A Lump in Your Scrotum – Causes and Treatments

Have you ever felt a lump in your scrotum? Then you’re not alone. Many men discover at least one during their lives. We realise that this can be a delicate subject you’re not eager to talk about, but it’s important for you to know just what’s involved.

The scrotum is part of your reproductive system and serves to protect your testicles, and a lump in the scrotum is also called a scrotal mass.

A lump can form for any one of a number of reasons, but most of the time it’s nothing to get too worried about. Most scrotal masses are benign and eventually go away by themselves.

But a lump can turn out to be a serious matter, so it’s important to know how to identify the symptoms of a scrotal mass and understand the various causes and treatments for them.

How to Identify a Lump in the Scrotum

When you do a self-examination of your balls (which we describe in detail elsewhere) you’ll know everything is OK if they easily roll around between your fingers and in your palms. The most convenient time for a self-exam is when you’re trimming your balls.

To examine your scrotum, gently grasp a ball and roll it between your fingers and thumb while feeling for a hard lump or anything else unusual like a change in its size, shape or firmness. This is, of course, only possible if you do regular self-exams, so you’ll know how your balls normally feel like.

If you feel a lump or nodule, it probably means that something is not quite right. Again, it’s not a cause for immediate concern, but you shouldn’t ignore it either.

What can cause a lump in your scrotum?

Varicocele

Cause

Varicocele describes a condition in which the veins in your testicles become enlarged. This can lead to lower sperm counts and could reduce fertility, so it’s important that you know how to recognise this.

Symptoms

Varicocele usually doesn’t have any acute symptoms and can slowly develop virtually unnoticed. At some point you might detect a lump that feels like a sac of worms.

If, however, you suffer any of the following symptoms, you should visit your physician.

  • It’s painful when you sit down or stand up.
  • You detect blood spots under the foreskin while urinating.
  • The pain you experience is sometimes dull and sometimes sharp. 

Treatment

As already mentioned, varicocele often goes unnoticed, and it is often only detected during a professional medical exam – so make sure you get that annual check-up!

Testicular Torsion

This describes a condition in which the spermatic cord spins and a gonad has been twisted. The result can be partial or total interruption of blood supply to your scrotum and balls. This in turn, can cause your scrotum to swell and produce intense pain.

Besides the pain, you’ll notice that your balls are bigger than normal and have become very sensitive.

Cause

Testicular torsion can happen to any man, no matter his age. It is, however, more common among men aged 12 to 18. This may, in part, be due to rapid growth during puberty. Cold temperatures and a sudden increase in testosterone may contribute to testicular torsion.

Symptoms

You should suspect testicular torsion if a severe and apparently inexplicable pain wakes you while sleeping.

You may be suffering from Testicular Torsion if:

  • Your balls are larger than normal – the average size of men’s balls is 3cm to 5cm long and 2cm to 3cm wide.
  • Your balls are hanging too loosely.
  • You have suffered some trauma resulting in some testicular injury. 

Other symptoms, aside from the pain, include:

  • Swollen ball sack
  • Pain in the lower abdomen
  • A frequent urge to urinate
  • A ball that hangs much higher than normal
  • Nausea and vomiting

Treatment

Testicular torsion often happens suddenly without warning and constitutes a medical emergency, so you need to seek help right. The treatment, unfortunately, is almost always surgery, although some cases can be relieved by manual manipulation (‘detorsion’) by a qualified expert. 

In the surgical procedure, the subject is placed under anaesthesia, then the surgeon makes a small incision into your scrotum in order to get at the spermatic cord and repair the damage. 

Testicular torsion is serious, mate! The sooner surgery occurs, the better – within 12 hours if at all possible. Any longer than that, and the chances of losing your balls increases.

Epididymal Cysts and Spermatocele

The epididymis is an important reproductive organ located above and behind each testicle. It is a long, tightly coiled tube that collects and conveys sperm from the testicles.

A cyst in the epididymis is normally painless.

Spermatocele describes another type of cyst that may develop and cause swelling. It is also called a spermatic cyst. This kind of cyst occurs in a small organ located near the top of each testicle. It is essentially a sac that contains fluid and sperm cells.

These organs are located close to each other near the top of your testicles, both kinds of cysts feel firm and smooth, and the lump might develop as the result of a blockage of the vessels that convey sperm.

These cysts could also be the result of a bacterial or viral infection, or even by an STD. In most cases, you don’t have to worry about them, they almost always disappear without treatment and don’t affect sexual reproduction.

You can treat these lumps by applying a warm cloth. If they are bothersome, you can have a physician remove them.

These cysts can also be caused by an STD, viral infection, or bacterial infection. Both scrotal masses are benign and don’t interfere with reproduction.

