Description

Scrotal masses are lumps or swelling in the scrotum, the pouch of skin that contains the testicles.

Scrotal masses could be:

  • A buildup of fluids.
  • The growth of irregular tissue.
  • Inflammation and swelling or hardening of parts in the inside of the scrotum.

It is the key to getting a scrotal mass reviewed by a health care professional, even if you have no pain or other symptoms. Some masses of cancer. Or it could be caused by another medical condition that affects the health of the testicles and how well it works.

Each month, check in the scrotum for any changes. Also you get the area checked during regular checkups. This can help you to detect things early, when many of the treatments work better.

Symptoms

The symptoms of scrotal masses vary. Some cause pain and others do not. Depends on the cause. The symptoms of a scrotal mass may include:

  • An unusual lump.
  • Sudden pain.
  • Dull pain or a feeling of heaviness in the scrotum.
  • Pain that spreads around the area of the groin, in the area of the stomach or the lower part of the back.
  • A tender, swelling or hardening of testicle or epididymis (ep-ih-DID-uh-miss). The epididymis is soft, comma-shaped tube above and behind the testicle that stores and carries sperm.
  • Swelling in the scrotum.
  • A change in the color of the skin of the scrotum.
  • Stomach pain or vomiting.

If an infection causes a scrotal mass, symptoms may also include:

  • Fever.
  • Need to urinate frequently.
  • Pus or blood in the urine.

When to see a doctor

Get emergency medical help if you have sudden pain in the scrotum. Some of the problems should be treated immediately to help prevent permanent damage to a testicle.

Consult a health care professional if you notice a lump in the scrotum or other unusual changes. To get a checkup, even if you have a lump that is not painful or tender.

Some scrotal masses are more common in children. Consult your child's pediatrician or other health care professional if you:

  • Your child has symptoms of a scrotal mass.
  • You have any concerns about your child's genitals.
  • A testicle is "missing". Sometimes, a testicle does not move down from the area of the abdomen into the scrotum before birth. This is called an undescended testicle. Could increase the risk of some scrotal masses later in life.

Causes

Many health conditions can cause a scrotal mass or an unusual change in the scrotum. These include:

  • Testicular cancer. This is a cancer that starts in the testicles. This often causes a painful lump or swelling in the scrotum. But some people with testicular cancer have no symptoms. See your doctor or other health care professional if you notice a new lump in the scrotum.
  • Spermatocele. This fluid-filled sac in the scrotum is often above the testicle. It tends to be painless. And usually, not the cancer. A spermatocele is also known as a spermatic cyst or cyst of the epididymis.
  • Epididymitis.This is when the coiled tube at the back of the testicle called the epididymis, is inflamed. Often, epididymitis is caused by an infection with bacteria. For example, the bacterial infections that are spread through sex, such as chlamydia, can cause. Less often, a virus can cause epididymitis.
  • Orchitis. This is when the inflammation, which can include pain and swelling, affects the testicles. Usually, it is due to a disease caused by a virus, most of the times the mumps.
  • Hydrocele.This is when fluid collects between the layers of a sac that surrounds each testicle. More often, there is a small amount of fluid in this space. But the excess fluid of a hydrocele can lead to a painless swelling of the scrotum. In adults, a hydrocele can happen due to an imbalance in the amount of fluid produced or absorbed. Often, this is due to an injury or infection in the scrotum. In infants, a hydrocele tends to happen due to an opening between the stomach and the scrotum does not close properly during development.
  • Hematocele. This is a collection of blood between the layers of a sac that surrounds each testicle. An injury, such as a direct blow to the testicles, that is the most likely cause.
  • Varicocele. This occurs when the veins inside the scrotum becomes larger. The Varicocele is more common on the left side of the scrotum due to the differences in how blood is flowing from each side. A varicocele can cause infertility, which is when you can't get your partner pregnant after a year of unprotected sex.
  • Inguinal Hernia.This is when a part of the small intestine pushes through an opening or weak spot in the tissue that separates the stomach area and the groin. It may appear as a mass in the scrotum or higher in the groin. In infants, an inguinal hernia often occurs before birth when you step from the area of the abdomen to the scrotum does not close.
  • Testicular torsion. This is a painful problem that cuts off the blood supply to the testicle. This occurs due to a torsion of the spermatic cord. This is a bundle of blood vessels, nerves, and the tube that carries semen from the testicles to the penis. Without timely treatment, the testicular torsion can lead to the loss of the testicle.

