Testicle Swelling

WHEN TO SEE YOUR DOCTOR

* A lump or protrusion can be felt on the otherwise smooth, even surface of a testicle.

* Your testicles and scrotum look or feel swollen or larger than they normally do.

What Your Symptom Is Telling You

Your average, healthy, run-of-the-mill testicle feels like a small, peeled hard-boiled egg—same shape, same texture, same firmness. But even with "swelling" the testicle itself may not change, because the most common form of swelling happens not to the testicle but to the sac that surrounds it, says E. Douglas Whitehead, M.D., a urologist, co-director of the Association for Male Sexual Dysfunction in New York City and an associate clinical professor of urology at Mount Sinai School of Medicine of the City University of New York. For reasons doctors don't understand, the sac can simply and painlessly fill up with fluid, causing a swelling that's called hydrocele.

Sometimes the veins in the scrotum will dilate, causing a swelling that probably won't even be recognized. The medical term for the condition is varicocele. "Most guys don't notice varicoceles," Dr. Whitehead says, "but it looks sort of like varicose veins." If you have a varicocele, you also may feel a sort of heaviness or dragging sensation in the scrotum.

Scrotal swelling also can result from an infection, although the swelling produced from the bacterial invasion probably will be painful. Any lump that appears on the testicle could be epididymitis, but it must, of course, be checked for cancer. Epididymitis is an infection of the epididymis—the coiled tubes that lie behind the testicles and serve to store and transport sperm cells.

Symptom Relief

Only surgery, if even necessary, can cure the various causes of testicular or scrotal swelling. For hydrocele, some doctors will drain the fluid, but most urologists will recommend surgery to alleviate the problem. Varicocele won't interfere with a normal sex life, but it may affect your ability to have children. "Most men don't need treatment for it," Dr. Whitehead says. "Only if there are fertility problems or testicular discomfort may surgery be needed."

But your testicular health isn't entirely in the urologist's hands. There is one crucial thing you can do.

Pass the testicle test. Beginning at 13 or 14 years old, males should examine their testicles at least once a month. It will help identify hydrocele or varicocele, but most important, "it's key for the earliest detection of testicular cancer," Dr. Whitehead says.

Only 2 out of 100,000 men will get cancer of the testicles, which manifests itself first as a small lump or hardened area. While without a doubt rare, it still ranks as the number one cancer in males between the ages of 15 and 35. The good news is that it's curable—if detected early enough. Survival rates, in fact, are close to 100 percent.

Perform the exam in the shower, when the scrotum is more supple and relaxed. Roll each testicle between the thumb and the first three fingers of your hand, feeling for any lumps, hardness or other irregularity, Dr. Whitehead says. Except for the epididymis, you should feel only the smooth surface of the testicles. Also be sure to note any pain or sensation of heaviness, he says.

See also Testicle Pain