From the Guidelines
Testicular edema is primarily caused by conditions such as epididymitis, testicular torsion, and idiopathic scrotal edema, which can lead to fluid accumulation and swelling in the scrotum. The causes of testicular edema can be varied, including:
- Infections like epididymitis, which is the most common cause of acute scrotum in adolescent boys and adults 1
- Testicular torsion, a surgical emergency that requires prompt recognition and treatment to prevent testicular loss 1
- Idiopathic scrotal edema, a rare and self-limiting condition that is usually painless and has a characteristic appearance on ultrasound 1
- Other conditions like hydrocele, varicocele, and trauma to the area can also cause testicular edema
- Systemic conditions such as heart failure, kidney disease, or liver problems can lead to fluid retention and scrotal swelling
The diagnosis of testicular edema involves a thorough physical examination and imaging studies like ultrasound to determine the underlying cause. Treatment depends on the cause, with antibiotics for infections, surgical intervention for torsion, and supportive care for trauma or other conditions. Prompt medical attention is essential to prevent permanent damage from conditions like testicular torsion. Pain relief can be achieved with NSAIDs like ibuprofen, and scrotal elevation and cold compresses may help reduce swelling 1.
From the Research
Testicular Edema Causes
- Inflammation of the epididymis, or epididymitis, can cause testicular edema, especially in young adults between 20 and 40 years of age 2
- The main causative agents of epididymitis are Chlamydia trachomatis and Neisseria gonorrhoeae in sexually active males, while enterobacteria are more common in prepubertal children and adults older than 35 years 2, 3
- Testicular infarction, a rare complication of prolonged epididymitis, can also cause testicular edema, often presenting with chronic unilateral testicular pain, tenderness, and palpable swelling 4
- Idiopathic scrotal edema, characterized by a minimally painful scrotal swelling produced by subcutaneous edema, is another possible cause of testicular edema, with a localized allergic phenomenon being the most likely etiologic factor 5
- Reflux of urine into the ejaculatory ducts is considered a common cause of epididymitis in children younger than 14 years, which can lead to testicular edema 3
Common Causes by Age Group
- In patients younger than 35 years, testicular edema is often caused by sexually transmitted diseases, such as Chlamydia trachomatis and Neisseria gonorrhoeae 2, 3
- In patients older than 35 years, testicular edema is usually caused by enteric bacteria transported by reflux of urine into the ejaculatory ducts secondary to bladder outlet obstruction 2, 3
- In prepubertal children, testicular edema is often caused by enterobacteria 2