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Scrotal Mass

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Definition

Scrotal masses are made up of fluid or solid material in or around the scrotum or the testicles.

Scrotum is a loose sac of skin, below the penis. The testicles reside inside the scrotal sac. A scrotal mass or swelling may be a sign of something as serious as cancer, or may indicate a less serious or harmless condition like a scrotal cyst. You can develop a scrotal mass at any age. However, any unusual lumps or swelling in the scrotal area needs to be examined and taken care of as soon as it is noticed or detected by the physician.

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Causes

Cysts
Spermatocele
This common type of benign cyst develops in the spermatic cord which lies adjacent to the epididymis near the top of the testicle.
Hydrocele
This soft swelling in the scrotum is a collection of watery fluid in the sheath that holds the testicle. Normally this sheath contains just enough fluid to lubricate the testicle. When the body produces too much fluid or can not absorb enough, the excess liquid creates a hydrocele. Hydroceles may occur on one or both sides and occur most often in older men.
Varicocele
Enlarged scrotal veins cause this benign, painless swelling which commonly occurs on the left side. Due to a problem with valves inside the veins, blood backs up from the testicular and scrotal veins. The swelling feels like a bag of worms on touch. This sensation may disappear when you lie down. The varicocele itself is not serious, but it may contribute to infertility.
Infection
Epididymitis

This infection in the tubular coil (epididymis) that collects sperm from the testes produces pain in the top and rear of the scrotum. The pain is generally severe and develops gradually over several hours or days. Fever and swelling are common.

Orchitis
This inflammation of the testicle is often due to a infection by a bacteria or the mumps virus. It involves pain and swelling in the scrotum along with a feeling of added weight in the scrotum. Orchitis may also occur when there is an infection of the prostate or the epididymis or it may appear as a manifestation of other less common diseases. This condition can permanently damage one or both testicles, resulting in diminished size of the testicle, inadequate hormone production and infertility.
Hernia
Inguinal Hernia
An inguinal hernia develops when the small bowel protrudes through a weak point of the abdominal wall in the groin area. The result is a bulge in the groin area that may extend into the scrotum and be painful or uncomfortable.
Tumors
Testicular Cancer

This condition is serious and is identified by a lump or swelling within a testicle, sometimes accompanied by a heavy feeling in a testicle. If detected and diagnosed early, this type of cancer often is treatable.

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Implications

Besides being painful and uncomfortable, scrotal swellings that may arise due to severe inflammation can permanently damage the testicular tissue. This may result in inadequate hormone production and infertility.

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What You Can Do

Treatment
Spermatocele
Most spermatoceles are small, cause no symptoms and require no treatment. Large and painful spermatocele may require surgical removal. Draining the fluid by puncturing the spermatocele through the skin may provide temporary relief. But the fluid invariably accumulates again within a few weeks.
Hydrocele
Usually, no treatment is required for a hydrocele unless the scrotal swelling is large and uncomfortable.
Varicocele.
Surgically tying off (ligation) the varicocele may improve your chances of becoming fertile again.
Epididymitis
This usually acute condition can be treated with antibiotics.
Orchitis
Antibiotics may be prescribed by your physician to treat bacterial orchitis. Orchitis associated with viral infections such as mumps can be treated by conservative means such as rest and pain-relieving medications.
Inguinal Hernia.
Surgery may be recommended for painful or bothersome inguinal hernia. However, hernias can recur after surgery, but this happens quite rarely.
Testicular Cancer
Please see treatment options for Testicular Cancer
Prevention
Testicular Self-Examination

Testicular Self-Examination (TSE) is a simple procedure of examining your testicles standing in front of a mirror. This can dramatically reduce your risks of overlooking a tumor or abnormality. Testicular Self Examination cannot substitute for a doctor's examination done during regular physical check ups. Place the index and middle fingers under the testicle while placing your thumbs on the top and gently roll the testicle between the thumbs and the fingers. Testicles are usually smooth, oval shaped and somewhat firm. It is normal for one testicle to be slightly larger than the other. Also, the cord leading upward from the top of the testicle (epididymis) is a normal part of the scrotum. If you find a lump, consult your physician as soon as possible

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For More Information

American Association for Cancer Research

American Cancer Society

National Cancer Institute

National Coalition for Cancer Survivorship

National Digestive Diseases Information Clearinghouse (NDDIC)

Healthfinder

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Scrotal Mass