The scrotum is a skin envelope in which the testicles are located. Testicles are a very sensitive body organ; therefore, you may feel pain or swelling in this area occasionally. If this ever happens to you, make an appointment with a specialist, as the origin of the pain can vary. It could be a swollen testicle, an abdominal problem, a hernia or cancer. If you’re experiencing a feeling of heaviness or severe pain, the professionals at Cliniques Marois can treat you. Our team of urologists and sexual health specialists will provide you with the most effective treatment.

Possible causes

The causes of scrotal swelling are varied. Some are common, while others are more rare.

• Common causes

  One of the most common causes is hydrocele. This condition occurs after a trauma or infection that may have gone unnoticed. Hydrocele is a disorder characterized by an accumulation of fluid between the layers of tissue around the testicles. In the case of hydrocele, the swelling is very pronounced.

  An inguinal hernia can also cause swelling. This enlargement of the groin occurs when organs in the abdomen move out of their cavity through an opening between the abdomen and the thigh. The hernia can be caused by overexertion from lifting heavy objects or chronic coughing.

  Another common cause of large testicles is varicocele. This is an enlargement of the veins of the spermatic cord. In the case of varicocele, the blood has difficulty circulating in the swollen testicle, causing a reduction in sperm production.

  A spermatocele can also cause an enlargement of the scrotum. This condition, which is often benign, is characterized by an accumulation of semen above the testicle. Spermatocele doesn’t cause pain, but it does cause discomfort.

  Enlargement may also be caused by local trauma or groin trauma. Testicular trauma tends to cause an increase in the size of the testicles. A blow to the testicles, a contusion or a scrotal hematoma can cause testicular trauma.

• Less frequent causes

  Among the less common causes is hematocele. This medical term refers to an accumulation of blood in the testicle. Hematocele is the result of bleeding caused by burst blood vessels. It can occur after surgery or traumatic injury. In some men, hematocele is a sign associated with testicular cancer. In this case, the tumour has grown to the point where it has corrupted the integrity of the scrotal vascular network.

  Testicular cancer is one of the least common causes of enlarged testicles. Although this disease isn’t widespread, it’s one of those that must be eliminated urgently. Testicular cancer is the most common cancer affecting men under the age of 30. It’s manifested by the presence of a mass on the testicle. Today, this cancer has an excellent prognosis, with the affected child or adult healing in more than 95 per cent of cases.

  Finally, testicular torsion is among the less common causes of swollen testicles. Torsion occurs when a testicle rotates to the point of twisting. In this case, the blood flow to the testicle is blocked, causing severe pain, fever and vomiting. In the event of torsion, the patient must be taken care of very quickly. Otherwise, the patient may lose his testicle. While testicular torsion is rare in adults, it’s common in children and adolescents.

When to consult?

If you experience enlarged testicles or severe testicular pain, consider making an appointment. If it’s a painless swelling that suddenly becomes painful, the appointment should be made within 6 hours. This is because the pain may be due to an inguinal hernia whose blood supply has been stopped. During the visit to the doctor, they’ll begin by asking you questions about the symptoms you’re experiencing. This information will help the doctor learn more about your medical history. It will also help them focus the clinical examination to understand the cause of the swelling.

Before the clinical examination, the doctor will ask you when the first signs of enlargement appeared. They’ll then ask if the pain is more or less severe when standing or lying down. Usually, doctors also want to know if you have edema related to heart failure or a liver problem. These diseases can also cause the enlargement of the testicle.

Possible examinations

To detect swelling, the specialist has the choice of different examinations. The first of these is a palpation of the man’s testicles. During the palpation, you stand and then lie down. During this time, each testicle is felt. This examination is used to detect the location of the mass and its sensitivity. Finally, the doctor may place a bright light near the scrotum during the examination to detect fluid accumulation.

Before making a diagnosis, the doctor performs another examination, a scrotal ultrasound. This examination allows the contents of the testicles to be visualized. The scrotum contains the testicles, the epididymis and a specific fluid. The testicles produce sperm and testosterone. The epididymis is a long duct attached to the surface of the testicle to transport sperm. The fluid bathes the testicles and the epididymis.

Scrotal ultrasound: The examination takes less than half an hour. To perform it, you lie on your back and gel is applied to your testicle. The urologist then places a probe on the skin to get a clear view of the testicle. The image is immediately visible on a screen. This examination isn’t painful. It’s recommended when the urologist is looking for trauma in the patient. The doctor may also decide to perform it if the testicle is swollen, if they detect a suspicious mass or if you complain of pain.

