Common Causes of a Lump in Your Scrotum (and What to Do About It) - BALLS

Common Causes of a Lump in Your Scrotum (and What to Do About It)

Written by: Tommy Buckley

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Time to read 7 min

Have you recently discovered a lump in your scrotum?

The scrotum is part of the male reproductive system responsible for protecting the testicles.


Lumps in the scrotum—also known as a scrotal mass—is a sensitive subject for men, but an important one to talk about. Many men experience scrotal masses at some point in their lives.


Scrotal masses can happen for many reasons. This may be alarming to some but is not a cause for concern. It's always good to know what they are so you don't panic. Most testicular lumps are benign and will go away on their own with no treatment necessary.


We’ll talk about the different causes of scrotal masses, symptoms to look out for, and treatments that work best. 


How to Identify a Lump in the Scrotum

You know your balls are in good shape when you can feel them rolling around between the palms of your hands. The perfect time to conduct a self-examination is when trimming your balls.


If any scrotal mass or nodules come up, it could be a sign that there might be something wrong with one of your balls—which could lead to more serious health problems down the line.


Hold your testicle between both thumbs and fingers with one hand. Rub the surface of it gently, feeling for any hard lumps or smooth rounded scrotal masses or a change in size, shape, or consistency.


What Causes Testicular Lumps?

Varicocele


Varicose or an enlarged scrotum are common causes of low sperm production and quality. As a result, fertility could be affected, and it can also cause shrinkage of the testicles.


Symptoms

Varicocele usually doesn’t have any symptoms, but since these conditions develop over time, you should seek medical attention if you experience any of the following:


  • Pain when sitting down or standing up
  • Blood spots appearing under the foreskin during urination
  • Discomfort that varies from sharp to dull 

Treatment

Since varicocele rarely presents any symptoms, it often requires no treatment. They’re often discovered during fertility or routine physical exams.

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Testicular Torsion

Testicular torsion is a sudden, often painful condition that occurs when the testicle rotates and twists on its spermatic cord. It causes reduced blood flow, which induces pain or the development of a scrotal mass in one of your balls.


It most commonly happens between ages 12 and 18, but isn’t always that exclusive. Although the cause is not particularly clear, it can happen after vigorous activity, a minor injury to the testicles, or during excessive movement while you sleep.


Testicular torsion has also been linked to rapid growth during puberty—a sudden spike in testosterone levels and cold temperatures.


Symptoms

You'll know if you have testicular torsion when there’s severe pain that wakes you up in the middle of the night or early in the morning.


Other symptoms include:


  • Sudden pain in the balls
  • Swollen testicles
  • Abdominal pain
  • Nausea and vomiting
  • One ball positioned higher than normal
  • Frequent urination
  • Fever

Treatment

Testicular torsion is a medical emergency that will most likely happen without much warning. It requires immediate surgery to correct, except in cases where manual detorsion can relieve pressure. Surgery usually takes place under general anesthesia. 


The doctor will make a small incision into your scrotum, and your spermatic cord may need to be stitched on the inside. The sooner surgery begins after feeling pain, the better the chances of saving your balls. Anything past 12 hours increases the risk of having your balls removed.

Epididymal Cysts and Spermatocele

The role of the epididymis in the male reproductive system is to collect and transport sperm from the testis.


An epididymal cyst is a painless scrotal mass in the long, tightly coiled tube that lies above and behind each testicle.


Spermatocele, also known as a spermatic cyst, is similar to an epididymal cyst—a painless swelling in the fluid-filled sac that grows near the top of a testicle, except it also contains sperm cells.


Both cysts feel like a smooth, firm testicular lump just outside of your scrotum on top of the right or left side of your testis. The lump could be caused by an obstruction of the tubes that carry sperm from the testicles. Cysts can also be caused by an STD, viral infection, or bacterial infection. Both scrotal masses are benign and don’t interfere with reproduction.


Most of the time cysts will disappear on their own, if they are swollen, a warm washcloth will help them go down. Alternatively, a doctor can remove them quite simply under a local anesthetic if you wish.

