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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes An Enlarged Testicle?

Last week, I had redness of foreskin of my penis and other symptoms of balanitis such as foreskin not pulling back, itchy penis and surrounding areas including testicles. It could have possibly caused because of recent camping tour where I had an ejaculation and had to be in the same underwear for 2 days. I immidiately went to a doctor who prescribed a topical antifungal cream and a course of antibiotics. Around the same time, I noticed some swelling in my right testicle. It started off as a rash on the skin of the testis, but now, 5 days later, my whole right testis is swollen and is shifted up near the penis and noticeably so. The swelling itself is painless. The itch on foreskin has gone and looks like I am cured of balanitis, but now I am left with an enlarged right testicle. What do you think can it be? I am continuing the antibiotics as my physician thinks its orchitis. But from what I read, Orchitis is painful and I am not having any pain. Any help in finding the cause (if other than bacterial orchitis) will be really helpful. And yes, I never had any unprotected sex and am married with just one partner, so any STDs seem highly unlikely.
Mon, 7 Dec 2015
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General Surgeon 's  Response
Hi.
Noted your history of posthitis (infection of the foreskin is called posthitis) which got settled with antibiotics but there was the development of the swelling of the right side of the testicle/scrotum.
This indicates that the infection of the foreskin has traveled to the upper urinary tract, also called as retrograde infection.
I would advise you in such a situation the following:
Get the microscopy , culture and sensitivity of the urine and semen.
Ultrasonography and color doppler and/or MRI to get the accurate diagnosis whether this is the orchitis, epididymo-orchitis or just infection of hte scrotal skin.
Once diagnosed the treatment becomes specific.


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What Causes An Enlarged Testicle?

Hi. Noted your history of posthitis (infection of the foreskin is called posthitis) which got settled with antibiotics but there was the development of the swelling of the right side of the testicle/scrotum. This indicates that the infection of the foreskin has traveled to the upper urinary tract, also called as retrograde infection. I would advise you in such a situation the following: Get the microscopy , culture and sensitivity of the urine and semen. Ultrasonography and color doppler and/or MRI to get the accurate diagnosis whether this is the orchitis, epididymo-orchitis or just infection of hte scrotal skin. Once diagnosed the treatment becomes specific.