Scrotal lumps or pain can have many causes. Most lumps are not cancerous, and many are not serious. However, if you have pain or have a lump in this area, you should always see a doctor.
What is the scrotum?
The scrotum is a loose bag of skin that hangs behind the penis in men and boys. Inside are two testicles. The testicles make the androgen, testosterone, and produce sperm (semen). The sperm collects along many tubes inside the testicles into a tube called the epididymis and is stored there. The sperm then pass through another tube called the vas deferens. The vas deferens carries the sperm to the penis.
Boys and men should know what their testicles usually feel like, so if anything changes, they will know about it.
What causes a lump or pain in the scrotum?
A swollen scrotum may be due to.
Extra fluid inside.
Abnormal tissue growth.
Normal tissue becoming swollen, inflamed, or hard.
What are the symptoms of a scrotal lump?
Symptoms depend on the cause of the problem. Possible symptoms include
Noticing a lump there that was not there before.
Sudden pain.
A vague pain.
Redness or warmth of the scrotal skin.
Pressure pain in one or both testicles or their surrounding structures.
Swelling of the scrotum.
Feeling sick (nausea) or being sick (vomiting).
Have a fever, urinate more often, or have pus or blood in your urine (if it is the cause of an infection).
Common causes of scrotal pain or painful lumps.
Testicular torsion.
When a testicle twists in the scrotum, the condition is called testicular torsion. Usually emergency surgery is needed to treat this condition.
It most often occurs in teenage boys. The problem sometimes occurs in newborns and young children. It is rare in adults over the age of 25, but sometimes occurs in middle-aged and older adults.
The typical symptom is severe pain that develops rapidly – within a few hours, often more rapidly. The pain is in the affected testicle, but you may also feel it in the middle of your stomach (abdomen). The affected testicle quickly becomes tender, swollen and inflamed.
Epididymitis and orchitis.
Epididymitis is an inflammation of the epididymis and/or testicles. Epididymitis is the inflammation of the epididymis. Orchitis is inflammation of the testicles. It is usually due to an infection, most commonly originating from a urinary infection or a sexually transmitted infection. It can also occur in boys with mumps. It is common in men between the ages of 15-30 and in men over 60. It is not common until puberty.
Symptoms usually develop quickly – within a day or so. The affected epididymis and testicles swell rapidly, and the scrotum also becomes large, painful and red on pressure. It can be very painful. If epididymitis is complicated by another infection, there may be other symptoms. For example, if you have a urinary tract infection, you will have painful urination; if you have a urinary tract infection, there will be discharge from the penis; and so on. With an infection, you may have a high fever and generally feel unwell. A course of antibiotics will usually clear up the infection. Full recovery is usually possible. Complications are uncommon.
Sphingomyelomeningocele.
A syringomyelia is a collection of blood that surrounds the testicle. This is usually painful and may be caused by trauma.
Common causes of painless scrotal masses.
Sphingomyelomeningocele.
A syringomyelia is a collection of fluid in the scrotum.
The size of syringomyelia varies widely. Most syringomyelia occurs in adults and is most common in men over the age of 40. Syringomyelia is usually painless. Large syringomyelia may cause discomfort because of their size. Some babies are born with syringomyelia. These usually improve without any treatment up to one year of age as well. Surgery is usually recommended only if the syringomyelia is still present after 12-18 months of age.
Inguinal hernia.
A hernia is a mass that appears from a weak point in the abdominal wall. Males have a small tunnel in the inguinal tissue that forms when they are infants. This tunnel allows the testicles to descend from the abdominal cavity into the scrotum. Intestinal tissue can also pass through this tunnel, and an inguinal hernia is formed. If you have an inguinal hernia, a sausage-shaped lump can be felt from the groin to the scrotum. When you lie down, it may disappear. This is because the tissue slides back along the tunnel to where it should be.
Epididymal cysts/seminal cysts.
An epididymal cyst is a fluid-filled sac that arises at the tip of the testicle. It is benign (i.e. not caused by cancer). The mass can be felt independently of the testicle. men around the age of 40 are most likely to develop these cysts.
A seminal cyst is a cyst that feels like an epididymal cyst, but it is filled with sperm (semen).
Varicose spermatocele.
A varicocele is a collection of enlarged (dilated) veins (blood vessels) in the scrotum. It appears near and above one or both testicles. Varicocele is very common. About 1 in 7 men will develop varicocele — usually between the ages of 15 and 25. Varicocele is usually painless and does not usually cause symptoms.
Testicular cancer.
Testicular cancer is a cancer that starts in the testicles. Less than 4 percent of scrotal masses turn out to be cancer. About half of all cases occur in men under the age of 35, but testicular cancer rarely occurs before puberty. In most cases, the first symptom is noticing a lump in one testicle. The lump is usually painless, but some people will notice some pain or discomfort in the affected testicle.
Other rare or uncommon causes of scrotal swelling or pain include
Squamous cell carcinoma: This is a type of skin cancer of the scrotum.
Extensive edema: This occurs when there is too much fluid overall in the body.
Sebaceous cysts: These are non-cancerous masses under the skin.
Syphilis: This is a sexually transmitted infection. It sometimes causes soft, textured lumps called syphilitic tumors.
Nematodes: Infected worms can block the body’s fluid drainage system.
Allergic purpura: This is a condition that can cause a rash, abdominal pain and joint pain. Sometimes the testicles can also be red and swollen. It arises from the immune system’s response to a trigger (usually an infection). Most people with allergic purpura are children.
Allergic rash.
Cutaneous nodular disease: is a disease in which small lumps called granulomas appear in several parts of your body due to inflammation. Usually it affects the lungs, but occasionally occurs in the scrotum.
Septic sweat glands: These are recurring skin boils.
When to seek medical attention.
If you notice any pain or swelling in your scrotum, you should always see a doctor. If it is painful, you should seek medical attention immediately.
What tests are available for scrotal lumps or pain?
Your doctor will often be able to tell what kind of swelling it is just by a physical exam. For example, they may shine a light through your scrotum because the fluid transmits light. Or, they may ask you to cough, which can make the hernia more visible. You will usually have an ultrasound scan to determine the cause and to determine if you need treatment. An ultrasound scan is a painless test that uses sound waves to produce images of organs and structures in your body. Sometimes a blood test may also be helpful.
What is the treatment for a scrotal mass or lump?
Treatment depends entirely on the cause. Often no treatment is needed. Other times – for example, testicular torsion or testicular cancer urgently needs treatment. It is always necessary to see your doctor and consult him about the need for treatment.