There are many causes of lumps or pain in the scrotum, including hydrocele, varicocele, and testicular torsion. Most lumps are not cancer, and many are not serious. However, you should always see a doctor if you have pain or a lump in this area.
You should always see a doctor if you notice any pain or swelling in your scrotum. If it is painful, you should seek advice urgently.
Swellings in the scrotum can be due to:
- Extra fluid inside.
- Abnormal tissue growing.
- Normal tissue which has become swollen, inflamed, or hard.
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).
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Causes of pain or lumps in the scrotum
- 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)
- Testicular cancer.
Uncommon causes of scrotal swellings or pain
Other rare or less common causes include:
- Squamous cell carcinoma.
- Generalised oedema.
- Sebaceous cysts.
- Henoch-Schönlein purpura.
- Allergic skin rashes.
- 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.
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.
Further reading and references
Scrotal pain and swelling; NICE CKS January 2022 (UK access only)
Crawford P, Crop JA; Evaluation of scrotal masses. Am Fam Physician. 2014 May 189(9):723-7.
Basta AM, Courtier J, Phelps A, et al; Scrotal swelling in the neonate. J Ultrasound Med. 2015 Mar34(3):495-505. doi: 10.7863/ultra.34.3.495.
Velasquez J, Boniface MP, Mohseni M; Acute Scrotum Pain