Testicular pain or swelling can be alarming, especially with the widespread fear of testicular cancer. While cancer is a serious possibility, it's important to know that most cases of testicular discomfort are not cancer-related. Understanding the common, less dangerous causes can help reduce anxiety—and more importantly, guide you toward the right treatment.

In this blog, let’s explore the non-cancerous causes of testicular pain and swelling, symptoms to watch for, and when to seek medical care.

Why You Should Never Ignore Testicular Discomfort

Your testicles play a vital role in your reproductive and hormonal health. Pain or swelling in this area could indicate anything from a simple infection to a medical emergency. It’s always best to seek professional evaluation.

While testicular cancer is real—and early detection is crucial—it’s not the most common cause of testicular symptoms. In fact, conditions like infections, injuries, and fluid buildup are more frequently the culprits.

Common Non-Cancerous Causes of Testicular Pain or Swelling

1. Epididymitis

Epididymitis is inflammation of the epididymis, the coiled tube behind the testicle that stores and carries sperm. It’s most often caused by:

• Bacterial infections (including sexually transmitted infections like chlamydia or gonorrhea)
• Urinary tract infections

Symptoms include:

• Gradual onset of testicular pain
• Swelling and redness
• Pain during urination or ejaculation
• Fever and chills

Treatment: Usually involves antibiotics, rest, scrotal elevation, and anti-inflammatory medications.

2. Orchitis

Orchitis is inflammation of the testicle, which may occur on its own or along with epididymitis. It’s commonly caused by:

• Viral infections (especially mumps)
• Bacterial infections

Symptoms include:

• Sudden or severe pain
• Swelling in one or both testicles
• Fever
• Nausea

Treatment: Antivirals or antibiotics, depending on the cause, plus pain management.

3. Hydrocele

A hydrocele is a fluid-filled sac around the testicle, often causing painless swelling. It may result from trauma or infection, but in many cases, the cause is unknown.

Symptoms include:

• Noticeable swelling in the scrotum
• Heaviness or discomfort (not pain)

Treatment: Small hydroceles may resolve on their own, while larger ones may require surgical drainage.

4. Varicocele

A varicocele is an enlargement of the veins within the scrotum, similar to varicose veins in the legs. It’s more common on the left side and may affect fertility.

Symptoms include:

• Dull aching pain
• Visible or palpable “bag of worms” texture
• Swelling that worsens with standing or physical activity

Treatment: Often managed with lifestyle changes, but surgery may be required if fertility is affected.

5. Testicular Torsion (Medical Emergency)

Testicular torsion occurs when the spermatic cord twists, cutting off blood supply to the testicle. It’s most common in teenagers and young men.

Symptoms include:

• Sudden, severe pain
• Swelling and redness
• Nausea and vomiting
• Testicle positioned higher than usual

Treatment: Emergency surgery is required to save the testicle. If treated within 6 hours, it can usually be saved.

This is a true urological emergency—seek help immediately.

6. Inguinal Hernia

Sometimes, part of the intestine protrudes through the abdominal wall into the scrotum, causing pain and swelling.

Symptoms include:

• Bulge in the groin or scrotum
• Discomfort or pain when bending, coughing, or lifting
• Swelling that comes and goes

Treatment: Surgical repair is typically recommended.

7. Trauma or Injury

A direct blow or accident involving the scrotum can lead to bruising, swelling, or even rupture of the testicle.

Symptoms include:

• Immediate, intense pain
• Swelling and discoloration
• Nausea or vomiting

Treatment: Minor injuries may need rest and ice, but severe trauma requires immediate medical care.

How Is the Cause Diagnosed?

To determine the exact cause of testicular pain or swelling, your doctor may recommend:

• Physical exam
• Ultrasound of the scrotum
• Urine and blood tests
• STD screening
• Scrotal exploration (in emergencies)

Prompt diagnosis ensures the best possible outcome.

What About Testicular Cancer?

Testicular cancer is relatively rare, especially when compared to the other conditions above. However, it’s the most common cancer in males aged 15–35.

Signs include:

• A lump or hard area in the testicle
• Dull ache in the lower abdomen or groin
• A feeling of heaviness in the scrotum

It usually doesn’t cause severe pain initially, which is why painless swelling or lumps should never be ignored.

When to See a Doctor Immediately

Seek urgent medical attention if you experience:

• Sudden, severe testicular pain
• Swelling with fever or chills
• Pain that doesn’t improve with rest
• A lump or change in the shape of your testicle

Key Takeaways

• Not all testicular pain or swelling points to cancer
• Infections like epididymitis and orchitis are common causes
• Torsion is an emergency and needs surgery within hours
• A proper diagnosis is crucial—don’t self-diagnose or delay treatment

If you're experiencing testicular pain, swelling, or unusual symptoms, don’t wait—get a professional evaluation. Dr. Neeraj Agarwal, a highly experienced urologist, offers comprehensive care for testicular conditions, urinary problems, and men’s health issues. With state-of-the-art diagnostics and a patient-centric approach, he ensures accurate diagnosis and effective treatment—whether it’s an infection, varicocele, or other concern.

Your health and peace of mind are worth it. Book your consultation with Dr. Neeraj Agarwal today and take the first step toward lasting relief and reassurance.