Scrotal swellings

A non-inflammatory swelling of the scrotal contents may be a:

• Testicular tumour
• Epididymal cyst (spermatocele)
• Varicocele
• Hydrocele
• Hernia

Clinical examination:

The following points enable distinctions to be made:

• If it is possible to get above the swelling and palpate a normal cord, the swelling is NOT a hernia
• If there is a cough impulse in the groin or, with the patient lying flat, the scrotal mass disappears or is reducible, the swelling is a hernia
• If the testicle lies anteriorly and the epididymis posteriorly, gentle palpation establishes where the swelling lies and therefore its origin
• Hydroceles transilluminate
• Varicoceles are more apparent with the patient standing and feel like a bag of worms