Symptoms

A spermatocele will often not cause any symptoms. You might simply detect a lump above one of your testicles or notice that one ball looks or feels larger than it normally does. 

When symptoms arise, they may take the form of:

  • Pain in the scrotum
  • Pain in the groin or lower back and abdomen
  • Redness
  • Pressure or heaviness at the base of your penis
  • Swelling or tenderness
  • Hardened balls

Treatment

These cysts usually don’t need medical treatment and eventually subside. If you detect a lump or have any symptoms, however, it would be wise to see a physician or go straight to a urologist in case treatment is required.

In rare cases, these cysts may cause pain, grow abnormally large, and even impede the supply of blood. In such an event, the cyst may need to be removed in a surgical procedure called spermatocelectomy.

Testicular Cancer

No one wants to hear of cancer in any form, and testicular cancer can be a serious matter, indeed. Despite research into lung cancer, for example, there is no certain way to determine the exact cause for any kind of cancer.

Cancer describes a condition in which the normally natural division of cells in your body runs amuck and forms abnormal cells that serve no useful purpose. A tumour is essentially a mass of such cells.

The American Cancer Society has established that testicular cancer will afflict approximately one man out of 250 in the course of their lives. The good news is the survival rate when the cancer is diagnosed early: 96–99%.

Symptoms

Testicular cancer usually arises in only one testicle. There are various symptoms that could indicate cancer, including:

  • An enlarged testicle
  • Your balls feel heavy
  • You experience a dull ache in the groin
  • Your balls feel swollen (because fluid is collecting in the scrotum)
  • You experience discomfort or pain in one of your balls
  • Your breasts enlarge and feel tender
  • You experience backaches

Since there are other causes for these symptoms, they may go away. If, however, symptoms persist for more than two weeks, you should seek medical attention. Even if the cancer itself can be treated successfully, it could still trigger other problems with your health or fertility if you wait too long.

Treatment

Don’t fool around with this one, mates! If you get medical attention early enough, the cancer can be treated. So, see your physician.

An examination for testicular cancer merely involves ultrasound. Ultrasound uses sound waves to see inside your body and, in this case, to see if anything unusual is forming in there. If there is, a further procedure is used to determine if the cancer is benign or malignant.

Significant progress in fighting cancer has been made recently due to improvements in surgical procedure and new advancements in chemical and radiation treatment. 

Inguinal Hernia

Inguinal hernias happen when abdominal contents rupture the abdomen’s muscular wall and protrude through it. This, in turn, results in fatty tissue and the small intestine protruding into the groin and exerting pressure on the scrotal sack.

Over time, the rupture can get worse, which increases pain and causes swelling. In such an acute case, surgery will be necessary before the intrusion of intestines cause serious damage to the scrotum.

You may be experiencing an inguinal hernia if:

  • You notice a bulge on one side of your pubic bone.
  • The bulge aches or causes a burning sensation.
  • You experience pain in your groin
  • Your groin feels heavy or causes a dragging sensation.
  • Your groin feels weak, or you feel pressure there.
  • The intestine has protruded into the scrotum, which causes pain and swelling there.

Treatment 

There are two treatments for inguinal hernia:

  • Open hernia repair — in this more serious surgical procedure, an incision is made in the groin and the protruding mass is pushed back through the rupture and into the abdomen. Weeks are necessary to recover from this procedure.
  • Minimally invasive repair — in this far less drastic procedure, several, smaller incisions in the abdomen allow the surgeon to get to and repair the hernia with a laparoscope and other instruments that can be deployed through the incision.

How You Can Treat Scrotal lumps at Home

There are several things you can do to treat or reduce the pain some lumps cause. Beware, however, some of the symptoms we’ve already mentioned require professional attention

Self-Treatment

Purpose

Apply ice within 24 hours of detecting a lump.

Reduce swelling

Take non-prescription painkillers

Relieve pain

Wear an athletic supporter

Support and relieve pressure from your balls

Soak in a shallow bath

Relieve pressure on affected veins

Reduce swelling

Forgo strenuous activities

Prevent possible testicular torsion

 

How You Can Prevent Lumps and Swelling

It’s difficult to know just what to do because lumps in your scrotum arise from various causes.

One way to catch warning signs early is by conducting regular self-exams. We can’t overstress just how beneficial regular self-exams can be for heading off serious health problems.

We also completely support the idea of annual physical check-ups since a physician is more likely to detect a problem before you do.

Manscaping can play a useful role in protecting your health. Trimming or shaving your balls regularly makes it easy for you to inspect your balls and groin, get to know how they normally look and feel, and thus allow you to determine if something unusual has arisen.

Your reproductive tackle is important to you. So, take the time necessary to get to know its various components and pay attention to what’s going on down there!