It is not uncommon for a man to complain of enlargement of his scrotum, but it is often difficult for him to determine which anatomic structures in the scrotum are enlarged. Ask these questions:
''When did you first notice the enlargement?''
''Is the enlargement painful?''
''Have you sustained any injury to your groin?''
''Does the enlargement change in size?''
''Have you ever had the enlargement before?''
''Have you had any problems with fertility?''
Swellings in the scrotum can be related to testicular or epididymal enlargement, a hernia, a varicocele, a spermatocele, or a hydrocele. Testicular enlargement can result from inflammation or tumor. Most of the time, enlargement is unilateral. Painful scrotal enlargement can result from acute inflammation of the epididymis or testis, torsion of the spermatic cord, or a strangulated hernia. Varicoceles are often a cause of decreased fertility.
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