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Causes
By Mayo Clinic staff
A number of different disorders can result in a scrotal mass or the development of an abnormality in the scrotum:
- Testicular cancer is a tumor made of abnormal testicular tissue. A cancerous tumor can usually be felt as a lump in the scrotum. Although such tumors often don't cause other symptoms, some men experience pain in the scrotum, a dull ache, pain that radiates throughout the groin, or swelling of the scrotum. Testicular cancer is more common in adolescent boys and young men.
- Spermatocele, also known as a spermatic cyst or epididymal cyst, is a typically painless, noncancerous (benign), fluid-filled sac located in the scrotum, usually above the testicle. A spermatic cyst usually contains dead sperm.
- Epididymitis (ep-ih-did-uh-MY-tis) is inflammation of the epididymis, the comma-shaped structure located above and behind the testicle that stores and transports sperm. Epididymitis is often caused by a bacterial infection, including sexually transmitted bacterial infections, such as chlamydia and gonorrhea. Less commonly, epididymitis is caused by a viral infection or abnormal flow of urine into the epididymis.
- Orchitis (or-KY-tis) is inflammation of the testicle usually due to a viral infection — most commonly mumps. When orchitis is caused by a bacterial infection, the epididymis is usually infected also.
- Hydrocele (HY-droe-seel) is a collection of excess fluid between the layers of a sac that surrounds each testicle. A very small amount of fluid in this space is normal. The excess fluid of a hydrocele usually results in a painless swelling of the scrotum. In infants, a hydrocele occurs usually because an opening between the abdomen and the scrotum hasn't properly sealed during development. In adults, a hydrocele occurs usually because of an imbalance in the production or absorption of fluid, often as a result of injury or infection in the scrotum.
- Hematocele (HE-muh-toe-seel) is a collection of blood between the layers of a sac that surrounds each testicle. Traumatic injury, such as a direct blow to the testicles, is the most likely cause of a hematocele.
- Varicocele (VAR-ih-koh-seel) is enlargement of the veins within the scrotum that carry oxygen-depleted blood from each testicle and epididymis. Varicocele is more common on the left side of the scrotum than on the right side because of differences in how blood circulates from each side. Although varicocele is fairly common, the exact cause isn't known. If varicocele results in a large mass, it can cause infertility.
- Inguinal (ING-gwih-nul) hernia is a condition in which a portion of the small intestine pushes through an opening or weak spot in the tissue separating the abdomen and groin. In infants, an inguinal hernia usually occurs because the passageway from the abdomen to the scrotum has failed to close during development. An inguinal hernia may appear as a mass in the scrotum or higher in the groin.
- Testicular torsion is a twisting of the spermatic cord, the bundle of blood vessels, nerves and the tube that carries semen from the testicle to the penis. This painful condition cuts off blood to the testicle and results in the loss of the testicle if not promptly treated. The affected testicle is usually sideways in the scrotum. It may be enlarged and positioned higher than normal. There may be a knot or lump that can be felt above the testicle. Testicular torsion can happen at any age, including infancy, but it most often occurs during adolescence.
References
- Orchitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec17/ch239/ch239e.html. Accessed May 22, 2009.
- Epididymitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec17/ch239/ch239d.html. Accessed May 22, 2009.
- Testicular cancer. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec17/ch241/ch241h.html. Accessed May 22, 2009.
- Haynes JH. Inguinal and scrotal disorders. Surgical Clinics of North America. 2006;86:371.
- Junnila J, et al. Testicular masses. American Family Physician. 1998;57:685.
- Shaw J. Diagnosis and treatment of testicular cancer. American Family Physician. 2008;7:469.
- Brenner JS, et al. Causes of painless scrotal swelling in children and adolescents. http://www.uptodate.com/home/index.html. Accessed May 28, 2009.
- Galejs LE. Diagnosis and treatment of the acute scrotum. American Family Physician. 1999;59:817.
- Elder J. Disorders and anomalies of the scrotal contents. In: Kliegman R, et al., eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders/Elsevier; 2007. http://www.mdconsult.com/das/book/body/142753628-2/0/1608/1246.html?tocnode=54484554&fromURL=1246.html#4-u1.0-B978-1-4160-2450-7..50547-8_9817. Accessed May 20, 2009.
- Cole FL, et al. The acute, nontraumatic scrotum: Assessment, diagnosis, and management. Journal of the American Academy of Nurse Practitioners. 2004;16:50.
- Marcozzi D, et al. The nontraumatic, acute scrotum. Emergency Medical Clinics of North America. 2001;19:547.
- Testicular cancer: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/sites-types/testicular. Accessed May 25, 2009.
- Cooper C, et al. Undescended testicle (cryptorchidism). http://www.uptodate.com/home/index.html. Accessed May 22, 2009.
- Barthold JS, et al. The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy. Journal of Urology. 2003;170:2396.
- Eyre RC. Evaluation of the acute scrotum in adult men. http://www.uptodate.com/home/index.html. Accessed May 28, 2009.
- Information from your family doctor. Testicular cancer. American Family Physician. 2004;69:613.
