What is a Scrotal Mass? Symptoms, Causes, & Treatment

A scrotal mass is any lump, swelling, or abnormal growth you can feel in your scrotum – the sac of skin that holds your testicles. Most scrotal masses are benign (non-cancerous) and treatable, though some require prompt medical attention to rule out serious conditions.

Finding a lump in this sensitive area can feel alarming, but you're not alone in this experience. Many men discover scrotal masses at some point in their lives, and the vast majority turn out to be harmless conditions that doctors can easily address.

What are the symptoms of scrotal masses?

The most obvious symptom is feeling a lump, bump, or area of swelling in your scrotum. This might feel different from your normal anatomy when you touch the area during bathing or routine self-examination.

Beyond the physical lump itself, you might notice several other changes that can help your doctor understand what's happening. These symptoms can vary depending on the underlying cause, and some masses cause no discomfort at all.

Common symptoms that may accompany scrotal masses include:

• Pain or tenderness in the affected area
• A feeling of heaviness or dragging sensation in your scrotum
• Swelling that gets bigger over time
• Changes in the size or shape of one testicle compared to the other
• A soft, fluid-filled feeling when you gently squeeze the mass
• Discomfort that worsens with physical activity or standing for long periods

Some scrotal masses develop gradually and cause minimal symptoms, while others appear suddenly and may be quite uncomfortable. The key is paying attention to any changes in how your scrotum feels or looks.

What are the types of scrotal masses?

Scrotal masses fall into several categories based on where they develop and what causes them. Understanding these types can help ease your concerns and give you better insight into what your doctor might be looking for during examination.

The most common types include fluid-filled masses, solid growths, and masses related to the tubes and structures that support your testicles. Each type has distinct characteristics that help doctors make an accurate diagnosis.

Fluid-filled masses

Hydroceles are the most common type of scrotal mass, occurring when fluid builds up around one or both testicles. This creates a soft, painless swelling that often feels like a water balloon around your testicle.

Spermatoceles, also called epididymal cysts, are small fluid-filled sacs that develop in the epididymis – the coiled tube that stores sperm. These typically feel like small, smooth bumps above or behind your testicle and rarely cause pain.

Solid masses

Epididymitis creates swelling in the epididymis due to infection or inflammation. This condition often causes significant pain and tenderness, especially when walking or sitting.

Testicular tumors are solid masses that develop within the testicle itself. While testicular cancer is relatively rare, it's the most serious type of scrotal mass and requires immediate medical evaluation.

Varicoceles occur when veins in the scrotum become enlarged and twisted, similar to varicose veins in your legs. These often feel like a "bag of worms" and may cause a dull ache or feeling of heaviness.

Rare types

Inguinal hernias can sometimes extend into the scrotum, creating a mass that may come and go depending on your position or activity level. These occur when part of your intestine pushes through a weak spot in your abdominal wall.

Torsion of testicular appendages involves twisting of small tissue remnants attached to your testicles. This rare condition typically affects young boys and teenagers, causing sudden, severe pain.

What causes scrotal masses?

Scrotal masses develop through various mechanisms, ranging from normal bodily processes gone slightly awry to infections and genetic factors. Most causes are not related to anything you did or didn't do – they're simply part of how bodies sometimes function.

Understanding the different causes can help you recognize that most scrotal masses result from benign conditions that doctors encounter regularly in their practice.

Common causes include:

• Fluid accumulation due to normal bodily processes or minor injury
• Bacterial infections spreading from the urinary tract
• Inflammation from physical trauma or strain
• Blocked ducts that normally drain fluid from the testicles
• Enlarged blood vessels due to faulty valves
• Cysts forming in the sperm-carrying tubes

Infections often develop when bacteria travel up through your urethra and reach the epididymis. This can happen after urinary tract infections, sexually transmitted infections, or even following certain medical procedures.

Less common causes include genetic conditions that affect how your reproductive system developed, autoimmune disorders that cause inflammation, and rarely, cancerous growths within the testicle itself.

