The scrotum is a sack of skin that contains the male testicles. A scrotal mass is an abnormal bulge or bump inside the scrotum. A scrotal mass can be fluid, tissue, or a swollen testicle. It is possible that your mass could be related to cancer, but there are a number of other reasons for a mass in your scrotum that are benign (noncancerous).
The symptoms you experience as a result of your scrotal mass will vary depending on their cause. In some cases, there aren’t any symptoms other than a mass in your scrotum that can be felt with your fingers. You might also experience a dull ache, a sudden pain, or a feeling of heaviness in your scrotum.
Other symptoms you might experience include:
- pain that spreads to your groin, abdomen, and back
- testicles that are hard or swollen
- a swollen epididymis (tube located behind your testicles that stores and transports sperm)
- a swollen scrotum
If the cause of your scrotal mass is an infection, you might have a fever and feel you need to urinate more often. There might also be blood or pus in your urine.
Some causes of scrotal masses don’t require immediate attention. However, it is generally a good idea to talk to your doctor about any masses in your scrotum. Some causes of scrotal masses can cause permanent damage to your testicles. You can’t know what has caused your mass without proper diagnosis.
Many conditions can cause scrotal masses. Epididymitis, which is inflammation of the epididymis, can lead to a scrotal mass. Epididymitis is most often caused by a sexually transmitted infection (STI), such as chlamydia.
Hydroceles can also cause you to develop a scrotal mass. A hydrocele occurs when one of the naturally occurring sacs that surround each testicle fills with fluid. These sacs normally contain a small amount of fluid. If the fluid collects, swelling can occur.
Testicular cancer starts out as abnormal cells in the testicles and can be a potential cause of scrotal masses.
Other potential causes of a scrotal mass include:
- twisting of the nerves that connect your penis to your testicles
- a hernia
- enlarged veins in the scrotum
- inflammation of a testicle caused by a virus such as the mumps
If your scrotal mass is the result of infection-causing bacteria, antibiotics will be a part of your treatment. If your infection is the result of a virus, antibiotics will be of little help and the best course of treatment is rest and pain medication.
Depending its size, your doctor may simply leave the mass alone. If the mass is noncancerous and doesn’t cause you severe pain or discomfort, treatment might not be needed. If your mass causes you discomfort, it might be removed. This can be done surgically or, as with a hydrocele, your mass might be drained of the fluid within.
If the masses in your scrotum are caused by cancer, a cancer treatment specialist will evaluate you to determine whether or not you are a good candidate for treatment. Important factors in determining if cancer has spread beyond your testicles are your age and your overall health. The same factors are important in determining if cancer treatment is right for you.
Treatment for cancer includes:
- radical inguinal orchiectomy: a surgical treatment that involves the removal of your affected testicle and the tube that connects it to your body
- radiation therapy: beams of intense X-rays destroy cancer cells that can be left behind after surgery
- chemotherapy: powerful drugs kill cancer cells
You can help prevent scrotal masses that are caused by STIs by practicing safe sex. While using protection isn’t 100 percent effective against all STIs, it can reduce your risk.
Wear a cup while playing sports to protect your testicles from injury. Checking your scrotum and testicles for lumps each month can help you and your doctor detect any problems as early as possible.