kidney and urinary tract disorders
Scrotal Swelling
Evaluation of Scrotal Swelling
The following information can help men know how quickly to see a doctor and what to expect during the evaluation. In men with a lump in the scrotum, the most concerning signs are A solid lump that is attached to or part of the testis A balloon-like bulge that extends from the abdomen into the scrotum and cannot be pushed back Men who have a balloon-like swelling that extends from the abdomen into the scrotum and cannot be pushed back could have an inguinal hernia that has become trapped (incarcerated). They should see a doctor right away. If a painless swelling suddenly becomes painful, men should also see a doctor right away because the cause may be an inguinal hernia that has become trapped and the blood supply shut off ( Inguinal Hernia ). Other men should see a doctor when an office appointment is available. A delay of a week or so is not harmful. Doctors first ask questions about the man's symptoms and then do a physical examination. What they find during the history and physical examination often suggests a cause of the swelling and the tests that may need to be done (see table Some Causes and Features of Scrotal Swelling ). Doctors ask how long the swelling has been present and whether there is any change in the swelling when the man stands up or lies down or when abdominal pressure increases (such as with coughing or straining to lift something). Doctors also ask about the man's medical history because disorders in other parts of the body (for example, edema related to Heart Failure (HF) or The physical examination is done with the man standing and lying down. The doctor carefully feels the testis, epididymis, and spermatic cord to detect the exact location of the swelling or lump, and whether the swelling is tender. Sometimes the doctor shines a bright light behind the scrotum to see if light passes through (transillumination). Light can often pass through a collection of fluid (such as a hydrocele) but not through a solid lump (such as a cancer). Sometimes the doctor can determine the cause of the swelling based on the symptoms and the results of the physical examination. If the symptoms and physical examination do not reveal the cause, testing is usually needed. Often the first test is ultrasonography. Ultrasonography is done when Doctors are unsure of the diagnosis Doctors detect a hydrocele during the examination (ultrasonography may show the source of the fluid) Transillumination does not show fluid in the area of swelling Depending on the results of ultrasonography, further testing may be done for cancer of a testis. Testing for testicular cancer includes blood tests and sometimes computed tomography (CT) of the abdomen, pelvis, and chest. 