What causes orchialgia (testicular pain) with scrotal edema (swelling)?

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Last updated: April 25, 2025View editorial policy

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Differential Diagnosis for Boggy Testicles

  • Single most likely diagnosis
    • Epididymitis: This is the most likely diagnosis due to the common presentation of epididymitis with swollen, tender, and boggy testicles, often accompanied by symptoms such as pain, redness, and warmth of the scrotum.
  • Other Likely diagnoses
    • Orchitis: Inflammation of one or both testicles, which can cause the testicles to become swollen, tender, and boggy.
    • Hydrocele: A condition where fluid accumulates in the scrotum, causing swelling and potentially a boggy texture.
    • Varicocele: Enlargement of the veins within the scrotum, which can cause the testicles to feel boggy or irregular.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular torsion: A medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. Although it typically presents with sudden, severe pain and a high-riding testicle, it's crucial to consider in any case of acute scrotal pain or swelling.
    • Testicular cancer: While less common, testicular cancer can present with a painless testicular mass or swelling. Early detection is key to successful treatment.
  • Rare diagnoses
    • Spermatocele: A cystic structure filled with sperm, which can cause a boggy or irregular texture of the testicle.
    • Cystic dysplasia of the testis: A rare congenital anomaly where the testis is replaced by multiple cysts, potentially causing a boggy texture.
    • Filariasis: A parasitic infection that can cause lymphatic obstruction, leading to scrotal swelling and potentially a boggy texture, although this is more common in endemic areas.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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