When to see a doctor for scrotal masses?

You should see a doctor whenever you discover a new lump or mass in your scrotum, even if it doesn't hurt. Early evaluation helps ensure proper diagnosis and treatment, especially since some conditions require prompt attention.

While many scrotal masses are harmless, certain symptoms warrant immediate medical care. Don't wait if you experience sudden, severe pain, as this could indicate testicular torsion – a condition that requires emergency treatment to save your testicle.

Seek immediate medical attention if you experience:

• Sudden, severe scrotal pain that comes on quickly
• Nausea and vomiting along with scrotal pain
• A hard, painless lump within the testicle itself
• Rapid growth of any scrotal mass
• Signs of infection like fever, chills, or red, warm skin

Schedule a routine appointment with your doctor for masses that are painless, slow-growing, or cause only mild discomfort. Even benign conditions benefit from proper medical evaluation and treatment when appropriate.

What are the risk factors for scrotal masses?

Several factors can increase your likelihood of developing scrotal masses, though having risk factors doesn't mean you'll definitely develop problems. Age plays a significant role, with different types of masses being more common at different life stages.

Many risk factors are beyond your control, relating to genetics, anatomy, or normal aging processes. However, understanding these factors can help you stay alert to changes and seek appropriate care when needed.

Age-related risk factors include:

• Infancy and early childhood for congenital hydroceles
• Adolescence and young adulthood for testicular cancer
• Middle age and beyond for acquired hydroceles and varicoceles
• Older age for epididymitis related to prostate problems

Other risk factors that may increase your chances include a personal or family history of testicular problems, previous groin injuries, frequent urinary tract infections, or certain medical conditions that affect fluid balance in your body.

Having an inactive lifestyle, chronic constipation, or conditions that increase abdominal pressure may raise your risk for hernias that extend into the scrotum. However, many men with these risk factors never develop problems.

What are the possible complications of scrotal masses?

Most scrotal masses cause few complications when properly diagnosed and treated. However, leaving certain conditions untreated can lead to more serious problems over time.

The complications you might face depend largely on the type of mass and how quickly you seek treatment. Some complications affect fertility, while others can cause ongoing pain or more serious health issues.

Potential complications include:

• Fertility problems from untreated varicoceles or infections
• Chronic pain from persistent inflammation
• Testicular damage from severe infections
• Psychological stress from worry about cancer
• Cosmetic concerns from large, persistent masses

Testicular torsion represents the most serious complication, potentially leading to loss of the affected testicle if not treated within hours. Severe infections can also cause permanent damage to sperm production or transport.

Fortunately, seeking prompt medical care dramatically reduces your risk of complications. Most scrotal masses respond well to appropriate treatment, and serious complications are relatively rare when conditions are caught early.

How can scrotal masses be prevented?

While you can't prevent all types of scrotal masses, certain steps can reduce your risk of developing some conditions. Many scrotal masses result from factors beyond your control, but focusing on overall health and good hygiene can help.

Prevention strategies primarily target infections and injuries that can lead to scrotal masses. Practicing safe sex, maintaining good hygiene, and protecting yourself during physical activities can all play a role.

Helpful prevention measures include:

• Practicing safe sex to prevent sexually transmitted infections
• Maintaining good genital hygiene
• Wearing protective gear during contact sports
• Treating urinary tract infections promptly
• Performing regular self-examinations to catch changes early
• Staying hydrated and maintaining good overall health

Regular self-examination is particularly important for early detection rather than prevention. Learning how your testicles normally feel helps you notice changes quickly, leading to earlier treatment when problems do arise.

How are scrotal masses diagnosed?

Your doctor will start with a physical examination, carefully feeling your scrotum to assess the size, location, and characteristics of any masses. This hands-on evaluation provides crucial information about what type of condition you might have.

During the physical exam, your doctor will check both testicles, the surrounding structures, and may examine your abdomen and groin area. They'll ask about your symptoms, medical history, and any recent changes you've noticed.

