Scrotal swelling in children

Schönlein-Henoch purpura is a condition that may cause painful scrotal swelling in youngboys along with rash, joint pain, stomach pain, and blood in the urine; its cause is unknown.Diagnosis and treatment of scrotal swellingAny scrotal swelling needs to be examined by your child's healthcareprovider. The diagnosis begins with taking a medical history and asking about when the swelling started andhow painful it is. A physical exam will include an exam of the belly, thescrotum, and the testicles.In almost all cases, your child's healthcare provider will request a urine sample to look for signs of infection. The medical team may also do an ultrasound exam, which involves taking pictures of the structures inside the scrotum by using sound waves.Depending on the findings, treatment may need:Surgery.For testicular torsion, emergency surgery is usually needed to save the testicle. Surgery may also be needed in cases of a hernia that traps some intestine in the scrotum ora severe injury to the testicle.Antibiotics.If the healthcare provider finds evidence of bacterial infection, he or she will prescribe antibiotics. Young boys who are not sexually activeshould also have special X-ray studies to look for an abnormality in their urinary system as a possible cause of infection.Observation and other treatments.For conditions like minor trauma, mumps, small hernias, hydroceles, idiopathic swelling, and Schönlein-Henochpurpura, no treatment may be needed. Many of these conditions can be watched to see whether they clear up on their own. Other conditions needattention. Without treatment, varicoceles may over time resultin infertility and testicular injury that is not reversible. Testicular cancer in boys responds very well to cancer drugs. Pain medicines and medicines that reduce swelling may also be used during observation for some of these conditions.When to see the healthcare providerIf you child has scrotal swelling at any age, he should be seen by his healthcare provider. Most scrotal swelling is not painful, but still needs to be evaluated. Your child should be seen right away if he:Has any pain from injury to the testicles that lasts longer than an hour.Has painful scrotal swelling, especially swelling that is severe and starts suddenly. Thisis a medical emergency.