Renal & Urology

Scrotal Lumps (overview)

Assess every scrotal lump by urgency, relation to the testis, fluid versus solid character and positional behaviour; first exclude torsion and malignancy, then manage the common benign lesions according to symptoms.

Definition

A scrotal lump is any palpable swelling within the scrotum. The common benign lesions are hydrocoele, epididymal cyst and varicocoele, but the assessment must identify testicular torsion, hernia and testicular cancer.

First principles

Triage before naming the lump

Sudden severe unilateral pain, nausea/vomiting or an acutely tender high-riding testis is testicular torsion until proven otherwise and needs emergency urological assessment. A non-painful enlargement, change in shape or texture of the testis needs urgent suspected-cancer assessment.

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