Q. I have painful swelling in my right scrotum with slight discomfort. Please help.

Answered by
Dr. Samer Sameer Juma Ali Altawil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 05, 2020 and last reviewed on: Sep 09, 2020

Hello doctor,

I am a 30-year-old male. I have swelling in my right scrotum for two days which was painful on the first day but not painful now. But it is causing me discomfort.



Welcome to

Pain and swelling of the scrotum have few causes.

1. Epididymo-orchitis (inflammation of cord and testis).

2. Torsion twist of cord on its access.

3. Hernia.

4. Skin and scrotal edema.

Inflammation of testis or epididymis can be due to urinary infection or sexually transmitted infections or other chronic infections like TB. It happens gradually over hours to days. It is painful, but with the intake of antibiotics it gets better.

Torsion is emergency and needs immediate surgical correction as blood supply to testis get untrusted depends on the degree of twist pain happens suddenly and it severe.

Hernia is a protrusion of abdomen content like bowel or fat into scrotum usually is a painless swelling.

Varicocele is dilated veins around the testis with less swelling and usually painless.

Scrotal edema happens in generalized edema of legs usually and affects the scrotum.

For diagnosis, we need an ultrasound of scrotum. Treatment is upon diagnosis as treatment is different. Urine test for analysis and culture to role out infection. No need for urethral swab as no discharge.

I recommend you to start tablet Augmentin (Amoxicillin and Clavulanic acid) 625 mg thrice daily for 10 days, and you can take Brufen 400 mg twice daily for pain with capsule Omeprazole 20 mg once at night and get urine and ultrasound tests. Please follow up after results.

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