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Causes of painless scrotal swelling in children and adolescents

Joel S Brenner, MD, MPH
Aderonke Ojo, MD
Section Editors
Amy B Middleman, MD, MPH, MS Ed
Gary R Fleisher, MD
Laurence S Baskin, MD, FAAP
Deputy Editor
James F Wiley, II, MD, MPH


The clinical presentation, diagnosis, and management of hydrocele, varicocele, spermatocele will be discussed below along with the presentation and diagnosis of testicular cancer.

Inguinal hernia, the evaluation of scrotal pain and swelling, and the causes of scrotal pain in children and adolescents are discussed separately. (See "Inguinal hernia in children" and "Evaluation of scrotal pain or swelling in children and adolescents" and "Causes of scrotal pain in children and adolescents".)


The spectrum of conditions that affect the scrotum and its contents ranges from incidental findings to pathologic events that require expeditious diagnosis and treatment (eg, testicular torsion, testicular cancer).

The most common causes of painless scrotal swelling in children and adolescents include hydrocele and inguinal hernias that are not incarcerated. Less common causes are varicocele, spermatocele, localized edema from insect bites, nephrotic syndrome (swelling is usually bilateral), and rarely, testicular cancer (table 1). Scrotal swelling and testicular masses warrant prompt evaluation.


A hydrocele is a collection of peritoneal fluid between the parietal and visceral layers of the tunica vaginalis. Hydroceles may be communicating or noncommunicating.

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Literature review current through: Nov 2017. | This topic last updated: Aug 04, 2017.
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