Painful or enlarged testicles: causes and treatments

enlarged testicles
Medically reviewed by Dr. Devindra Bhatt

Key Takeaways

  1. Testicles, also known as testes, are a pair of male reproductive organs found in the scrotum, a pouch of skin located below the penis. Swollen testicles are common and can indicate a number of underlying medical conditions.
  2. Underlying causes vary from inguinal hernia, trauma, hydrocele, cyst formation, or congenital reasons. It can only be diagnosed and treated by a healthcare professional. 
  3. Seek medical attention as soon as you see the swollen testicle. It will help you get the diagnosis and treatment at the right time.


Swollen testicles can be troublesome, discomforting, and painful. If the underlying cause is serious, arising from bacterial infection or tumor, it will need medications to be treated. Causes can include hydrocele, cyst formation, epididymitis, orchitis, trauma/Injury, or congenital reasons. It sometimes goes away on its own in a few days. In any case, it is important to note that seeking medical help will benefit you in getting the correct diagnosis and treatment at the right time to avoid any medical consequences later on.

What are swollen testicles?

Swollen testicles, also called scrotal swelling/Inflammation, are a medical condition that needs to be addressed by the healthcare provider. It is comprised of inflammation, swelling, and lumps on the scrotum (penis), the male reproductive organ.

It is one of the body’s most sensitive parts, where swelling, inflammation, or lumps can be quite discomforting. Self-examination is always encouraged for these parts of the body, and medical consultation is crucial to avoid any serious medical consequences later on.

Swollen testicles can be a painful and embarrassing condition. Try seeking immediate online consultation from a qualified professional.

What would cause a testicle to enlarge?

There are a number of reasons for a testicle to enlarge or become swollen. Changes like swelling or lumps formation can directly affect the male’s fertility health along with the frequency of sexual activity. 

The following are the causes of testicles becoming enlarged, swollen, or lump formation. 

1. Hydrocele

Pronounced as Hy-dro-sal, it is one of the less common causes of swollen testicles in adults. Hydrocele is the accumulation of fluid in the sac that surrounds the testicles. It’s mostly observed in newborn infants (specifically in case of premature birth) and is painless. 

It can either be primary (harmless) or secondary (due to an underlying condition). Primary hydrocele usually goes on its own after some time ( days to a few weeks) and does not need medication for the treatment.

In the case of secondary hydrocele, where it persists for a longer period of time, it should be examined properly for the diagnosis as it might indicate tuberculosis.

2. Epididymitis

Epididymitis and Orchitis both occur due to sexually transmitted or bacterial infections already present in your body, affecting the passage/vein ( coiled tube )  in the back of the scrotum that usually stores and carries sperm. 

It can lead to severe pain, discomfort, and swelling for longer periods of time. Infections like chlamydia and gonorrhea can lead to epididymitis and affect a person’s overall fertility. 

Symptoms include swelling (either in one or both testicles) and scrotum pain. It will persist until the underlying condition is not treated. Once you get the treatment medications for the underlying condition, the swelling will go away. 

3. Injury/trauma

Sudden shock, injury, or trauma is among the most common and frequent causes of swollen testicles in teenage boys and adult males. It usually gets noticed after the trauma and can lead to serious medical conditions if left untreated.

4. Cyst formation

Cyst formation in the testicle can be felt and seen in the form of a bulged lump anywhere on the surface of the scrotum. Cysts inside the scrotum can be painful and can also indicate cancerous growth. 
Cancerous cells inside the scrotum can grow and multiply gradually if left untreated and can spread all over the male reproductive area.  Cyst formation can rarely be an indication of tuberculosis bacterial infection and should be diagnosed and treated by a healthcare provider with proper medications, says Dr. Richard Honaker, M.D

5. Inguinal hernia

An inguinal hernia is a medical condition comprised of a hernia present in the inguinal canal of the scrotum. Hernia (cyst-like structure) is formed when the intestinal tissue enters the scrotum’s inguinal canal, leaving testicles in pain. 

It can lead to pain and swelling of the testicles, leading to discomfort. It’s important to understand that medical supervision and diagnosis are crucial if you observe swelling in the testicles. Your healthcare provider can suggest surgery to remove the hernia from the body. Seek medical help immediately from your healthcare provider to get the proper diagnosis of the condition, says Dr. Richard Honaker, M.D.

6. Congenital conditions

Congenital conditions (by birth) can also be one of the causes of swollen testicles. There could be a number of medical conditions that can affect the fertility. It’s important to seek medical consultation to get the right diagnosis.

These are serious conditions requiring medical attention. Seek professional help to escape any complications.

Signs of enlarged testicles

Major signs are:

  • Swelling scrotum 
  • Bruising 
  • Itching and pain 
  • Pain and difficulty in urinating 
  • Burning pee (in case of infection) 
  • Fever

It should be noted that there is a very low probability of swollen testicles in males that do not originate from the underlying medical condition (mostly infection). If you are experiencing swelling or inflammation in your testicles, it should be examined by a healthcare provider for the proper diagnosis and treatment.

What are the treatments for an enlarged testicle?

Treatment of an enlarged testicle depends on the severity and pathology of the swelling.

 If it’s due to a harmless reason, It will be examined by a healthcare provider, and remedies will be suggested for you, including: 

  • Cold compress
  • Avoid tight clothing 
  • Cold compresses. 
  • Avoid the usage of a bandage or any wrap. 
  • Pinch the area for a while in case of bleeding.

What medication is good for swollen testicles?

Over-the-counter pain relief medications (Tylenol – Acetaminophen ) or (Advil-Ibuprofen)  can be helpful for painful ejaculation and irritation due to pain in your testicles. Further medication choice will depend on the underlying condition that leads to painful or swollen testicles. If it’s congenital, it might go away on its own, and no medications will be needed. 

If it’s due to the existing bacterial infection in the body, antibiotics like Ceftriaxone will be the first choice of drug to combat bacterial infection. 

In case of a cyst, hernia, or any other tumor, surgery will be needed by the healthcare professionals as per the diagnosis.

Do not take for granted. Seek professional advice if you have any of the above signs or symptoms.

FAQs about painful or enlarged testicles

What happens if a swollen testicle is left untreated?

If the swollen testicle is left untreated, it can lead to serious medical consequences. In the case of bacterial infections, it might progress more and lead to severe infections. Pain can also escalate to chronic pain and inflammation.

How long does an enlarged testicle last?

A mildly swollen testicle usually lasts a few days due to a small injury or trauma. If there is a severe underlying medical condition, it can last longer than expected and needs medical attention for complete diagnosis and treatment.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Cass, Alexander S., and Michael Luxenberg. “Testicular injuries.” Urology 37.6 (1991): 528-530.
  • Reisman, E. Michael, et al. “Brucella orchitis: a rare cause of testicular enlargement.” The Journal of urology 143.4 (1990): 821-822.
  • Albers, P., et al. “Guidelines on testicular cancer.” Eur Urol 68.6 (2015): 1054-68.
  • Cummings, K. Michael, et al. “What young men know about testicular cancer.” Preventive Medicine 12.2 (1983): 326-330.
  • Sieger, Nadine, Francesca Di Quilio, and Jens-Uwe Stolzenburg. “What is beyond testicular torsion and epididymitis? Rare differential diagnoses of acute scrotal pain in adults: A systematic review.” Annals of medicine and surgery 55 (2020): 265-274.

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