Symptoms

Sometimes, a spermatocele will not generate any symptoms. You might feel extra scrotal masses above the testicle on one side of your scrotum, or you might notice that your balls look or feel larger than usual. 


When there are symptoms, they may include:


  • Pain, swelling,
  • Scrotum redness
  • Feeling pressure or heaviness at the base of your penis
  • Swollen or tender epididymis
  • Swollen or hardened balls
  • Pain in the groin or lower back and abdomen

Treatment

These scrotal masses often don’t require treatment since they go away on their own. However, it’s vital to see a urologist to determine if treatment is necessary.


Epididymal and spermatic cysts may need surgical removal if they grow too large or cause pain and discomfort, or cut off the blood supply. 


The procedure is called spermatocelectomy, performed to drain excess fluid and restore blood flow.

Testicular Cancer

Testicular cancer is every man’s nightmare. The last thing you want to hear from your doctor is the dreaded C word.


The causes of testicular cancer are still unknown. Health professionals know that it occurs when healthy cells in a man's balls become altered. 


When healthy cells grow and divide, they do so in order to keep the body functioning normally. When cell growth gets out of control, abnormal cells begin to form, causing tumors.


According to the American Cancer Society, the average American male has a 1 in 250 chance of getting testicular cancer. It’s the most common form of cancer in men between the ages of 20 and 34, but can strike at any age.

Symptoms

Cancer usually affects only one testicle, but if you have any pain or scrotal mass in your groin area, it could be a sign that there are more than just cancer cells growing on the tissue. 


Signs and symptoms of testicular cancer include:


  • Enlargement in either testicle
  • Feeling of heaviness in the scrotum
  • A dull ache in the groin area
  • Sudden fluid collection in the scrotum
  • Pain or discomfort in a testicle or the scrotum
  • Enlargement or tenderness of the breasts
  • Back pain

If these symptoms last longer than two weeks, see your doctor as soon as possible as this can lead to other health issues or problems with fertility later down the line.

Treatment

Testicular cancer is curable if caught early enough, so be sure not to put off that doctor's visit. The diagnosis is determined via ultrasound.


The ultrasound uses sound waves to get images from inside your body, which highlights changes in a particular benign condition and determines if it requires treatment.


In recent years, a lot of progress has been made in treating testicular cancer. Surgical methods have evolved and, thanks to new advancements in radiation technology, doctors can be more precise with their chemotherapy treatments.


Inguinal Hernia

An inguinal hernia occurs when part of your intestines protrude through a weak spot in the abdominal muscles. The result is an abnormal bulge and bowel pokes that can often be painful, especially if you cough or bend over.


Inguinal hernias can enlarge over time, causing pain and swelling. They need to be repaired surgically to prevent scrotal masses from appearing.


Symptoms include:


  • A bulge on either side of your pubic bone
  • A burning or aching sensation at the bulge
  • Pain or discomfort in your groin
  • A heavy or dragging sensation in your groin
  • Weakness or pressure in your groin
  • Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum

Treatment

There are two ways to treat inguinal hernia:


  • Open hernia repair—involves making an incision in the groin and pushing the protruding tissue back into the abdomen. It takes weeks to heal.
  • Minimally invasive repair—involves making several incisions in the abdomen and using laparoscopic instruments to repair the hernia.

How to Care for the Affected Testicle

There are a few home remedies for scrotal swelling and these are by no means substitutes to medical care.


Care
Purpose

Use ice cubes within 24 hours of noticing a scrotal mass

To reduce scrotal swelling

Take over-the-counter painkillers

To relieve pain

Wear athletic support

To help cushion your balls

Soak in a shallow bath

To ease pressure from affected veins and reduce swelling

Avoid strenuous activities

To prevent torsion

How to Prevent Testicular Lumps and Swellings


There isn’t a sure-fire way for preventing a testicular lump, but regular check-ups and self-exams go a long way to help you identify them early on. The testicles are sensitive and need to be cared for.


Manscaping is useful for your overall reproductive health and it’ll help you notice abnormalities and get the situation handled before they evolve into serious medical conditions.