Epididymitis. This is when the coiled tube at the back of the testicle called the epididymis, is inflamed.

Often, epididymitis is caused by an infection with bacteria. For example, the bacterial infections that are spread through sex, such as chlamydia, can cause. Less often, a virus can cause epididymitis.

Hydrocele. This is when fluid collects between the layers of a sac that surrounds each testicle. More often, there is a small amount of fluid in this space. But the excess fluid of a hydrocele can lead to a painless swelling of the scrotum.

In adults, a hydrocele can happen due to an imbalance in the amount of fluid produced or absorbed. Often, this is due to an injury or infection in the scrotum.

In infants, a hydrocele tends to happen due to an opening between the stomach and the scrotum does not close properly during development.

Inguinal Hernia. This is when a part of the small intestine pushes through an opening or weak spot in the tissue that separates the stomach area and the groin. It may appear as a mass in the scrotum or higher in the groin.

In infants, an inguinal hernia often occurs before birth when you step from the area of the abdomen to the scrotum does not close.

Risk factors

Things that may increase the risk of a scrotal mass include:

  • Undescended testicle. An undescended testicle, do not let the area of the stomach and move down into the scrotum before birth or later in the year.
  • The conditions that are present at birth. Some people are born with irregular changes in the testes, the penis, or the kidneys. This can 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, your risk of developing cancer in the other testicle is larger. Having a father or a brother who had testicular cancer also increases the risk.

Complications

Not all scrotal masses of the long-term medical conditions. But any mass that affects the health and function of the testis may result in:

  • Delayed or poor development during puberty.
  • The infertility.

Diagnosis

To find out what kind of scrotal mass that you have, you may need tests such as:

  • A physical exam. During this test, a doctor or other health professional feels its scrotum, its content, and the nearby areas of the groin, while you're standing up and lying down.
  • The transillumination. The shining a bright light through the scrotum may provide information on the size, location and makeup of a scrotal mass.
  • Ultrasound. This test uses sound waves to create an image of the inside of the body. You can provide detailed information on the size, location and makeup of a scrotal mass. You can also show the condition of the testicles. An ultrasound is often necessary to diagnose a scrotal mass.
  • Urine test. Laboratory testing of a urine sample can be found an infection caused by a virus or a bacterium. A urine test can also detect the presence of blood or pus in the urine.
  • Blood test. Laboratory testing of a blood sample can be found a bacterial or viral infection. Or they could detect high levels of certain proteins that are linked with testicular cancer.
  • Computed tomography (CT scan). If other tests show that you have testicular cancer, the more likely it is to get this series of x-rays. A ct scan of the chest, in the area of the stomach and the groin can check to see if the cancer has spread to other tissues or organs.

Treatment

The treatment of a scrotal mass mainly depends on its cause.

Infections

Medicines called antibiotics can treat a scrotal mass caused by bacteria, as is often the case with epididymitis. If a virus cause epididymitis or orchitis, the usual treatment consists of rest, ice and the pain relief of the medicine.

Scrotal masses that are not cancer

You may hear these called benign masses. Sometimes you don't need treatment. Other times, they need to be removed with surgery, repaired, or drained. Treatment decisions depend on factors such as whether the scrotal mass:

  • Cause discomfort or pain.
  • Contributes to or increases the risk of infertility.
  • Infected.

