What is scrotal masses ?

The scrotum masses is the mass of a lump or swelling that can be felt in the scrotum.

Benign scrotal masses that may constitute:

* Hematokel
* Hydrocele
* Varicocele
* Spermatokel.


CAUSE
The cause of the formation of a mass in the scrotum varies and can be something benign or malignant.

The cause of the formation of scrotal masses can be:
- Inflammation or infection (eg epididymitis)
- Physical injury to the scrotum
- Herniation (inguinal hernia)
- Tumors.
The incidence and risk factors varies, depending on the cause.


SYMPTOMS
In general, scrotal masses cause symptoms as follows:

* A lump / swelling in the scrotum, with or without pain
* Can occur sterility
* The scrotum enlarges.


Hematokel

Hematokel is the accumulation of blood that usually occurs after a scrotal injury. If only a few, usually the blood will re-absorbed, but if a lot, need to do surgery to get rid of.


Hydrocele

Hydrocele is accumulation of fluid in the membrane that encloses the testes, which causes swelling in one testicle soft. Hydrocele may be congenital or acquired later in life; can only attack one or both sides of the scrotum.

Hydrocele is often found in newborns. Hydrocele occur due to failure of testicular descent where the channel closure of the abdominal cavity into the scrotum. Peritoneal fluid to flow through open channels and trapped inside the scrotum to scrotum to swell. Normally, the hydrocele will disappear by itself within a few months after birth.

Hydrocele can also occur due to:
- Inflammation or injury to the testis and epididymis
- Fluid or blood blockage within the spermatic cord.
Sometimes the hydrocele associated with inguinal hernia. If the amount of fluid accumulated change, then the most likely culprit is an inguinal hernia.


Varicocele

Varicoceles are varicose veins in the scrotum. Varicoceles occur due to abnormalities in the valves in the veins along the spermatic cord. Abnormalities of this valve blocking the flow of blood so that blood flows back and venous dilation occurs. The development of varicocele usually progresses slowly and can be without symptoms. More common in men aged 15-25 years.

Varicocele is the cause of infertility in 39% of patients with infertility. Varicocele appears suddenly in the elderly can be caused by a kidney tumor that has been on the renal vein and cause disruption of blood flow through the spermatic vein.

Varicoceles usually develop in the left scrotum, these masses usually feel / look real if the patient standing and disappear when the patient rests due to the venous blood flow is reduced.

Spermatokel

Spermatokel is a mass in the scrotum that resembles a cyst, which contains fluid and dead sperm cells. If the size is large and intrusive, can be done surgically to remove it.


Diagnosis
Diagnosis based on symptoms and physical examination. Physical examination showed a mass in the scrotum that:
- Unilateral (only found in one testicle)
- Software
- Smooth, winding or irregular shape
- Fluctuating, demarcated or solid.

Other tests that may need to do is:

* Scrotal ultrasound
* Biopsy.

The existence of hydrocele can be known with a flashlight shining on the scrotum. The scrotum is filled with clear fluid will be translucent light (transillumination). Varicocele palpable as a mass of winding along the spermatic cord.


TREATMENT
Hematokel, hydrocele and spermatokel usually benign and do not need to be treated. Sometimes need surgery to remove blood, fluids or cells that die. Hydrocele usually harmless and treatment is usually only done if the patient has been bothered or feel uncomfortable or if hidrokelnya so great that it threatens the flow of blood to the testicles.

Treatment can include aspiration (suction fluid) with the help of a needle or surgery. But if done aspirations, most likely to be recurrent hydrocele and infection can occur. After aspiration, can be injected sclerotic substances (eg tetracycline, tetra sodium decyl sulfate or urea) to block / close the hole in the scrotal sac so that fluid will not be buried again.

Hydrocele associated with inguinal hernias should be corrected with surgery as soon as possible. Varicoceles can be treated conservatively with scrotal support. But if the pain persists, there infertility or testicular shrinkage occurs, then performed ligation (binding).