There are many different “nonacute” scrotal conditions in men.
Normal anatomy of the scrotum:
- There are many structures that may be involved in nonacute scrotal conditions:
- Testis
- Tunica vaginalis
- Epididymis
- Spermatic cord and vas deferens
- Testis (testicle):
- Produces sperm and testosterone
- Tunica vaginalis:
- A fascial layer that surrounds the testicle
- Fluid may accumulate here, causing swelling
- Epididymis:
- Storage and transportation of sperm
- Vas deferens:
- Carries sperm from the epididymis out of the body
Scrotal swelling:
- Your doctor will perform a physical exam to determine the cause of your scrotal swelling:
- Swelling around the spermatic cord, feeling like a “bag of worms” may represent a varicocele, or dilated veins to the testicle
- Unilateral or bilateral swelling around the testicle which feels very uniform is suggestive of a hydrocele
- Swelling above or behind the testicle, which arises from the epididymis, is likely a spermatocele or epididymal cyst
- Your doctor may order a scrotal ultrasound to try and determine the cause of the swelling
Testicular pain may be caused by many different conditions. Your family physician will complete the initial work-up for your testicular pain. Patients with chronic pain that does not improve may be referred to urology.
Some of the common causes include:
- Infection
- Tumor
- Groin hernia – either a present hernia or one that has been repaired
- Torsion of the testicle
- Trauma
- Pelvic floor muscle tension
- Tendonitis
- Referred pain
Conservative treatments for chronic testicular pain:
- Heat
- Ice
- Scrotal support (tight boxers/briefs)
- Analgesia (Tylenol or Advil as necessary)
- Physiotherapy for back or pelvic floor tension
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