Excessive scrotal tightness, worse when needing to move my bowel for the last 3 years which started after excess straining due to constipation. help!

Maybe a hernia: I would recommend going to a local physician to get checked for an inguinal hernia. These hernias can extend into the scrotum and abdominal straining can increase the amount of herniated tissues, making the scrotum tighter or enlarged. If the feeling/swelling goes down if you relax and lie down, it's even more likely to be a hernia.