Additional tests your doctor might recommend include:

• Ultrasound imaging to see internal structures clearly
• Blood tests to check for infection or tumor markers
• Urine tests to identify bacterial infections
• CT scans if cancer is suspected and staging is needed

Ultrasound is often the most helpful test because it can distinguish between solid masses and fluid-filled cysts. This painless procedure uses sound waves to create detailed images of your scrotal contents.

If your doctor suspects testicular cancer, blood tests for specific proteins called tumor markers can provide additional information. However, most scrotal masses can be diagnosed through physical examination and ultrasound alone.

What is the treatment for scrotal masses?

Treatment depends entirely on what type of scrotal mass you have and whether it's causing symptoms. Many benign masses require no treatment at all, while others benefit from medication or surgical procedures.

Your doctor will explain the benefits and risks of different treatment options based on your specific situation. The goal is always to address your symptoms while preserving normal function and preventing complications.

Treatment options may include:

• Watchful waiting for small, painless masses
• Antibiotics for infections causing epididymitis
• Anti-inflammatory medications for pain and swelling
• Surgical drainage or removal for large or symptomatic masses
• Specialized cancer treatment if malignancy is found

Simple hydroceles often resolve on their own, especially in infants and young children. However, large or uncomfortable hydroceles may require a minor surgical procedure to drain the fluid and prevent recurrence.

Varicoceles that cause pain or fertility concerns can be treated with surgical procedures that redirect blood flow through healthier veins. Most men experience significant improvement in symptoms after these procedures.

How to manage scrotal masses at home?

While professional medical care is essential for proper diagnosis and treatment, several home measures can help you feel more comfortable while managing scrotal masses. These approaches work best alongside your doctor's recommendations, not as replacements for medical care.

Home management focuses on reducing discomfort and supporting your overall healing process. Simple measures can make a significant difference in how you feel day-to-day.

Helpful home care strategies include:

• Wearing supportive underwear to reduce discomfort from heavy or swollen areas
• Applying ice packs for 15-20 minutes to reduce acute swelling
• Taking over-the-counter pain relievers as directed by your doctor
• Avoiding heavy lifting or strenuous activities that worsen symptoms
• Elevating your legs while lying down to improve blood flow

For masses that cause a dragging sensation or discomfort, wearing snug-fitting briefs instead of boxers can provide helpful support throughout the day. Some men find that athletic supporters offer even better relief during physical activities.

Always follow your doctor's specific instructions about activity levels and self-care measures. What works well for one type of scrotal mass might not be appropriate for another condition.

How should you prepare for your doctor appointment?

Preparing for your appointment helps ensure you get the most from your visit and provides your doctor with the information they need to help you effectively. Good preparation can also help ease any anxiety you might feel about discussing intimate health concerns.

Start by writing down your symptoms, when you first noticed them, and any changes you've observed over time. This information helps your doctor understand your condition's progression and severity.

Before your appointment, prepare:

• A list of all symptoms you've experienced, including timing and severity
• Information about any medications or supplements you're taking
• Questions you want to ask your doctor
• Your medical history, including previous groin injuries or surgeries
• Details about your sexual health and any recent infections

Don't feel embarrassed about discussing intimate details with your doctor. They're trained professionals who regularly address these types of concerns and need complete, honest information to help you effectively.

Consider bringing a trusted friend or family member if their presence would help you feel more comfortable or remember important information discussed during your visit.

What's the key takeaway about scrotal masses?

The most important thing to remember is that finding a scrotal mass doesn't automatically mean you have a serious problem. The vast majority of scrotal masses are benign conditions that doctors can easily diagnose and treat when necessary.

However, any new lump or mass in your scrotum deserves medical evaluation to ensure proper diagnosis and appropriate care. Early detection and treatment lead to the best outcomes for all types of scrotal conditions.

Don't let embarrassment or fear prevent you from seeking medical care. Your doctor has seen these conditions many times before and wants to help you maintain your health and peace of mind. Taking action when you notice changes shows wisdom and self-care, not weakness.