Scrotal masses

Causes

A scrotal mass can be noncancerous (benign) or cancerous (malignant).

Benign scrotal masses include:

• Hematocele -- blood collection in the scrotum
• Hydrocele -- fluid collection in the scrotum
• Spermatocele -- a cyst-like growth in the scrotum that contains fluid and dead sperm cells
• Varicocele -- a varicose vein along the spermatic cord

Scrotal masses can be caused by:

• Abnormal bulge in the groin (inguinal hernia)
• Diseases such as epididymitis
• Injury to the scrotum
• Testicular torsion
• Tumors

Symptoms

• Enlarged scrotum
• Painless or painful bulge or lump in the scrotum (testicle lump)

Exams and Tests

During a physical examination, the health care provider may feel a growth in the scrotum. This growth may:

• Feel tender
• Be smooth, twisted, or irregular
• Feel liquid, firm, or solid
• Be only on one side of the body

The inguinal lymph nodes in the groin may be enlarged or tender on the affected side.

The following tests may be done to help diagnose a scrotal mass:

• Biopsy
• Ultrasound of the scrotum

Treatment

A health care provider should evaluate ALL scrotal masses. Hematoceles, hydroceles, and spermatoceles are usually harmless and do not need to be treated.

Sometimes the condition may improve with self-care, antibiotics, or pain relievers. Painful growths in the scrotum need IMMEDIATE medical attention.

A jock strap (scrotal support) may help relieve the pain or discomfort from the scrotal mass. A hematocele, hydrocele, or spermatocele may sometimes need surgery to remove the collection of blood, fluid, or dead cells.

Outlook (Prognosis)

Most conditions that cause scrotal masses can be easily treated. Even testicular cancer has a high cure rate with early diagnosis and treatment.

Have your health care provider examine any scrotal growth as soon as possible.

Possible Complications

Complications depend on the cause of the scrotal mass. For example, varicoceles may lead to infertility.

When to Contact a Medical Professional

Call your health care provider if you find a lump or bulge in your scrotum. Any new growth in the testicle or scrotum needs to be checked by your health care provider to determine if it may be testicular cancer.

Prevention

You can prevent scrotal masses caused by sexually transmitted diseases (for example, epididymitis) by practicing safe sex.

To prevent scrotal masses caused by injury, wear an athletic cup during exercise.

Alternative Names

Testicular mass; Scrotal growth

References

Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010;37:613-626.

Montgomery JS, Bloom DA. The diagnosis and management of scrotal masses. Med Clin North Am. 2011;95:235-244.

U.S. Preventive Services Task Force. Screening for Testicular Cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2011;154:483-486.

Barthold JS. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 132. 

Update Date: 10/9/2012

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.