Scrotal masses
Screening and
diagnosis
Most men discover
scrotal masses themselves, either unintentionally or while doing a
testicular self-examination to check for lumps.
If you alert your
doctor to a scrotal mass, or he or she discovers a lump during a routine
office visit, a physical exam and lab tests can confirm an infection or
another cause. You may also undergo an ultrasound examination. This
painless test passes sound waves through your scrotum to make an image
of the contents of your scrotum.
Treatment
Most scrotal
masses require minimally invasive treatment or no treatment at all, but
some require more serious procedures.
-
Epididymitis.
This usually acute condition can be treated with antibiotics.
-
Spermatocele.
Most spermatoceles are small, cause no symptoms and require no
treatment. However, sometimes they can grow large enough to cause
signs and symptoms such as pressure, pain or swelling in the scrotum
and require surgical removal. Draining the fluid by puncturing the
spermatocele through your skin may provide temporary relief. But the
fluid invariably accumulates again within a few weeks.
-
Hydrocele.
Usually, you don't need treatment for a hydrocele unless the scrotum
is so swollen that it's uncomfortable.
-
Varicocele.
If you have a varicocele and you're infertile, surgically tying off
(ligation) the varicocele improves your chances of becoming fertile
again.
-
Orchitis.
Doctors use antibiotics to treat orchitis associated with bacterial
infections. Treatment for orchitis associated with viral infections
such as mumps is only by conservative means such as rest and
pain-relieving medications.
-
Inguinal
hernia.
Your doctor may recommend surgery if your hernia is painful or
bothersome. Hernias can recur after surgery, but this happens less
than 10 percent of the time.
-
Cancer of
the testicle.
Stage I testicular cancer, in which cancer is found only in the
testicle, and stage II testicular cancer, in which cancer has spread
to the lymph nodes in the abdomen, are successfully treated in more
than 95 percent of cases. Stage III testicular cancer, in which
cancer has spread beyond the lymph nodes to other regions of the
body, such as the lungs or liver, is successfully treated in about
70 percent of cases.
Generally, doctors
use the following treatments for testicular cancer:
-
Radical
inguinal orchiectomy.
This surgical procedure involves removal of one or both testicles
through an incision in the groin. Lymph nodes in the abdomen also
may be removed (lymph node dissection). If only one testicle is
cancerous and removed, there is a small chance that the other
testicle will become cancerous at some time. As a result, your
doctor will likely recommend regular follow-up exams with a
urologist.
-
External
beam radiation therapy.
This treatment uses high-dose X-rays or other high-energy radiation
to kill cancer cells.
-
Chemotherapy.
Chemotherapy is used to kill cancer cells outside the testicle. This
drug therapy is usually given by intravenous (IV) infusions,
typically in the hospital, several days each month. In some cases,
chemotherapy may also be given by intramuscular injection or in pill
form. Chemotherapy has made the biggest difference in reducing death
from testicular cancer.
-
Bone marrow
transplant.
In this procedure, some of your bone marrow is removed, treated with
drugs to kill any cancer cells and then frozen. You then undergo
chemotherapy, with or without radiation, to destroy the remaining
cancer cells in your body. This chemotherapy also destroys your
remaining bone marrow. The frozen marrow is then thawed and injected
back into you through a needle in a vein. This relatively new
treatment for testicular cancer has had some promising initial
results. Yet it's not routinely recommended by doctors because
traditional chemotherapy treatments are typically very successful.
Surgery may be in
combination with radiation therapy or chemotherapy or both. Your
treatment depends on the type and stage of your cancer. Your age and
overall health also are factors in choosing treatment options.
