BUMPS AND LUMPS IN THE SCROTUM

There are many reasons for the swellings over the scrotum .They can be as simple as skin swellings( furuncles, sebaceous  cysts) , innocuous conditions like hydrocele,spermatocele and epididymal cyst.

sometimes harmful and dangerous conditions like testicular tumor can disguise themselves like these conditions.

We had a 70 year old gentleman presenting to us with huge left hemi scrotal swelling. The patient had undergone hydrocele repair 3 months back. His ultrasound revealed epididymal cyst measuring around 8 cm in dimensions.

We explored the hemiscrotum and excised the cyst in Toto.

 

 

Epididymal cyst:

 

These cysts arise from behind of the testicle from the epididymis. These  cysts can be as small as peanut to large like grapefruit.( like in above said case).

These are common in mid aged individuals but can arise in younger population also. They are usually asymptomatic but if these grow large they can cause discomfort.

The pain, fever and tenderness etc. can happen if the cyst gets infected.

We usually avoid excision in symptomatic individual if the patient is young. As the cyst is in the sperm conducting pathway ; any excision of the cyst can compromise sperm transport. We resort to  aspiration when it causes discomfort because of the cyst.

In older individual we go for hemi scrotal exploration and excision of the cyst.