right side.

Symptoms: Patients may be asymptomatic and discover the condition incidentally during a physical examination.
The affected side of the scrotum may exhibit swollen, twisted veins resembling "a bag of worms." Some patients may experience a sensation of fullness, heaviness, or aching in the testicle or groin; symptoms may worsen with prolonged standing or straining and may improve or resolve when lying down.
In severe cases, varicocele can lead to testicular atrophy.
Studies have indicated that men with varicocele may have lower testosterone levels, which could indirectly contribute to erectile dysfunction.

Varicocele can impact male fertility.
If a couple has been married for a year and has not achieved pregnancy despite not using contraception, the male should undergo a semen analysis and evaluation for varicocele.
In the absence of significant symptoms, observation is recommended, along with advice to avoid tight-fitting underwear.
However, since the condition varies among patients, it is essential to consult a healthcare professional for a thorough assessment, including medical history, physical examination, and diagnostic tests to confirm the diagnosis and determine the appropriate treatment.
If symptoms are present, it is advisable to seek evaluation from a urologist.

Reply Date: 2015/08/24

More Info

Swollen scrotum without pain can be concerning, but it is important to understand the potential causes and when to seek medical attention. In your case, noticing swollen blood vessels in the left side of your scrotum could indeed suggest a condition known as a varicocele, which is an enlargement of the veins within the scrotum. Varicoceles are relatively common, especially in adolescent males, and they can occur due to the increased blood flow during puberty.
While varicoceles are often asymptomatic, meaning they do not cause pain or discomfort, they can sometimes lead to complications such as infertility or testicular atrophy (shrinkage). However, the absence of pain and the fact that you have not experienced any other symptoms, such as testicular shrinkage or significant discomfort, are positive signs.
It is also worth noting that other conditions can cause swelling in the scrotum, such as hydrocele (fluid accumulation around the testicle), epididymitis (inflammation of the epididymis), or even hernias. Each of these conditions has its own set of characteristics and potential complications.
Given your age and the changes your body is going through during puberty, it is not uncommon to experience variations in the size and appearance of the scrotum and its contents. However, it is always best to err on the side of caution when it comes to health concerns. Here are some recommendations:
1. Monitor the Symptoms: Keep an eye on the swelling. If it changes in size, becomes painful, or if you notice any other symptoms such as redness, warmth, or changes in urination, it would be wise to seek medical attention.

2. Consult a Healthcare Professional: Even if you are not experiencing pain, it is advisable to consult a healthcare provider, particularly a urologist. They can perform a physical examination and may recommend an ultrasound to assess the blood vessels and rule out any other conditions.

3. Discuss Your Concerns: When you visit the doctor, be open about your concerns and any changes you have noticed. This will help them provide you with the best possible care.

4. Educate Yourself: Understanding your body and the changes it undergoes during puberty can help alleviate some anxiety. Many young men experience similar issues, and knowledge can empower you to make informed decisions about your health.

In summary, while a swollen scrotum without pain may not be an immediate cause for alarm, it is essential to monitor the situation and consult a healthcare professional for a thorough evaluation. Early diagnosis and treatment can prevent potential complications and provide peace of mind. Remember, taking care of your health is important, and seeking help when needed is a sign of strength.

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