The treatments

Whatever the cause of the enlargement, Les Cliniques Marois can find the most appropriate solution.

• A cure for hydrocele

  If there is a problem, the urologist performs a hydrocele cure. This technique consists of an incision of the testicle. This opening helps drain fluid and excision a part of the envelope. The second phase consists of taking the necessary steps to avoid a recurrence.

  During a hydrocele cure, a drain is placed for about a week. Apart from surgery, there’s no other solution to treat a hydrocele. However, it’s possible to opt for a temporary solution to improve the patient’s comfort, i.e. treatment by puncture. On the other hand, having surgery can lead to complications. These include the formation of a hematoma, delayed healing, infection or testicular atrophy.

• A treatment for varicocele

  If the patient has a varicocele, there are several options. When the varicocele isn’t significantly developed, abstaining from treatment is preferable. If the varicocele causes fertility problems, it’s strongly recommended to treat it. For this, the surgeon proceeds to obstruct the spermatic vein, which is dilated.

  The operation is performed under local anesthesia. A catheter is introduced into the femoral artery. The catheter must reach the dilated vein to inject a substance that will permanently block the duct. A urologist may also proceed to ligate the varicose vein. If varicocele cannot be prevented, surgery can improve sperm quality.

• A cure for spermatocele

  A scrotal ultrasound may reveal that the patient has a spermatocele. Generally, spermatoceles aren’t bothersome or symptomatic. However, if it becomes too large, uncomfortable or unsightly, it’s best to opt for a spermatocele cure.

  At the Marois Clinics, the spermatocele cure is performed under local anesthesia. The procedure begins with an incision to free the epididymis. After a spermatocele cure, you must remain at complete rest. It’s only after a few days that you can start walking again. You should also wear tight-fitting underwear day and night and not engage in activities that may cause pain. As for sexual activity, you can only resume it after two weeks.

• Surgery after testicular torsion

  In the case of testicular torsion, the best solution is surgery. For this, a three-step operation is performed. The first step is to open the scrotum to untwist the swollen testicle and restore its blood supply. Once the testicle is back in place, the surgeon warms it up and checks that it’s still viable.

  The second step is to avoid the risk of recurrence. To achieve this, the surgeon fixes the affected testicle to the scrotum with thread. For safety reasons, the second testicle is also attached to the testicle. If the fixation is permanent, you will not feel any discomfort. After the operation, the operated testicle may atrophy. In this case, regular medical follow-up is required.

• Analgesic infiltration

  Another treatment option is analgesic infiltration. This technique involves applying a long-lasting, non-adrenalized local anesthetic to the cord. An infiltration is effective in reducing spontaneous scrotal pain and pain on palpation.

  This operation is suitable for men suffering from chronic or persistent scrotal pain that’s difficult to relieve with medical treatments. The analgesic infiltration is done under local anesthesia. A liquid is injected under the skin at high pressure so you don’t feel the pain. The analgesic infiltration is done under ultrasound guidance and lasts only 10 minutes.

• Removal of the swollen testicle

  In the case of cancer, one of the first treatments is the removal of the swollen testicle. To do this, the surgeon administers a general or spinal anesthetic before making an incision in the groin. Through this opening, he removes the testicle and the spermatic cord.

  In some cases, the surgeon may remove both testicles. A removal takes an average of half an hour, and you can go home the same day. If desired, after the removal of the testicle, the surgeon can place a prosthesis. This prosthesis has the same weight and shape as a normal testicle.

• The scrotal support

  Another solution for pain or enlargement is to wear underwear that provides excellent support. A scrotal support is an undergarment for men that is similar to a brief and provides support for the genitals.

  Most often worn by athletes during physical activities, the scrotal support is also recommended for those who suffer from painful inflammation of the testicles. It can also be used in case of hydrocele or ectopia. This undergarment consists of adjustable under-thighs and an elastic waistband. In addition to scrotal support, consulting a specialist can provide advice that can help you minimize or prevent the pain.

Conclusion

If you’re experiencing testicular or scrotal pain, make an appointment with one of our specialists. At Cliniques Marois, you’ll be examined by urologists with years of experience in the field. These professionals also have state-of-the-art equipment. Therefore, the examinations let them know precisely what ailment you’re suffering from.

Once the disease has been identified, you’ll receive the most appropriate treatment. At Cliniques Marois, you deal with professionals who care about your well-being. Whatever the problem you have, don’t hesitate to contact us so that you can get back to normal and no longer have pain in your testicles.