Scrotal lymphedema is a buildup of lymph fluid in your scrotum and/or the surrounding areas. It occurs when a blockage or breakdown of the lymphatic system causes fluid to leak into the area. Treatment may include complex decongestive therapy or surgery.
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Scrotal lymphedema (skro-tel lim-fi-DEE-muh) is a buildup of fluid (lymph) in the soft tissues of your scrotum. It can also extend to the surrounding areas, including your penis. Your scrotum is the pouch of skin beneath and behind your penis that normally holds your testicles.
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Scrotal lymphedema is a type of lymphedema, which is a chronic (long-lasting) condition that occurs after a blockage in or damage to your lymphatic system. Your lymphatic system is part of your immune system. It helps remove waste and toxins from your body and balance your body fluids. Often, the damage to your lymphatic system relates to cancer treatments or surgeries, filariasis or congenital urinary abnormalities.
Scrotal lymphedema is rare, especially in the United States. But healthcare providers and medical researchers aren’t sure exactly how often it occurs.
Your lymphatic system includes many different organs. But the following parts contribute to scrotal lymphedema:
The most apparent scrotal lymphedema symptom is an enlarged scrotum. Your scrotum can swell to many times its normal size. In some cases, it can reach the size of a grapefruit, basketball or larger. Healthcare providers sometimes call this giant scrotal lymphedema.
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Other symptoms may include:
In severe cases, scrotal lymphedema may cause a buried penis. Buried penis occurs when severe swelling (edema) causes the scrotal tissues to envelop the penis. This makes your penis appear hidden or absent.
In the U.S., most scrotal lymphedema cases occur due to a blockage or breakdown of the lymphatic system in your genital area. This prevents lymph from draining from the genital area.
Outside the U.S., lymphatic filariasis is the most common cause of scrotal lymphedema. Lymphatic filariasis is a parasitic infection that mosquitoes transmit.
No, scrotal lymphedema isn’t contagious. It isn’t a sexually transmitted infection (STI).
You may have an increased risk of developing scrotal lymphedema after treatment to cure cancer, including radiation therapy or surgery. You also have an increased risk if you have a body mass index (BMI) greater than 30 (have obesity).
Possible scrotal lymphedema complications may include:
To diagnose scrotal lymphedema, a healthcare provider will begin with a physical exam and review your medical history. They may also order imaging tests. These help providers better understand the extent of the blockage. They also help rule out other conditions that can cause scrotal swelling. Imaging tests may include:
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As of now, there’s no cure for scrotal lymphedema. However, treatment exists that can help reduce your symptoms and prevent swelling from getting worse.
Typically, healthcare providers first recommend complex decongestive therapy to treat scrotal lymphedema. Complex decongestive therapy may help reduce mild to moderate swelling, especially in the early stages. It includes:
A provider may recommend surgery in severe cases of scrotal lymphedema that don’t respond to complex decongestive therapy. Testicular lymphedema surgery removes the mass and any affected tissue and covers the area with healthy skin (skin graft). The surgical team may include a urologist and a plastic surgeon. During the procedure, your team will generally:
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Most people respond well to scrotal lymphedema surgery. However, possible complications may include:
It depends on the severity of your scrotal lymphedema and the recommended treatment. With complex decongestive therapy, swelling may reduce within a week or two. If you have surgery to correct scrotal lymphedema, you should recover after about six weeks.
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Your healthcare provider will give you an expected recovery timeline according to your situation.
Healthy eating habits may help you control scrotal lymphedema swelling. Your lymphatic system is more effective when you follow eating patterns that include plenty of fruits, vegetables, lean protein and whole grains. It’s also a good idea to:
Scrotal lymphedema can also affect you emotionally. It’s a good idea to talk about your feelings to trusted family members and friends. Ask a healthcare provider if they can recommend a therapist or scrotal lymphedema support group.
It may not be entirely possible to prevent scrotal lymphedema that cancer treatment may cause. However, proper treatment can help reduce swelling and minimize complications. The following tips can help lower the risks:
There’s currently no way to reverse lymphatic system damage that causes scrotal lymphedema. That means scrotal lymphedema is a long-term condition. But proper treatment can help reduce your symptoms and improve and maintain your quality of life.
Schedule an appointment with a healthcare provider if you have symptoms of scrotal lymphedema, especially if you’ve gone through cancer treatment. Without treatment, it can get worse and may cause other complications.
During your appointment, you may wish to ask the following questions:
If you have scrotal lymphedema, go to the nearest emergency room if you have signs of an infection, including:
Scrotal lymphedema is a rare condition that causes swelling in your scrotum and/or the surrounding genital area. It usually occurs after something damages or affects your lymphatic system, but it can also develop after a filariasis infection. It’s a chronic condition, and symptoms can be frustrating or embarrassing because they affect a sensitive area of your body. Treatment and lifestyle changes can reduce scrotal lymphedema symptoms and their impact on your life. If you have any questions, talk to a healthcare provider.
If you have a condition that’s affecting your urinary system, you want expert advice. At Cleveland Clinic, we’ll work to create a treatment plan that’s right for you.
Last reviewed on 04/21/2025.
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