Scrotal lumps, pain and swelling

Male Reproductive Organs

Cross-section view

Testicles photo

Swellings in the scrotum can be due to:

• Extra fluid inside.

• Abnormal tissue growing.

• Normal tissue which has become swollen, inflamed, or hard.

Patient picks for Testicle and scrotum problems

Men's health

Getting to know your testicles

If you are a young man or teenage boy, you should be aware of how your testicles (testes) normally feel. Report any changes or lumps to your doctor.

by Dr Laurence Knott

Men's health

Epididymo-orchitis

Epididymo-orchitis is an inflammation of the epididymis (the tube which stores and transports sperm) and/or testicle (testis). In adults, epididymo-orchitis is usually due to infection, most commonly from a urine infection or a sexually transmitted infection. A course of antibiotic medicine will usually clear the infection. Full recovery is usual. Epididymo-orchitis complications are uncommon.

by Dr Pippa Vincent, MRCGP

Symptoms

The symptoms depend on the cause of the problem. Possible symptoms include:

• Noticing a lump which has not been there before.

• A sudden pain.

• A dull ache.

• Redness or warmth of the skin of your scrotum.

• The testicle (testis) or structures around it may be very tender.

• Swelling of your scrotum.

• Feeling sick (nauseated) or being sick (vomiting).

• Having a temperature, passing urine more frequently, or pus or blood in your urine (if the cause is an infection).

Causes of pain or lumps in the scrotum

Common causes of pain or swelling in the scrotum include:

• Torsion of the testis.

• Epididymo-orchitis and orchitis.

• Haematocele (collection of blood around your testicle that may be caused by an injury).

• Hydroceles (see Hydrocele in Adults and Hydrocele in Children).

• Inguinal hernia.

• Epididymal cyst.

• Spermatocele - a cyst which feels like an epididymal cyst but it is filled with sperm (semen)

• Varicocele.

• Testicular cancer.

Uncommon causes of scrotal swellings or pain

Other rare or less common causes include:

• Squamous cell carcinoma.

• Generalised oedema.

• Sebaceous cysts.

• Syphilis.

• Roundworms.

• Henoch-Schönlein purpura.

• Allergic skin rashes.

• Sarcoidosis.

• Hidradenitis suppurativa.

What tests are used for scrotal lumps or pain?

Your doctor will often be able to tell what kind of swelling it is just from examining you. For example, they may shine a light through your scrotum, as fluid will light up. Or they may ask you to cough which may make a hernia more obvious.

You will usually have an ultrasound scan to be sure of the cause and to find out whether you need any treatment. An ultrasound scan is a painless test that uses sound waves to create images of organs and structures inside your body. Sometimes a blood test may be helpful too.

Treatment

The treatment totally depends on the cause. Often no treatment at all is needed. Other times - for example, in testicular torsion or testicular cancer - treatment is needed urgently. See each individual leaflet for further information on the different treatments.

NB: always see a doctor for advice about whether treatment is needed.