In the “courtyard” of the scrotum, only the testicles, epididymis and spermatic cord are normally inhabited. When we suddenly find a lump in the scrotum, we will be very frightened and worried. Please don’t be anxious, here is an easy three-step method to determine scrotal lumps. 1. Observe whether the lump is related to the abdomen. Although the scrotum is located at the front and bottom of the pelvis, its internal structure is often associated with the abdomen. If you pinch the lump with two fingers at the root of the scrotum and the lump is completely under your fingers, it is an intra-scrotal lump; if the lump is located between your fingers, then it may descend from the abdomen. Most of the masses descending from the abdomen are either inguinal hernias (commonly known as small intestinal pneumonia) or originate from the spermatic cord. The former is mostly in the shape of a mass, while the latter is in the shape of a strip, resembling a tangled mass of earthworms in severe cases, and their common feature is that they can disappear after lying down. 2. Determine whether the mass is substantial or cystic. It is important to distinguish between substantial or cystic to differentiate the nature of the lumps in the scrotum. Most of the parenchymal ones are tumors or inflammation, while most of the cystic ones are cysts or fluid accumulation. Parenchymal masses are harder, whereas cystic are more pliable or flexible. When a flashlight is shone upward in a dark room at the base of the scrotum, the parenchymal ones are dark black, while the cystic ones are translucent and red. If it is still difficult to identify, it can be confirmed with ultrasound at the hospital. 3. Feel whether the lump is painful or not. Generally speaking, most of the substantial lumps with pain are inflammatory, while those without pain may be tumors or tuberculosis. A painful lump outside the testicle may be epididymitis. A painless lump outside the testicle may be tuberculous epididymitis or adenoma-like tumor; a painful lump in the testicular area may be orchitis or testicular torsion, and a painless lump may be a testicular tumor. The specific ones can also be confirmed by ultrasound at the hospital. Through this three-step diagnosis, you will have a preliminary understanding of testicular lumps, and if necessary, you can go to the hospital for further examination to confirm the diagnosis, which is mainly ultrasound testing in addition to the routine physical examination. After diagnosis, inflammation can be treated with anti-inflammatory treatment, small benign lumps can be temporarily observed, and the rest need surgical treatment.