Testicular Swelling Causes and Treatment in Singapore

• Men experiencing persistent scrotal swelling lasting more than 48 hours
• Patients with sudden onset testicular swelling accompanied by severe pain
• Individuals with gradual testicular enlargement affecting daily activities
• Those experiencing swelling with fever, nausea, or urinary symptoms
• Men with recurrent episodes of testicular swelling
• Patients with swelling following trauma or injury to the groin area
• Individuals with family history of testicular conditions seeking preventive evaluation
• Men noticing asymmetry or changes in testicular size or consistency

• Sudden, severe testicular pain with rapid swelling
• Testicular swelling accompanied by high fever and chills
• Nausea and vomiting along with testicular pain
• Swelling following significant trauma to the groin
• Changes in skin colour of the scrotum (redness or darkening)
• Inability to urinate or blood in urine with swelling

Some conditions causing testicular swelling, particularly testicular torsion, require emergency treatment within hours to prevent permanent damage. Delaying treatment can result in loss of the affected testicle. Any sudden onset of severe testicular pain and swelling warrants immediate medical evaluation. Our urology specialists can quickly assess your condition and determine whether emergency intervention is necessary or if your condition can be managed with scheduled treatment.

Conservative medical treatment manages many causes of testicular swelling. For infectious causes like epididymitis or orchitis, antibiotic therapy targets the specific bacteria causing inflammation. Treatment typically involves oral antibiotics for 10-14 days, with the antibiotic choice based on the patient’s age and likely causative organisms. Anti-inflammatory medications help reduce swelling and provide pain relief. Supportive measures include scrotal elevation, ice pack application, and wearing supportive underwear to minimise discomfort during healing.

For symptomatic hydroceles, aspiration involves draining accumulated fluid using a needle under local anaesthesia. This procedure provides immediate relief from swelling and discomfort. Sclerotherapy may follow aspiration, where a sclerosing agent is injected into the hydrocele sac to prevent fluid reaccumulation. This minimally invasive approach suits patients who prefer to avoid surgery or have medical conditions that increase surgical risks. The procedure takes approximately 20-30 minutes and patients can return home the same day.

Surgical treatment becomes necessary for certain conditions or when conservative management fails. Hydrocelectomy surgically removes or repairs the hydrocele sac through a small scrotal or inguinal incision. Varicocelectomy addresses varicoceles by ligating dilated veins while preserving arterial blood flow and lymphatic drainage. For testicular torsion, emergency surgical detorsion and orchiopexy (fixing the testicle to prevent future torsion) are performed. Modern surgical techniques, including microsurgical approaches, minimise tissue trauma and improve outcomes.

Before initiating treatment, comprehensive evaluation determines the exact cause of testicular swelling. This includes detailed medical history, physical examination, and diagnostic tests such as scrotal ultrasound, urine analysis, and blood tests. Patients should inform their urologist about all current medications, allergies, and medical conditions. For surgical procedures, pre-operative instructions include fasting requirements, medication adjustments, and arranging transport home. Patients receiving medical treatment may need to provide urine samples for culture to guide antibiotic selection.

Medical treatment involves starting prescribed medications according to the specified schedule. Patients receive detailed instructions about dosage, timing, and potential side effects. For aspiration procedures, the area is cleaned and numbed with local anaesthetic before needle insertion to drain fluid. The process typically takes 15-20 minutes with minimal discomfort.

Surgical procedures are performed under general or regional anaesthesia depending on the specific operation and patient factors. Hydrocelectomy typically takes 30-45 minutes, while varicocelectomy may require 45-60 minutes. The surgeon makes precise incisions to access the affected area, addresses the underlying pathology, and closes the incision with absorbable sutures. Throughout surgery, vital signs are continuously monitored to ensure patient safety.

Following medical treatment, patients can continue normal activities while taking prescribed medications. Regular follow-up ensures treatment effectiveness and monitors for side effects. After aspiration, patients rest briefly before discharge with instructions for home care and signs to watch for complications.

Post-surgical patients recover in the observation area until fully awake and stable. Pain medication is administered as needed, and the surgical site is checked before discharge. Most patients go home the same day for minor procedures, though complex cases may require overnight observation. Discharge instructions cover wound care, activity restrictions, pain management, and follow-up appointments.

During initial recovery, rest is essential for optimal healing. Apply ice packs to the scrotal area for 20 minutes at a time, several times daily, to reduce swelling and discomfort. Keep the area clean and dry, following specific wound care instructions if surgery was performed. Take prescribed pain medications as directed, typically before pain becomes severe. Wear supportive underwear or scrotal support to minimise movement and discomfort. Watch for warning signs including excessive bleeding, increasing pain, fever above 38°C, or discharge from incision sites.

Gradually increase activity levels while avoiding strenuous exercise, heavy lifting, or activities that strain the groin area. Continue taking antibiotics if prescribed, completing the entire course even if symptoms improve. Maintain good hygiene, gently cleaning the area during showers and patting dry. Attend scheduled follow-up appointments for wound checks and to monitor healing progress. Most patients can return to desk work within 3-5 days, though physical jobs require longer recovery. Swelling typically begins decreasing noticeably during this period.

Complete healing varies depending on treatment received and individual factors. Medical treatment for infections typically shows improvement within 3-5 days, with complete resolution in 2-3 weeks. Surgical recovery generally requires 2-4 weeks for return to normal activities, including exercise and sexual activity. Regular follow-up appointments monitor for treatment success and potential complications. Some residual swelling may persist for several weeks post-surgery, gradually resolving over time. Patients should report any recurrence of symptoms or new concerns promptly.

Most treatments for testicular swelling are well-tolerated with minimal side effects. Medical treatments may cause mild gastrointestinal upset from antibiotics, which usually resolves with food intake. Temporary bruising and mild discomfort at injection sites occur with aspiration procedures. Surgical patients commonly experience temporary scrotal swelling and bruising that peaks at 48-72 hours post-procedure. Mild to moderate pain is expected but well-controlled with prescribed medications. These effects typically resolve within 1-2 weeks without intervention.

Though uncommon with proper technique and post-operative care, potential complications include infection at surgical sites, requiring additional antibiotic treatment. Haematoma (blood collection) may develop, occasionally requiring drainage if large. Recurrence of the original condition occurs in a small percentage of cases, potentially necessitating repeat treatment. Injury to surrounding structures including blood vessels, nerves, or the vas deferens is rare with experienced surgeons. Chronic pain affects less than 1% of patients and usually responds to conservative management.

Our experienced urology team employs meticulous surgical technique and comprehensive pre-operative planning to minimise these risks. Proper patient selection, adherence to sterile protocols, and careful post-operative monitoring significantly reduce complication rates. Patients receive detailed instructions about recognising and reporting potential complications early, enabling prompt intervention if needed.