Scrotal swelling and testicular conditions
Hydrocele
A hydrocele is a sac filled with fluid that forms around the testicle. It is harmless and usually, the only symptom is a swollen scrotum.
Hydroceles can be caused by inflammation or injury in the scrotum. The inflammation may be caused by an infection (epididymitis) or another condition
To diagnose a hydrocele, your doctor will perform a physical examination and an Ultrasound of the scrotum will be requested to confirm the diagnosis and to exclude other conditions that can cause swelling of the scrotum as testicular cancer, epididymal cysts or inguinal hernia
No surgical treatment is required unless an increase in size and starts causing discomfort to the patient
Epididymal cyst
The epididymis is called the little tube that is attached to the testicle that rests on the backside of each testicle. It transports and stores sperm cells that are produced in the testes.
Epididymis cyst is a harmless swelling that grows from the epididymis and may be tender but do not usually cause symptoms.
They can be diagnosed with clinical examination from a specialist but a scrotal ultrasound scan can be performed to confirm the diagnosis.
If they do not cause pain or discomfort it's not necessary to be removed but if they cause symptoms or they are large and create a problem with a daily activity they can be removed with an operation.
Varicocele
A varicocele is a swelling of the veins within the scrotum and can result in decreased sperm production and quality and some cases can lead to infertility and shrinkage of the testicles.
The blood in varicocele doesn’t move through the veins like it should and begins to pool in the vein, causing it to enlarge. A varicocele develops slowly over time.
Usually the varicocele do not cause any symptoms but you might experience a lump in one of your testicles, dull ache in your scrotum, swelling in your scrotum, visibly enlarged veins in your scrotum, which are often described as feeling like a bag of worms.
Varicocele can be diagnosed with clinical examination from a specialist but a scrotal ultrasound scan can be performed to confirm the diagnosis
It’s not always necessary to treat a varicocele.
Indications for varicocele treatment are the pain or discomfort, testicular atrophy and infertility.
Treatment options are the varicocelectomy and varicocele embolization.
Testicular cancer
Testicular cancer is cancer that develops in the testicles and is a relatively rare type of cancer
The symptoms and signs that should be investigated to exclude the testicular cancer are lump or enlargement in either testicle, feeling of heaviness in the scrotum, dull ache in the groin, collection of fluid in the scrotum, pain or discomfort in a testicle or the scrotum
It's not clear what causes testicular cancer in most cases.
Men usually discover testicular cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps.
To determine whether a lump is testicular cancer, your doctor may recommend a testicular ultrasound test and blood tests (tumor makers) that can help your doctor in determining your diagnosis.
If the testicular ultrasound raise the suspicion for testicular cancer then removal of the testicle (radical inguinal orchiectomy) is recommended. Your removed testicle will be analysed to determine if the lump is cancerous and, if so, what type of cancer.
After the type of cancer is determined the next step is to determine the extent (stage) of the cancer with a CT scan and blood tests. The stage helps determine what treatments are best for you.
The options for treating your testicular cancer after the radical orchidectomy depend on several factors, including the type and stage of cancer and your overall health. It could be only regular follow ups, radiotherapy or chemotherapy