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What Causes an Enlarged Testicle?

By Meshell Powell
Updated Mar 03, 2024
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An enlarged testicle can be a cause for great concern among men who experience this symptom. Fortunately, most causes of enlargement do not represent a serious medical condition. Some of the more common causes of an enlarged testicle include epididymitis, orchitis, or a varicocele. In some cases, a swollen testicle may due to a tumor, although this is relatively rare.

Epididymitis is a medical condition characterized by inflammation of the tube that leads to the vas deferens from the testicle. This type of inflammation is usually caused by a bacterial infection. In addition to an enlarged testicle, symptoms often include pain, fever, and blood in the semen. Treatment for epididymitis generally involves the use of a prescription antibiotic. Pain medications, ice packs, and bed rest may also assist in the healing process.

Orchitis refers to inflammation involving one or both testicles and is most often caused by the same virus that causes the mumps. Bacterial infections, including some sexually transmitted diseases, may also lead to this condition. Pain, fever, and nausea are often present along with at least one enlarged testicle. Over-the-counter or prescription medications as well as bed rest and the application of ice packs are typical treatment options. Additional medications may be prescribed, depending on whether the condition is caused by a viral or bacterial infection.

A varicocele is another potential cause of an enlarged testicle. This is a condition that involves an enlargement or widening of the veins located in the scrotum, the sac that hold the testicles. A varicocele often develops during puberty and can cause low sperm production. The pain or discomfort associated with this condition is often relieved when lying down. Treatment may occasionally involve surgical repair, although most varicoceles disappear on their own without any type of medical treatment.

In some cases, an enlarged testicle may develop due to the presence of a tumor. When this is the cases, a lump that can be either seen or felt is often present. Testicular cancer is relatively rare, and most tumors found in this region of the body are benign. Even if the tumor is cancerous, early diagnosis and treatment often leads to an excellent prognosis for the patient. Any inflammation involving one or both testicles should always be evaluated by a medical professional in order to rule out serious medical conditions and ensure that the proper type of treatment is obtained.

How to Treat Enlarged Testicles

Enlarged testicles, or scrotal swelling, can be quite painful. To ease discomfort, you can do a few things:

  • First, avoid strenuous activity until the swelling and pain have subsided
  • Wear an athletic supporter
  • Apply ice packs to the afflicted area for the first 24 hours
  • Take a salt bath to decrease swelling

If swelling and pain do not subside or become worse, seek help from a medical professional. If the area feels hot or is red, you may have an infection which will require medication

Do Testicles Enlarge with Age?

Enlarged testicles can occur at any age. There are many causes for enlarged testicles:

  • Hernia, a condition in which an organ presses through or between the muscles holding the organ in place
  • Hydrocele, a condition in which fluid collects in the sheath that surrounds the testicle
  • Testicular cancer, a kind of rapid cell growth that affects the testes
  • Varicocele, an enlargement of the veins within the scrotum
  • Orchitis, an infection of one or both testes
  • Injury such as a hit, pinch or crush
  • Epididymitis, an infection of the seminal tube
  • Congestive heart failure (CHF), a condition in which the heart is decreasing in functioning
  • Fluid retention, a condition in which a part of or the entire body is holding onto fluid at a higher rate than it is evacuating it

As you age, your risks for enlarged testicles change. On the one hand, you are more likely to need a catheter as you age, which increases the risk of testicular infection. On the other hand, you may not be as sexually active as you were in the past, and your risk of acquiring a sexually transmitted infection decreases. Also, you may not be as physically active as you get older, which reduces your risk of injury-related testicular swelling. No matter your age, though, your testicles are delicate organs that face infection and injury.

Does Enlarged Prostate Cause Testicle Pain?

The prostate is a walnut-sized gland that sits between the bladder and the penis. An enlarged prostate can place pressure on the urethra and bladder, and can completely prevent urine from passing through the penis. When this happens, you may feel pain or discomfort around your bladder and prostate, but it is unlikely that you will feel pain in your testicles.

What Your Doctor Might Ask

In order to best treat you, your doctor may ask you a number of questions so as to determine the cause and treatment. Some questions include:

  • Have you had a recent injury to the testicles?
  • When did the swelling originate?
  • Have you had a recent infection?
  • Is the swelling uniform?
  • Is the swelling increasing still?
  • Are you sexually active?
  • Are there any lumps present?
  • Has this swelling occurred before?
  • Is there any heat or redness in the area?
  • How have you treated the swelling so far?

Your healthcare professional will likely conduct a physical and visual examination of the penis, scrotum, testicles, and surrounding areas. Your healthcare professional may perform an ultrasound as well, if necessary. Depending on the condition, your healthcare professional may prescribe antibiotics or recommend surgery.

Does Testicular Enlargement Indicate Infection?

One serious problem which causes testicular enlargement is orchitis, or inflammation of the testicle due to infection. Common bacteria causing this condition include Escherichia coli, Streptococcus, and Staphylococcus.

The infection can be a result of an infection occurring somewhere else in the body and traveling to the scrotum through the blood, or it can be an infection spreading from the epididymis. It is possible to have an infection in the prostate as well. Other bacteria caused by sexual contact can cause orchitis as well, such as chlamydia, syphilis, or gonorrhea. The infection may also be caused by non-sexually contracted intruders such as the virus that causes mumps. In the case of mumps infection, orchitis sometimes occurs 4 to 6 days after the virus enters the body. The mumps vaccine eliminates the risk of mumps-related orchitis. Urinary tract infections can also cause infection of the testes. Using a catheter also places you at risk of developing an infection. In the case of any bacterial infection, you will likely need antibiotics to treat the condition.

Can I Lose My Testicle?

Another serious condition causing testicular enlargement is testicular torsion, in which case one of your testicles has become twisted within the scrotum. This condition can sometimes be fixed by manipulating the teste within the scrotum, but in most cases, it requires surgery to remedy. Be sure to seek treatment immediately if this condition is suspected. Delaying treatment may result in the loss of the testicle due to a lack of blood flow.

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Discussion Comments
By gator11 — On Dec 10, 2013

My right testicle is swollen about four times the normal size and hardened to the touch. I haven't felt any kind of bump or growth and have little to no pain. The only activity I can associate it with was an increased amount of bike riding at the time.

By ZipLine — On Sep 26, 2012

@MikeMason-- That sounds like what I have, but yours was a tumor right?

Mine is not a tumor, it's basically dead tissue built-up from an infection I had a couple of years ago. I was very worried initially when they found a mass in my scan and I thought I had testicular cancer symptoms. Thankfully, it didn't turn out to be a tumor.

I think bacterial infections are a major cause of enlarged testicles but the treatment is easy, a course of antibiotics takes care of it. Sometimes, you can be left with a mass in the testicle though which makes it larger in size. But it doesn't pose a risk to my health so the doctor is not going to remove it.

By stoneMason — On Sep 26, 2012

@fBoyle-- I think appearance wise, they're about the same, but the underlying cause might give it different characteristics.

For example, I had a mass in my testicle which was removed and mine as enlarged to about two times its regular size. My testicle felt very hard to the touch. I think when it's swollen, it tends to be softer.

By fBoyle — On Sep 25, 2012

I think trauma to the testicles can cause testicle pain and cause them to swell as well right? What's the difference between an enlarged and swollen testicle appearance wise? How do we tell them apart?

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