Symptoms · Scrotum
Swelling or pain in the scrotum
The short answer
Sudden, severe pain in one testicle, especially in a teenager or young man, can be a twisted testicle (testicular torsion). This is an emergency: go to the emergency room immediately, because the testicle can be saved only if it is treated within hours. A slowly growing, painless swelling is more often fluid (a hydrocele) or a hernia. Any hard lump in the testicle needs a doctor's check within days.
How patients describe it
- Sudden pain in my testicle
- A swollen, heavy scrotum
- A lump in the testicle
- A bulge that goes down when I lie down
- A swollen scrotum in my child
Go to the emergency room now if you have
- Sudden severe pain in the scrotum, with nausea or vomiting, or a testicle that sits high or twisted
- Fever with a red, hot, swollen scrotum
- A swelling that is hard, very painful, and cannot be pushed back (a stuck hernia)
- Swelling after an injury with severe pain
- A baby or child with a swollen, red or painful scrotum
What can cause it
Twisted testicle (testicular torsion)
Sudden severe pain, often with nausea or vomiting, usually in teenagers and young men.
Next step: Go to the emergency room now.
Infection of the epididymis (epididymitis)
Pain that builds over a day or two, with fever or burning when passing urine.
Next step: See a doctor the same day; urine test and antibiotics.
Hydrocele
A smooth, painless swelling from fluid around the testicle.
Next step: Examination and ultrasound.
Inguinal hernia
A bulge from the groin into the scrotum that changes when you stand, cough or lie down.
Next step: Examination; repair is advised when it causes symptoms.
Varicocele or a testicular lump
A dull ache with a soft, swollen vein, or a hard painless lump in the testicle itself.
Next step: Ultrasound; a hard lump should be seen within days.
What you can do now
- Do not wait to see if sudden severe pain settles
- Check your testicles once a month, for example in the shower, for lumps
- Wear supportive underwear if the scrotum aches
- Tell the doctor about any injury, fever or burning when passing urine
- Avoid heavy lifting if you have a hernia
Tests your doctor may order
- Examination of the scrotum and groin
- Ultrasound of the scrotum, done urgently if torsion is suspected
- A urine test, and blood tests if a lump is suspected
When is surgery needed?
- A twisted testicle needs an emergency operation to untwist and fix it.
- A hernia is repaired by an operation. Large or uncomfortable hydroceles can be removed, and small ones can be watched.
- An infection is treated with antibiotics.
Related operation guides
Questions people ask
How long can a twisted testicle wait?
Only a few hours. The sooner it is treated, the better the chance of saving the testicle.
Is a painless lump in the testicle safe?
No. A hard lump in the testicle, even without pain, should be seen by a doctor within days.
Will a child's swollen scrotum go away by itself?
Sometimes, but it can also be a hernia or a twisted testicle. Hernias in children do not go away on their own, so a child with a swollen scrotum should be seen by a doctor.
This page gives general information and does not replace the advice of your treating team. In an emergency, go to the nearest emergency room.