Epididymitis, which is inﬂammation of the epididymis, can be caused by an infection. The condition may produce severe pain in the scrotum, fever, and a swollen area that may feel hot when touched. The doctor examines the testicle and tests a urine sample. He or she will prescribe antibiotics if the infection is bacterial. Additional treatment includes bed rest, over-the-counter painkillers, an ice pack applied to the scrotum, and a scrotal supporter if the infection is not bacterial. The condition usually does not cause permanent damage.
Orchitis, inﬂammation of the testicle, is a rare condition that is usually caused by mumps, or sometimes by an infection in the prostate gland or the epididymis. Symptoms include pain in the scrotum, swelling that usually occurs on only one side of the scrotum, and a feeling of “heaviness” in the scrotum. Diagnosis and treatment are the same as for epididymitis—the doctor performs a manual exam- ination of the testicle and tests a urine sample. He or she will prescribe anti- biotics for a bacterial infection or bed rest and pain relievers for a viral infection. Orchitis may cause permanent damage to one or both testicles and may lead to infertility.
Abnormal Fluid Accumulations
The sufﬁx “-cele” refers to a swelling or noncancerous tumor within a body cavity. Sometimes ﬂuids build up in the scrotum. For example, a hydrocele is a collection of watery ﬂuid in the membrane covering the testicles. A hematocele is a collection of blood that may result after injury to or rupture of a testicle. A spermatocele is a cyst full of sperm that develops next to the epididymis. A varicocele is a mass of varicoselike veins caused by a malfunction of the valves within the veins of the spermatic cord. It has been described as feeling like a “bag of worms.” Most often it causes a dull pain or a feeling of heaviness, usu- ally on the left side of the scrotum.
Diagnosis of these conditions can be a simple matter. The doctor may use a special ﬂashlight to shine light through the scrotum. If the light shines through the scrotum, it indicates a possible hydrocele. If light does not pass through the scrotum, it indicates a possible hematocele. A spermatocele lights up under a ﬂashlight in a darkened room. The varicocele usually will not allow light from a ﬂashlight to pass through the scrotum. Diagnosis is conﬁrmed by manual exam- ination or by an ultrasound examination of the scrotum.
These conditions are seldom serious or permanent and may even be painless. But if they continue to enlarge, they become very uncomfortable and may affect fertility. At this point, surgical removal is recommended.