Your doctor will rely on a number of factors to diagnose a scrotal mass. These may include:
- A physical exam. Your doctor will feel your scrotum, its contents and nearby areas of the groin while you're standing and lying down.
- Transillumination. Shining a bright light through the scrotum might provide information about the size, location and makeup of a scrotal mass.
- Ultrasound. Using sound waves to create an image of internal organs, this test can provide detailed information about the size, location and makeup of a scrotal mass, as well as the condition of the testicles. An ultrasound usually is necessary to diagnose a scrotal mass.
- Urine test. Laboratory tests of a sample of urine might detect a bacterial or viral infection or the presence of blood or pus in the urine.
- Blood test. Laboratory tests of a blood sample might detect a bacterial or viral infection or elevated levels of certain proteins that are associated with testicular cancer.
- Computerized tomography (CT) scan. If other tests indicate testicular cancer, you'll likely undergo a specialized X-ray exam (CT scan) of your chest, abdomen and groin to see if cancer has spread to other tissues or organs.
Most scrotal masses require minimally invasive or no treatment, but some require medicine or more-serious procedures.
Scrotal masses caused by a bacterial infection, as is usually the case with epididymitis, are treated with antibiotics. Viral infections causing epididymitis or orchitis are usually treated with rest, ice and pain relief medication.
Noncancerous (benign) scrotal masses
Benign scrotal masses might be left untreated or surgically removed, repaired, or drained. These treatment decisions depend on factors such as whether the scrotal mass:
- Causes discomfort or pain
- Contributes to or increases the risk of infertility
- Becomes infected
A specialist in cancer treatment (oncologist) will recommend treatments based on whether the cancer is isolated to a testicle or has spread to other tissues in the body. Your age and overall health also are factors in choosing treatment options for testicular cancer.
- Radical inguinal orchiectomy. This is the primary treatment for testicular cancer. It's a surgical procedure to remove the affected testicle and spermatic cord through an incision in the groin. Lymph nodes in your abdomen also might be removed if the cancer has spread to them.
- Chemotherapy. This is a drug treatment that uses powerful chemicals to kill cancer cells.
In some cases radiation therapy also may be used. This type of therapy uses high-dose X-rays or other high-energy radiation to kill cancer cells that may remain after removal of the affected testicle.
Most cases of testicular cancer can be cured, but follow-up care is necessary to watch for possible recurrences.
Lifestyle and home remedies
To perform a testicular self-examination, grasp and roll the testicle between your thumbs and forefingers, feeling for lumps, swelling, hardness or other changes.
Testicular self-exams might help you find a scrotal mass early, allowing you to get prompt medical care. If you perform this exam regularly, you'll understand what "normal" feels like and be better prepared to detect abnormality. To do a testicular self-exam, follow these steps:
- Examine your testicles once a month, especially if you've had testicular cancer or you have a family history of testicular cancer.
- Perform the exam after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to check.
- Stand in front of a mirror. Look for swelling on the skin of the scrotum.
- Cup your scrotum with one hand to see if it feels different from normal.
- Examine one testicle at a time using both hands. Place the index and middle fingers under the testicle; place your thumbs on top.
- Gently roll the testicle between the thumbs and fingers to feel for lumps. The testicles are usually smooth, oval shaped and somewhat firm. It's normal for one testicle to be slightly larger than the other.
- Feel along the soft, comma-shaped structure that runs above and behind the testicle (epididymis) to check for swelling.
If you find a lump or other abnormality, call your doctor as soon as possible.
Preparing for your appointment
If you're having pain, seek emergency care. If you detect a scrotal mass, you'll probably start by seeing your family doctor. You might be referred to a specialist in urinary tract and male genital disorders (urologist).
Preparing for your or your child's appointment with your doctor or a urologist will help you make the most of your time with the doctor.
What you can do
Write down information to share with your doctor, including:
- Symptoms you're experiencing, including any that may seem unrelated to a scrotal mass
- Key personal information, including major stresses or recent life changes
- Medications, vitamins and supplements you're taking
- Family history of testicular cancer or other disorders of the scrotum
- Personal medical history, including previous scrotal masses, undescended testicle or congenital defects related to the genitals
- Questions to ask your doctor
Questions about scrotal masses might include:
- What tests will I need?
- How long will it take to get the test results?
- If the scrotal mass is cancerous (malignant), what are the next steps?
- If the scrotal mass isn't cancerous, will I need treatment?
- Are there brochures or other printed material that I can take with me? What websites do you recommend?
Don't hesitate to ask any other questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- When did you discover a lump or experience other symptoms associated with a scrotal mass?
- Are you having or have you had pain in or near your scrotum?
- Have you had fever or blood or pus in your urine?
- Have you had a recent injury to the groin?
- Does anything, such as pain medication, improve your symptoms?
- Does anything worsen symptoms, such as exercise or exertion that puts a strain on the groin?
- Did you have an undescended or retractile testicle that was corrected with surgery?
- Have you ever had a sexually transmitted infection?
- Do you have multiple sex partners or a new sex partner?