Treatment for scrotal and testicular conditions varies widely depending on the type and severity of condition and whether it is causing you any problems. Some conditions, like hydrocele and varicocele may not require any treatment at all unless they are large or are causing pain or other symptoms. Infections, such as epididymitis, may only require medical treatment and home remedies. And some conditions, like testicular torsion, are medical emergencies and will always require surgery.
Treatments for testicular and scrotal conditions usually fall into the following categories:
- Antibiotics to treat infections
- Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain
- Other pain relieving medications to reduce pain
- Hormone replacement therapy to replace testosterone for hypogonadism
Outpatient therapy/home remedies
- Ice or cold packs
- Scrotal support and elevation
Most cases of epididymitis can be treated with antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), ice or cold packs, rest, and scrotal support and elevation. Timely and proper treatment can usually resolve the infection and accompanying symptoms. However, sometimes epididymitis can be severe enough to require hospitalization.
Testicular torsion is a medical emergency that requires immediate treatment in order to save the affected testicle. Treatment involves surgery to untwist the testicle. Most of the time, the surgeon will also perform a surgery called orchiopexy to secure the testicle to the scrotal wall to prevent future episodes of torsion. If an anatomical abnormality existed that led to testicular torsion, the surgeon will correct the abnormality in both testicles if necessary. Once in a while, a doctor can manually untwist the testicle without performing emergency surgery; however, any testicular torsion should ultimately be corrected surgically. Immediate treatment is vital to saving the testicle. When the testicle is untwisted within six hours of the onset of the condition, the success rate of surgery is almost 100 percent, which means the testicle can be saved. However, if the surgery isn't performed until after 24 hours, the success rate of saving the testicle is between 0 and 10 percent.
Although most varicoceles don't need to be treated, some will need to be corrected with surgery. For example, varicoceles that are causing male infertility can be surgically repaired in an attempt to restore fertility. The surgery performed to treat varicocele is called varicocele repair. It seals off the affected veins to restore normal blood flow to the scrotum and testicles. The surgery can be done traditionally, through an incision in the abdomen or below the groin, or laparoscopically. Recovery is usually quick, with only mild pain and discomfort. Another treatment option is percutaneous embolization, which involves releasing coils or a solution into the affected veins to scar them and create a blockage, interrupting blood flow and repairing the varicocele.
Hypogonadism in men can often be treated with testosterone replacement therapy. If there is an underlying cause of hypogonadism, such a pituitary condition, treating that problem may resolve the symptoms of hypogonadism. Hormone replacement may come in the form of an injection, a patch, or a gel. Some doctors may prescribe gum and cheek testosterone replacement or implantable testosterone pellets instead.
All types of orchitis are usually treated by taking non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, along with using ice or cold packs, supporting and elevating your scrotum, and resting in order to reduce the swelling and control pain and discomfort.
If orchitis is caused by a bacterial infection, you will have to take antibiotics to kill the bacteria. If you have a sexually transmitted infection (STI) that caused the orchitis, your sexual partner will have to be treated with antibiotics as well to make sure you don't get re-infected.
Most of the time, spermatocele won't require treatment. However, in rare cases, treatment may be necessary. If your spermatocele is causing pain or is quite large, your doctor may recommend treatment. Treatment options for spermatocele include medical therapy to relieve pain; minimally invasive therapy, such as aspiration or sclerotherapy; or surgery. Spermatocelectomy is the most common treatment for symptomatic spermatocele. It involves removing the spermatocele from the epididymal tissue with the goal of preserving the health of the reproductive tract. Spermatocelectomy is an outpatient procedure that usually takes less than an hour.
If your hydrocele isn't causing any problems, it may not require treatment. However, large or symptomatic hydrocele may require surgery. Surgery to correct hydrocele is called hydrocelectomy. Another treatment option is removing fluid from the hydrocele with a needle. This is called aspiration. However, aspiration is not usually recommended unless surgery is not an option because there is a high risk of recurrence and infection.
Testicular pain and swelling
Treatment for testicular pain and swelling will vary depending on the cause of the pain. Sometimes, it can be treated with simple measures like antibiotics and cold packs, and sometimes it will require surgery. If you have testicular pain or swelling, contact your doctor right away.
If you experience trauma or injury to your testicles, you will likely require some form of treatment. Minor trauma may be treated with pain medication and non-steroidal anti-inflammatory drugs (NSAIDs), ice or cold packs, rest, and scrotal support and elevation. Serious trauma, including testicular rupture, will require emergency surgery to preserve testicular function.
Testicular trauma can also lead to conditions like hematoceles and testicular dislocation, which can also require surgery.
Learn more about scrotal and testicular conditions