Finding the Cause of Painless Scrotal Lumps and Swelling

Friday, October 15, 2010

ROCHESTER, Minn. — A painless lump in the scrotum — the pouch of skin that holds the testicles — is worth a trip to the doctor. Numerous problems can cause scrotal masses. In older men, it's usually not cancer.

The October issue of Mayo Clinic Health Letter covers the usually painless conditions that can cause a scrotal mass.

• Varicocele: This is an enlargement of the veins that carry oxygen-depleted blood away from the scrotal tissues. Most varicoceles occur on the left side of the scrotum. They may not cause symptoms and often don't require treatment. Some patients may feel a dull ache in the scrotum that's more noticeable when standing. When needed, treatment involves a minimally invasive surgical procedure to seal off the enlarged veins.
• Hydrocele: This occurs when fluid accumulates within the layers of tissue surrounding the scrotum. Hydroceles usually are harmless. Painless swelling may be the only symptom. In some men, hydoceles become large and tense, leading to discomfort. Treatment is surgical removal of the fluid-filled tissues. Draining the hydrocele doesn't work, as it refills quickly.
• Spermatocele: This is a cyst (fluid-filled bulge) that occurs on the epididymis, the area at the top of the testicle that stores and transports sperm. If the cyst is bothersome, it can be surgically removed.
• Testicular cancer: This cancer usually first appears as a painless lump on the testicle and may be accompanied by a dull ache or sense of heaviness in the scrotum. However, testicular cancer is uncommon for men over age 40. For those over 65, testicular cancer is even rarer.

A painful scrotum is the sign of several other conditions, including inflammation, an inguinal hernia, or testicular torsion where the spermatic cord becomes twisted. Pain in the scrotum warrants emergency care to avoid possible permanent tissue damage.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit Mayo Clinic Health Letter Online.

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