Testicular cancer

If your scrotal mass is caused by cancer that begins in the testis, it is likely that you see a cancer doctor called an oncologist. The oncologist may recommend treatments depending on whether the cancer is in the testicle, or has spread to other parts of the body. Your age and general health are also factors.

The main treatment options include:

  • Radical inguinal orchiectomy. This is the main treatment for testicular cancer. Is the surgery to remove the affected testicle and the spermatic cord through an incision in the groin. The lymph nodes in the stomach area might also be removed if the cancer has spread to them.
  • Chemotherapy. This uses powerful chemicals to kill cancer cells. Most often, the chemotherapy is given through a needle placed into a vein. Often used to treat testicular cancer that has spread beyond the testicle. It is also used to reduce the chances of the cancer coming back after a testicle is removed with surgery. Chemotherapy is not a treatment for cancer, that only in the testis.

The radiation therapy may also be used. Sends high doses of X-rays or other high-energy radiation to specific parts of the body. This can kill cancer cells or slow growth. With testicular cancer, the main use of radiation to destroy cancer cells that have spread to the lymph nodes. Your healthcare provider may recommend this treatment after surgery to remove an affected testicle.

The majority of the cases of early testicular cancer can be cured. And even if the illness extends beyond the testicle, you may still be curable. But you'll need follow-up care to monitor for signs that the cancer has returned.

Lifestyle and home remedies

Self-examination of the testes may help you to find a scrotal mass early. To do a self-exam, follow these steps:

  • Check your testicles once a month. This is key if you've had testicular cancer or if a blood relative, such as his father or brother has had.
  • Do the test after a hot bath or shower. The heat of the water relaxes the scrotum, making it easier for you to check.
  • Stand in front of a mirror. Look for swelling in the skin of the scrotum.
  • The cup of his scrotum with one hand to see if it feels different to the usual.
  • Check one testicle at a time using both hands. Place the index and middle fingers under the testicle; place the thumbs at the top.
  • Gently roll the testicle between the thumb and fingers to feel for lumps. The testicles are usually smooth, oval-shaped, and something firm. Often, one testicle is slightly larger than the other.
  • Feel along the soft, comma-shaped structure that runs above and behind the testicle called the epididymis, to check the swelling.

If you find a lump, or out of the ordinary, to change, to seek medical attention to have it checked as soon as possible.

Preparing for your appointment

Get emergency medical help if you have pain in the scrotum or testicles. If you find a scrotal mass, it is likely to start by seeing your doctor or other health care professional. You may be referred to a doctor who is called a urologist, which is the urinary tract and male genital conditions.

The preparation for the appointment will help to make the most of your time during the visit.

What you can do

Type the information to be shared with your health care team, such as:

  • Your symptoms, including any that may seem unrelated to a scrotal mass.
  • Key personal information, including major stresses or recent life changes.
  • The drugs, vitamins, and supplements you are taking.
  • Family history of testicular cancer or other health problems with the scrotum.
  • The medical history, including previous scrotal masses, undescended testicle, or genital conditions of birth.
  • Questions to ask your health care team.

The questions that you can ask about scrotal masses are:

  • What tests are needed?
  • How much time does it take to get the results of the test?
  • If the scrotal mass is cancerous, what are the next steps?
  • If the scrotal mass is not cancerous, I need treatment?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Do not hesitate to ask any other questions.

What to expect from your doctor

Be prepared to answer many questions, including:

  • When you find a lump or notice other symptoms associated with a scrotal mass?
  • Do you have pain in or near your scrotum?
  • Have you had a fever or seen blood or pus in the urine?
  • Has had a recent injury to the groin?
  • Does anything, like medicine for the pain, improve symptoms? Does anything make the symptoms worse, such as exercise or activities that put a strain on the groin?
  • Do you have an undescended testicle that was corrected with surgery?
  • Have you ever had a sexually transmitted infection? Do you have more than one sexual partner or a new sexual partner?
Symptoms and treatment of Scrotal masses