A scrotal mass usually refers to any abnormal lumps or swelling in the scrotum, the skin sac that holds the testicles. Various conditions, including infections, fluid buildup, or tumors, can cause masses. Tumors are relatively rare, but benign (non-cancerous) tumors are seen more often in boys before puberty, while malignant (cancerous) tumors are more common after puberty.
Symptoms
- Swelling or lump in the scrotum.
- Pain or discomfort in the scrotal area.
- Change in the skin color of the scrotum.
- Fever
- Frequent need to urinate, and blood or other discoloration in the urine can indicate an infection.
- If an inguinal (groin) hernia is present, a visible bulge may appear, which increases in size when the child cries or strains.
Diagnosis
A scrotal mass may be visible and palpable (through touch) during the pediatric urologist’s physical examination. A scrotal ultrasound may be ordered to visualize the scrotum and testicles in more detail. Blood tests can check for tumor markers, and if there is concern for an infection, a urinalysis or urine test will be ordered.
Treatment
Treatment for a scrotal mass will depend on the symptoms and cause for the mass.
- Conservative Management involves regular monitoring of small, non-painful masses that are not suspicious for cancer.
- Antibiotics may be prescribed if epididymitis (inflammation of the small, coiled tube at the back of the testicle) or orchitis (inflammation of the testicle) is thought to be caused by an infection.
- If an inguinal hernia is present, manual reduction (physically pushing the hernia back in place) will be performed, and surgery is required to fix the hernia.
- Surgery is performed to repair inguinal hernias, remove fluid collections (called hydroceles), and remove any concerning masses.
- Orchiectomy (removal of the testicle) or testicle removal is necessary when a mass concerning for cancer is present.
Follow-Up
Regular follow-ups with your child’s pediatric urologist are essential. These can monitor recovery, ensure the effectiveness of the treatment, and detect any recurrence or complications early. In some cases, it is important that you regularly check your child’s scrotum for any changes, such as new lumps, and that you teach them how to check themselves.
If you have any questions or concerns about scrotal masses, schedule an appointment with an expert Georgia Urology pediatric urologist.