A scrotal mass is a lump or bulge that can be felt in the scrotum .

Alternative Names

Hematocele; Spermatocele

Causes, incidence, and risk factors

The potential cause of a scrotal mass may be varied and involve either benign or malignant processes. A benign scrotal mass may be referred to as a hematocele, hydrocele, varicocele or a spermatocele. A hematocele is a collection of blood within the scrotum . A hydrocele is a fluid collection in the scrotum. A spermatocele is a cyst-like mass within the scrotum that contains fluid and dead sperm cells. Possible causes of a scrotal mass include inflammatory or infectious diseases (for example, epididymitis ), physical trauma to the scrotum, herniation ( inguinal hernia ), or tumors. The incidence and risk factors vary greatly, depending upon the cause.

Signs and tests

A physical examination shows a mass within scrotum which is:

Typically unilateral (only on one side)

Tender or non-tender

Uniform, smooth, tortuous, or irregular

Fluctuant, firm, or solid

The groin (inguinal) lymph nodes may or may not be enlarged or tender on the involved side.

An

ultrasound evaluation of the scrotum may be necessary for diagnosis.

A

biopsy may be done on masses that are surgically removed.

Testicular self examination

is recommended on a regular monthly basis.

Treatment

ALL scrotal masses need to be evaluated by a primary health care provider. Hematoceles, hydroceles , and spermatoceles are usually benign and do not require treatment. Acute conditions may respond to local comfort measures and, in some situations, antibiotics or pain relievers . A scrotal support (jock strap) may provide some relief of the pain or discomfort associated with the scrotal mass. A hematocele, hydrocele, or spermatocele may occasionally require surgery to remove the collection of blood, fluid, or dead cells. See also:

Epididymitis

Hydrocele

Inguinal hernia

Orchitis

Seminoma

Sertoli-Leydig cell tumor

Spermatocele

Testicular cancer

Varicocele

Expectations (prognosis)

The majority of conditions that cause scrotal masses are either of no consequence, or can be easily treated with a high resolution rate. Even

testicular cancer , with early diagnosis and treatment, can be cured.

Complications

Varicoceles may lead to

infertility .

Hematoceles, hydroceles, and spermatoceles may recur after surgery.

Some aggressive forms of

testicular cancer may metastasize (move to other organs such as the lungs or liver) before a scrotal mass is large enough to be detected.

Calling your health care provider

Call your health care provider if you are male, of any age, noting any kind of lump or bulge within the scrotum .

Prevention

Scrotal masses (aggregations of cells) caused by a condition that may be linked to a sexually transmitted disease (for example,

epididymitis ) may be prevented by practicing safer sexual behaviors .

Scrotal masses resulting from local physical trauma may be prevented by wearing protective gear (such as an athletic cup) for high-risk activities.

Many causes of scrotal masses are not preventable. However, periodic

testicular self examination can assist in early diagnosis, treatment and therefore improved outcome.

All males, 15 years or older, who are not aware of how to perform testicular self examination should be taught how to do so by a physician.