Non-cancerous testicle problems FAQs

Epididymitis, Hydrocele, Torsion and Varicocele are not a folk group, they're the more common non-cancerous testicle problems.

Epididymitis

What is it?

An inflammation of the epididymis, the tube that transports sperm from the testicle towards the penis. If the swelling affects the testicle as well as the epididymis, the condition is known as epididymo-orchitis.

What are the main symptoms?
  • Severe pain in the scrotum
  • A swollen area that may feel hot to the touch
  • Fever
What's the risk?

It's unusual, although it's more common in childhood and has a peak occurrence in adolescence. 

What causes it?

In adults the condition may follow a viral or bacterial infection. Bacteria can sometimes find their way to the epididymis as a consequence of infection with the common bacteria that cause urinary infections or by other organisms such as those of chlamydia or gonorrhoea. Epididymitis can sometimes follow a vasectomy.

How can I prevent it?

The risk of epididymitis being caused as a result of a sexually transmitted infection (STI) can be reduced by always practising safer sex (i.e. using a condom during intercourse) and having regular check-ups for STIs at a GUM (genito-urinary medicine) clinic.

Should I see a doctor?

Yes. A urine test can diagnose the condition. Your doctor will make the diagnosis and exclude other potentially important conditions.

What are the main treatments?

Antibiotics (if it's a bacterial infection). You may also be advised to rest in bed, take painkillers (e.g. paracetemol or ibuprofen), and even apply an ice-pack to the scrotum. 

How can I help myself?

Follow your doctor's orders and be patient — epididymitis can take several months to clear up completely. 

What's the outlook?

Good, although sometimes the scrotum remains somewhat enlarged. 

 


Hydrocele

What is it?

A swelling in the scrotum, caused by a harmless build-up of fluid within the sacs surrounding the testicles.

What are the main symptoms?

A soft and usually painless swelling of the scrotum. Sometimes the swelling can be as large as a grapefruit. 

What's the risk?

Low. 

What causes it?

A build-up of fluid in the scrotum, sometimes caused by an injury to the testicles or following infection or inflammation. 

How can I prevent it?

It's not easy to prevent, except by protecting the testicles during sport or potentially risky work. 

Should I see a doctor?

Yes. It's important to rule out any more serious conditions.

The doctor will examine the testicles. He or she may also shine a light through the scrotum — if the light passes through, it's probably a hydrocele.

What are the main treatments?

Usually none, unless the swelling has become very large or uncomfortable. Hydroceles can be drained using a syringe or, more commonly, surgery is used to remove the whole hydrocele. For men with small hydroceles and no symptoms it is usually wiser to leave well alone.

How can I help myself?

There's not much you can do. 

What's the outlook?

Most serious cases can be permanently treated. 

 


Torsion

What is it?

Each testicle is suspended within the scrotum by the spermatic cord. This can become twisted, cutting off the blood supply to a testicle.

What are the main symptoms?
  • Sudden, very severe pain in a testicle
  • Swelling
  • Nausea and vomiting
  • Fever 
What's the risk?

Low. It's most common in teenage boys. 

What causes it?

Many cases have no known or obvious cause, although it can be linked to physical activity. Some men, who have naturally more mobile testicles, are at higher risk. 

How can I prevent it?

You can't. 

Should I see a doctor?

Definitely. In fact, torsion is a medical emergency — aside from the pain, if the spermatic cord is twisted for more than a few hours a testicle can die due a lack of blood supply, and will then have to be removed. 

What are the main treatments?

An operation to untwist the cord. 

How can I help myself?

There's not much you can do. 

What's the outlook?

Good, if treatment is carried out promptly. 

Who else can help?

Don't waste time trying to find out — you need to see a doctor as soon as possible. 

 


Varicocele

What is it?

Essentially a varicose vein within the testicle.

What are the main symptoms?
  • Varicoceles are often painless and almost always located on the left testicle.
  • There can be a swelling that is often described as feeling like a warm tangle of worms. This is usually more noticeable when you stand up.
  • There may be a "dragging feeling" in the testicle.
  • Fertility problems. It's thought that the accumulation of blood overheats the testicle and affects sperm production, although not all men with a varicocele are infertile. 
What's the risk?

Approximately 10—15% of men develop a varicocele. 

What causes it?

A damaged valve in the vein draining blood from the testicle. 

How can I prevent it?

You can't.

Should I see a doctor?

Yes. It's important to rule out any more serious conditions.

Varicoceles can usually be diagnosed through manual examination. A doctor may also shine a light through the testicle — a varicocele will block out the light. Small varicoceles can sometimes be diagnosed by ultrasound. 

What are the main treatments?

Usually none, although if you're uncomfortable you may be advised to wear supportive underwear.

If you have a fertility problem, however, it is possible to tackle the varicocele with a variety of surgical techniques. One increasingly used method is known as embolisation: small tungsten coils are inserted to block the veins leading to the varicocele.

How can I help myself?

There's not much you can do. 

What's the outlook?

Good, but varicoceles can sometimes recur. The treatment of varicoceles can result in a significant increase in fertility: improvements in semen quality occur in 50—90% of men.

 

We don't currently post comments online but are always keen to hear your feedback.

Last published 02/04/14
Date of last review 02/04/14
Date of next review 02/04/17

References