Many patients visit the urology clinic because of pain or lump in the scrotum. The structures in the scrotum which may cause problem include:
- the testicles (the organ that produces sperm and testosterone)
- the epididymis (storage organs for the sperm)
- the spermatic cord (contains blood vessels to the testicle)
In order to find out the cause of the problem, the doctor will ask the patient to give more details of the problem and how long ago the symptoms started. Through careful physical examination the doctor will usually have a reasonable idea of what is wrong. Sometimes patients will be recommended to go for ultrasound to confirm the diagnosis.
Scrotal conditions include:
The typical symptoms of infection are pain and swelling of the scrotum. Infections may be due to urinary tract bacteria or sexually transmitted organisms. Most infections can be treated with the appropriate antibiotic. If there is accumulation of pus in the scrotum, surgery may be necessary
Cancer of the testicle usually occurs in men in their 30’s and 40’s. A hard lump in the testicle could be cancerous and should be checked out immediately. Surgery can be performed to remove the cancerous testicle
3. Fluid accumulation in the testes (hydrocoele) or epididymis (epididymal cysts)
Most fluid accumulations are not harmful and do not need to be treated. Larger ones may cause discomfort and can be surgically removed.
4. Swollen testicular veins (varicocoele)
Varicocoeles are very common , especially on the left side. Up to 1/3 of normal men have incidental varicocoele that does not cause any problem. A very rare cause of varicocoele is large kidney tumour which compresses the testicular vein. Most varicocoeles do not need to be treated, unless they are suspected to be causing fertility problems.
Other conditions that may cause pain in the scrotum include:
5. Inguinal hernia
7. Previous groin surgery or vasectomy
Sometimes, all the test results are negative and no cause for pain can be identified. In this case the pain could be assumed to be a problem with the nerves in the scrotum or groin. Most of the time this can be treated with medication.