If the patient comes with a swelling in the testis, first thing we need to do is diagnose the condition and we need to diagnose whether it is an acute thing or it has been there for sometime. So we ask the patient how long the swelling is present. If the swelling is of very recent origin, like say few hours to few days then usually it is because of an infection or usually because of a torsion. Torsion means the rotation of the testis, which causes the blockage of the blood supply in the testicles. Usually these patients they presents within 1 or 2 hours with an intense pain and once we diagnose with the help of an ultrasound, the treatment has to be surgical. Immediately the patient has to be taken for the surgery and the testis has to be derotated and be put into a normal positon. If the swelling is because of infection, the treatment is usually medical. Initially we treat with some antibiotics, with some anti-inflammatory medicines. The duration varies between 5 to 7 days and most of the times they will respond to this infection If the infection is quite sever with a lot of pus accumulation, then we ned to drain the pus, along with the antibiotic, we need to drain that. If the swelling is because of any testicular cancer, then we ned to do other tests to support the diagnosis, especially the blood tests for something called as tumor markers. There is something called as tumor markers, which are elevated in the blood, especially in the testicular swelling. These patients have to be treated initially with the removal of the testis and based on the pathological response, we stage the patient depending on the stage of the disease the testicular tumor has to be managed.
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