Symptoms and Signs of Swollen (Inflamed) Testicles

Medical Author:
Medically Reviewed on 4/15/2022

Doctor's Notes on Swollen (Inflamed) Testicles

Swollen (inflamed) testicles are symptoms and signs of a potentially serious problem with the male sex organs; usually either due to testicular torsion, trauma to the testicles, or infection. Additional symptoms may include the following depending on the underlying cause:

Trauma and testicular torsion results in sudden pain while infection pain gradually occurs with infection. Trauma (usually blunt) and especially testicular torsion (twisting of the testicle inside the scrotum that can lead to blocking blood flow to the testicle) may require emergency surgery to save the testicle(s). Epididymitis (inflammation of the epididymis) is usually caused by infection.

As stated, causes of swollen testicles are usually due to trauma, testicular torsion, or infection. Less frequent causes include abnormal genitourinary development, prostate enlargement, inguinal hernia, viral orchitis, testicular tumors, hydrocele (fluid filled sac that forms around the testicle), scrotal edema from congestive heart failure or kidney problems, and possibly referred pain from kidney stones.

What Are the Treatments for Swollen Testicles?

The treatments are different for each of the three main causes:

  • Testicular torsion: For example, surgery is required for correction and prevention in the future (untwisting of the spermatic cord and stitching it to the scrotum to prevent further twisting). The procedure for untwisting is time dependent to save the testicle; after 6 hours from the pain onset, survival of the testicle begins to rapidly drop.
  • Testicular infections: most do not require surgery; they are treated with antibiotics for bacterial infections for about 1-2 weeks, including:
    • Doxycycline (most often used)
    • Ciprofloxacin
    • Trimethoprim-sulfamethoxazole
    • Others
    • Trauma to the testicles: usually surgical repair if a testicle is torn; if a testicle cannot be repaired, the testicle is surgically removed

If you are unsure about your testicular problem, see an emergency medicine doctor to help to get a diagnosis (See a doctor before 6 hours of pain occurs if testicular torsion is suspected).

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.