Scrotal masses

Alternative names

Hematocele; Spermatocele

Definition

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

Causes, incidence, and risk factors

A scrotal mass can be benign (generally harmless) or malignant (cancerous). Benign scrotal masses include:

• Varicocele - a varicose vein along the spermatic cord
  
• Hydrocele - fluid collection in the scrotum
  
• Hematocele - blood collection within the scrotum
  
• Spermatocele - a cyst-like mass within the scrotum that contains fluid and dead sperm cells
  

Scrotal masses can be caused by inflammatory or infectious diseases (for example, epididymitis), physical injury to the scrotum, herniation (inguinal hernia), or tumors.

See also:

• Orchitis
  
• Seminoma
  
• Sertoli-Leydig cell tumor
  
• Testicular cancer
  

Symptoms

• Painless or painful bulge or lump within the scrotum (testicle lump)
  
• Infertility
  
• Enlarged scrotum
  

Signs and tests
During a physical examination, the doctor may feel a mass within the scrotum that has a variety of possible features:

• Tender or non-tender
  
• Uniform, smooth, twisted, or irregular
  
• Fluctuant, firm, or solid
  
• Typically only on one side
  

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

The following tests may be performed to help diagnose a scrotal mass:

• Ultrasound of the scrotum
  
• Biopsy on masses that are surgically removed
  

To discover any lumps as early as possible, all men should perform testicular self examination each month.

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. Sudden, temporary conditions may respond to local comfort measures and, in some situations, antibiotics or pain relievers.