CausesBy 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 containing 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 or a dull ache 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 adult 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.
- 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 may also be infected.
- 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. A varicocele may 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 can result in the loss of the testicle if not promptly treated. The affected testicle may be sideways in the scrotum. It may be enlarged and positioned higher than normal.
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- Wampler SM, et al. Common scrotal and testicular problems. Primary Care: Clinics in Office Practice. 2010;37:613.
- Tiemstra JD, et al. Evaluation of scrotal masses. American Family Physician. 2008;78:1165.
- Trojian TH, et al. Epididymitis and orchitis: An overview. American Family Physician. 2009;79:583.
- Hagerty JA, et al. Pediatric scrotal masses. Clinical Pediatric Emergency Medicine. 2009;10:50.
- Testicular self-exam. American Cancer Society. http://www.cancer.org/cancer/testicularcancer/moreinformation/doihavetesticularcancer/do-i-have-testicular-cancer-self-exam. Accessed May 10, 2011.