Finding a bump on the testicles or scrotum is common. While many are benign, some may indicate a serious underlying condition requiring medical evaluation. Self-diagnosis is not a substitute for professional assessment. Understanding the possibilities can help guide appropriate action.
Common and Harmless Scrotal Bumps
Many scrotal bumps are normal or benign. One common type is an epidermoid cyst, also called a sebaceous cyst. These cysts result from blocked glands or inflammation in a hair follicle, leading to a buildup of a cheesy or oily substance under the skin. They usually appear as firm, skin-colored, whitish, or yellowish lumps, varying in size. Epidermoid cysts are often painless, though they can become tender or painful if infected.
Fordyce spots are another frequent finding. These are visible sebaceous (oil) glands that lack hair follicles. They appear as tiny, raised bumps, typically 1 to 3 millimeters in diameter, and can be white, yellowish, or skin-colored, often appearing in clusters. Fordyce spots are painless, non-contagious, and are a normal anatomical variation.
Ingrown hairs can also cause scrotal bumps, particularly in individuals who shave or wax the area. An ingrown hair occurs when a hair curls back into the skin, leading to a small, red, swollen, and sometimes painful or itchy bump. While often resolving on their own, ingrown hairs can sometimes become infected, presenting with pus or increased redness.
Concerning Scrotal Bumps and Conditions
Several conditions warrant prompt medical attention. Testicular cancer typically presents as a painless lump or swelling on one testicle. The affected testicle may also feel firm or change in size or shape. Early detection is crucial for successful treatment.
Epididymitis is an inflammation of the epididymis, the coiled tube behind the testicle that stores and transports sperm. This condition often causes pain, swelling, redness of the scrotum, and sometimes fever. Hydroceles involve a collection of fluid around the testicle, leading to a painless swelling of the scrotum. A hydrocele can sometimes be a sign of underlying infection, injury, or, rarely, testicular cancer in adults.
A spermatocele, also known as an epididymal cyst, is a benign, fluid-filled cyst that forms in the epididymis and typically contains sperm. It usually feels like a distinct, smooth lump located above or behind the testicle and is generally painless. Varicoceles are enlarged veins within the scrotum, often described as feeling like a “bag of worms” above the testicle. These can cause a dull ache, a feeling of heaviness, or discomfort, and in some cases, they may affect fertility.
An inguinal hernia occurs when a portion of the intestine or fatty tissue pushes through a weak spot in the abdominal wall and descends into the scrotum. This presents as a bulge in the groin or scrotum that may become more prominent with straining, coughing, or standing. An incarcerated or strangulated hernia is a medical emergency.
When to Consult a Doctor
Any new lump or swelling on the scrotum or testicle should be evaluated by a healthcare professional. This includes bumps that are growing in size, or those that feel hard or fixed in place.
Pain or tenderness in the scrotum or testicle, especially if sudden or severe, is a significant red flag. Symptoms such as redness, warmth, or fever accompanying a bump can indicate an infection or inflammation that requires treatment. Sudden swelling or bruising of the scrotum, or testicular pain accompanied by nausea or vomiting, also warrant immediate medical attention. Prompt evaluation by a doctor is essential for accurate diagnosis and timely intervention, even if the bump causes only minor discomfort or concern.
Your Doctor’s Visit
A doctor’s visit for a scrotal bump typically begins with a discussion of your symptoms and medical history. The doctor will ask about when you first noticed the bump, any associated pain or discomfort, and other relevant health information. This initial conversation helps the doctor understand the context of your symptoms.
A physical examination of the scrotum and testicles will be performed to assess the size, location, texture, and mobility of the bump. This examination provides crucial information to help narrow down potential causes. Depending on the findings from the physical exam, your doctor may recommend further diagnostic tests.
An ultrasound is often the first imaging test used, as it is non-invasive and can provide detailed images of the scrotal contents, helping to distinguish between fluid-filled cysts, solid masses, or enlarged veins. In some cases, blood tests may also be ordered, particularly if an infection or certain other conditions are suspected. The information gathered from these steps helps the doctor arrive at an accurate diagnosis, which then guides the most appropriate course of treatment. Treatment options vary widely, ranging from observation to medication, minor procedures, or surgery.