What are scrotal masses?
Scrotal masses are abnormalities in the bag of skin hanging behind the penis (scrotum). The scrotum contains the testicles and related structures that produce, store and transport sperm and male sex hormones.
Scrotal masses might be an accumulation of fluids, the growth of abnormal tissue, or normal contents of the scrotum that have become swollen, inflamed or hardened.
Scrotal masses need to be examined by a doctor, even if you’re not in pain or having other symptoms. Scrotal masses could be cancerous or caused by another condition that affects testicular function and health.
Self-examination and regular doctor exams of the scrotum are important for prompt recognition, diagnosis and treatment of scrotal masses.
How common are scrotal masses?
Please discuss with your doctor for further information.
What are the symptoms of scrotal masses?
The common symptoms of scrotal masses are:
- An unusual lump
- Sudden pain
- A dull aching pain or feeling of heaviness in the scrotum
- Pain that radiates throughout the groin, abdomen or lower back
- Tender, swollen or hardened testicle
- Tender, swollen or hardened epididymis (ep-ih-DID-uh-miss), the soft, comma-shaped tube above and behind the testicle that stores and transports sperm
- Swelling in the scrotum
- Redness of the skin of the scrotum
- Nausea or vomiting
If the cause of a scrotal mass is an infection, signs and symptoms also might include:
- Urinary frequency
- Pus or blood in the urine
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
Seek emergency medical care if you develop sudden pain in your scrotum. Some conditions require prompt treatment to avoid permanent damage to a testicle.
See your doctor if you detect a lump in your scrotum, even if it’s not painful or tender, or if you experience other symptoms of a scrotal mass.
Some scrotal masses are more common in children. See your doctor if your child experiences symptoms of a scrotal mass, if you have any concerns about the development of the genitals or if a testicle is “missing” — an undescended or retractile testicle, which might increase the risk of some scrotal masses later in life.
What causes scrotal masses?
Many conditions can cause scrotal masses. Epididymitis, which is inflammation of the epididymis, can lead to a scrotal mass. Epididymitis is most often caused by a sexually transmitted infection (STI), such as chlamydia.
Hydroceles can also cause you to develop a scrotal mass. A hydrocele occurs when one of the naturally occurring sacs that surround each testicle fills with fluid. These sacs normally contain a small amount of fluid. If the fluid collects, swelling can occur.
Testicular cancer starts out as abnormal cells in the testicles and can be a potential cause of scrotal masses.
Other potential causes of a scrotal mass include:
- A twisting of the nerves that connect your penis to your testicles
- A hernia
- Enlarged veins in the scrotum
- Inflammation of a testicle caused by a virus like the mumps
What increases my risk for scrotal masses?
Factors that increase the risk of a scrotal mass vary because of the various causes of scrotal abnormalities. Significant risk factors include:
Undescended or retractile testicle
An undescended testicle doesn’t leave the abdomen and enter the scrotum during fetal development or early infancy. A retractile testicle descends into the scrotum, but retreats to the abdomen. Either might increase the risk of:
- Inguinal hernia
- Testicular torsion
- Testicular cancer
Abnormalities present at birth
Abnormalities of the testicles, penis or kidneys present at birth (congenital) might increase the risk of a scrotal mass and testicular cancer later in life.
History of testicular cancer
If you have had cancer in one testicle, you’re at increased risk of cancer affecting the other testicle. Having a father or brother who has had testicular cancer also increases your risk.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How are scrotal masses diagnosed?
Your doctor will rely on a number of factors to diagnose a scrotal mass. These may include:
- A physical exam. Your doctor will feel your scrotum, its contents and nearby areas of the groin while you’re standing and lying down.
- Shining a bright light through the scrotum might provide information about the size, location and makeup of a scrotal mass.
- Using sound waves to create an image of internal organs, this test can provide detailed information about the size, location and makeup of a scrotal mass, as well as the condition of the testicles. An ultrasound usually is necessary to diagnose a scrotal mass.
- Urine test. Laboratory tests of a sample of urine might detect a bacterial or viral infection or the presence of blood or pus in the urine.
- Blood test. Laboratory tests of a blood sample might detect a bacterial or viral infection or elevated levels of certain proteins that are associated with testicular cancer.
- Computerized tomography (CT) scan. If other tests indicate testicular cancer, you’ll likely undergo a specialized X-ray exam (CT scan) of your chest, abdomen and groin to see if cancer has spread to other tissues or organs.
How are scrotal masses treated?
If your scrotal mass is the result of a bacterial infection, antibiotics will be a part of your treatment. If your infection is the result of a virus, antibiotics will be of little help and the best course of treatment is rest and pain medication.
Depending on the size, your doctor may simply leave the mass alone. If the mass is noncancerous and doesn’t cause you severe pain or discomfort, treatment might not be needed. If your mass causes you discomfort, it might be removed. This can be done surgically or your mass might be drained of fluid as is done for a hydrocele.
If the masses in your scrotum are caused by cancer, a cancer treatment specialist will evaluate you to determine whether or not you are a good candidate for treatment. Important factors in determining if cancer has spread beyond your testicles are your age and your overall health. The same factors are important in determining if cancer treatment is right for you.
Treatments for cancer include the following:
- Radical inguinal orchiectomy is a surgical treatment that involves the removal of your affected testicle and the tube that connects it to your body.
- Radiation therapy involves using beams of intense X-rays to destroy cancer cells that can be left behind after surgery.
- Chemotherapy involves using powerful drugs to kill cancer cells.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage scrotal masses?
Testicular self-exams might help you find a scrotal mass early, allowing you to get prompt medical care. If you perform this exam regularly, you’ll understand what “normal” feels like and be better prepared to detect abnormality. To do a testicular self-exam, follow these steps:
- Examine your testicles once a month, especially if you’ve had testicular cancer or you have a family history of testicular cancer.
- Perform the exam after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to check.
- Stand in front of a mirror. Look for swelling on the skin of the scrotum.
- Cup your scrotum with one hand to see if it feels different from normal.
- Examine one testicle at a time using both hands. Place the index and middle fingers under the testicle; place your thumbs on top.
- Gently roll the testicle between the thumbs and fingers to feel for lumps. The testicles are usually smooth, oval shaped and somewhat firm. It’s normal for one testicle to be slightly larger than the other.
- Feel along the soft, comma-shaped structure that runs above and behind the testicle (epididymis) to check for swelling.
- If you find a lump or other abnormality, call your doctor as soon as possible.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Scrotal masses. https://www.mayoclinic.org/diseases-conditions/scrotal-masses/symptoms-causes/syc-20352604. Accessed December 11, 2017.
Scrotal Masses. https://www.healthline.com/health/scrotal-masses. Accessed December 11, 2017.
Review Date: December 11, 2017 | Last Modified: December 11, 2017