Dr. CARLO A. BRAVI Urologist and Andrologist
Scrotal or Testicular Masses – What Do They Mean?
A scrotal or testicular mass refers to any lump, swelling, or abnormal area felt in the scrotum or on the testicle. Some are harmless and painless, while others may cause discomfort or represent more serious conditions. It’s important to have any new mass evaluated by a healthcare provider.
Common Causes of Scrotal/Testicular Masses
Masses in the scrotal area can arise from the testicles themselves or from surrounding structures such as the epididymis or blood vessels. Some potential causes include:
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Epididymal cysts or spermatoceles: Fluid-filled sacs near the top of the testicle, usually painless and benign.
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Hydrocele: A buildup of fluid around the testicle, often painless but can cause swelling.
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Varicocele: Enlarged veins in the scrotum, similar to varicose veins, often described as feeling like a “bag of worms.”
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Inguinal hernia: Occurs when part of the intestine pushes through the groin into the scrotum. May increase in size with standing or straining.
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Orchitis or epididymitis: Infection or inflammation of the testicle or epididymis; may cause swelling, redness, and pain.
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Testicular torsion: A surgical emergency where the spermatic cord twists, cutting off blood flow. Causes sudden, severe pain and requires immediate attention.
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Testicular cancer: Usually presents as a firm, painless lump in the testicle. Often detected by self-exam or incidentally.
How Are Scrotal Masses Diagnosed?
Evaluation aims to determine the cause and rule out serious conditions, especially testicular cancer, which is highly treatable when caught early.
Initial evaluation typically includes:
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Physical examination: A doctor will palpate (feel) the scrotum and testicles to locate and characterize the mass.
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Scrotal ultrasound: The most important and non-invasive test, used to differentiate solid from fluid-filled masses and assess blood flow.
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Urinalysis and urine culture: To check for infection or inflammation.
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Blood tests: May include tumor markers (like AFP, β-hCG, and LDH) if cancer is suspected.
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Additional imaging, such as CT scans, may be done if cancer is confirmed to check for spread.
Treatment options
If a scrotal or testicular mass is found and needs treatment, management is generally surgical. The specific approach depends on whether the condition is benign or potentially malignant.
Dr Bravi tailors each procedure to ensure optimal outcomes with minimal recovery time.
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Benign conditions (such as hydroceles, cysts, or varicoceles) are usually treated with minimally invasive peno-scrotal surgery, often performed as day cases, aimed at relieving swelling or discomfort with minimal downtime and excellent cosmetic outcomes.
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Suspicion of testicular cancer warrants a radical orchidectomy (full removal of the testicle).
Early evaluation and accurate diagnosis are key to selecting the appropriate surgical approach and achieving the best possible result.
When to See a Doctor
Any new, persistent, or growing lump in the scrotum should be evaluated by a healthcare provider—even if it’s not painful. Pain, swelling, or redness should also prompt medical attention. Immediate care is critical if symptoms suggest testicular torsion, which can lead to loss of the testicle if not treated quickly.
Key message
Scrotal or testicular masses range from harmless cysts to urgent surgical conditions or cancer. Early diagnosis is key to effective treatment and avoiding complications. Regular self-exams and prompt evaluation of changes are essential for men’s health.
