Cysts are relatively common and can occur anywhere on the body, including the scrotum. If a person has a scrotal cyst, it will likely either be an epididymal or sebaceous cyst.

Cysts are sac-like structures in the skin that typically contain fluid, pus, or gas. Most scrotal cysts are harmless and do not usually require treatment. However, it is important that people are able to identify any lumps on their scrotum or testicles.

Some possible causes for a scrotal lump may be more serious and require action. Therefore, if it is not possible to identify the cause of the scrotal lump at home, a person should seek medical advice.

In this article, we look at cysts that can occur on the scrotum, how to recognize them, and potential treatment options.

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A scrotal cyst typically refers to an abnormal sac of fluid on or inside the scrotum. The scrotum forms part of the male reproductive system and is a bag of skin that hangs under the penis. It contains and protects the testicles and keeps them at the correct temperature to produce sperm.

In addition to the testes, the scrotum also contains the epididymis. The epididymis is a long tube connected to each of the testicles that stores sperm.

Fluid-filled cysts on the scrotum are relatively common and typically occur more often in older males.

While most scrotal cysts are treatable and not serious, they are not the only cause of a lump on the scrotum. Therefore, people should see their doctor if they have any lumps or unusual symptoms around the scrotum.

If a person has a scrotal cyst, it will likely either be an epididymal or sebaceous cyst.

Epididymal cyst

Some people may also refer to epididymal cysts as spermatoceles, or spermatic cysts. However, these terms do differ slightly, as in addition to fluid, spermatoceles also contain sperm cells.

An epididymal cyst is a fluid-filled swelling that develops in the epididymis when fluid is unable to drain, possibly due to an obstruction. They are one of the more common conditions that occurs inside the scrotum, can vary in size, and are generally not painful.

Sebaceous cyst

A sebaceous cyst can occur anywhere on the skin, including the scrotum. Some people may refer to these as epidermoid cysts. They differ slightly, but can both occur on the scrotum. Sebaceous cysts contain a clear, oily liquid, while epidermoid cysts contain a more solid material.

Sebaceous cysts develop due to blockage or damage to a sebaceous gland. Similarly, epidermoid cysts can occur after inflammation in a hair follicle.

Other causes of scrotal lumps

In addition to cysts, there are a number of other possible causes for a lump on the scrotum. These can include:

Click to learn more about swollen scrotums or testicular lumps.

People with a scrotal cyst often have no symptoms. However, people may experience:

  • a feeling of heaviness in the scrotum or testicles
  • a dull pain, ache, or discomfort, but not sharp pain
  • swelling around the scrotum
  • a lump on or inside the scrotum, which can vary in size

It is also possible for a cyst to become infected, which may cause further pain. Some cysts may also burst and discharge pus.

If people experience severe and sudden pain in the testicles, it may be a sign of something more serious that could require immediate medical treatment.

A person may be able to identify a scrotal cyst following a testicular self-exam. A health care provider can show a person the correct technique. A cyst may look and feel like a pea-sized lump on top of the testicle or on the scrotum. In some cases, a person may be able to shine a light through a scrotal cyst.

Some signs of a scrotal cyst may overlap with symptoms of other possible, and more serious, causes of a lump. If a person notes anything unusual or suspicious, such as a larger size or unusual firmness, they should see a doctor.

A doctor can provide a more accurate diagnosis following a physical exam. They may also use tests, such as an ultrasound, which is relatively quick, noninvasive, and inexpensive, to confirm if it is a cyst.

If the scrotal cyst is small, and not causing any pain or interfering with any activities, a doctor may advise against any treatment. However, if the cyst is a bothersome size or causes pain, a doctor may suggest the following:

Medication

While there is no specific medication to cure or prevent scrotal cysts, taking pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may help ease pain.

Minimally invasive therapies

A doctor may suggest an aspiration or sclerotherapy. These procedures involve puncturing the cyst and draining the contents, or injecting the cyst with an agent that causes it to heal.

While these options may work, doctors do not use them often. This is because there is a risk of potential damage to the epididymis and the cysts may grow back after treatment.

Surgery

If the cyst is causing problems, a doctor will likely suggest surgical removal. This will usually involve the doctor removing the cyst through a small incision on the scrotum. A doctor will often perform this outpatient procedure using local or general anesthesia.

If the scrotal cyst is small and not causing any discomfort, a person may be able to treat the cyst at home using over-the-counter medicines to reduce any pain or swelling. However, people should first see their doctor to get an accurate diagnosis and then follow their advice.

Unfortunately, there is no way to prevent the development of a cyst on the scrotum. However, people can regularly perform a testicular self-exam to check their testicles for any abnormalities and catch anything unusual early. By becoming familiar with their testicles, people may be able to identify a cyst or something more serious and receive appropriate treatment.

People should perform a testicular exam monthly. To perform a testicular self-exam, a person should:

  • perform the exam after a bath or shower, when the scrotum is warm
  • stand in front of a mirror
  • check for any swelling on the skin
  • examine each testicle by rolling them between the thumbs and fingers
  • find the epididymis, behind the testicles, and check for any lumps

If people notice anything unusual, they should see their doctor for a checkup.

A scrotal cyst is a fluid-filled lump on or inside the scrotum. They are relatively common, usually harmless, and often do not require any treatment. In some cases, however, a doctor may need to surgically remove the cyst.

People can check for scrotal cysts during a testicular self-exam. If people notice anything unusual, or experience pain while performing a self-check, they should see a doctor.