Cysts are fairly common and can occur anywhere on the body, including the scrotum. Scrotal cysts are typically either epididymal or sebaceous cysts.

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.

While most scrotal cysts are treatable and not serious, they are not the only cause of a lump on the scrotum. This means people should speak with a healthcare professional if they have any lumps or unusual symptoms around the scrotum.

This article explains the type of cysts that can occur on the scrotum, how to recognize them, and potential treatment options.

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Fluid-filled cysts on the scrotum are relatively common and typically occur more often in older males. 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 differ slightly, as spermatoceles contain sperm cells in addition to fluid.

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 generally contain a yellowish, oily liquid, while epidermoid cysts contain a more solid material.

Sebaceous cysts may 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:

Learn more about 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.

Anyone with new or unexplained pain or lumps on their scrotum should speak with a healthcare professional.

A person may be able to identify a scrotal cyst following a testicular self-exam. 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.

How to perform a testicular self-exam

Experts recommend that individuals check their scrotums each month beginning in their teens. A testicular self-exam only takes a few minutes.

To perform a self-exam follow these steps:

  • Perform the exam while standing.
  • Check for swelling in the scrotum.
  • Gently feel around the scrotal sac to find a testicle.
  • Firmly and gently check each testicle, one at a time, by rolling it between the thumb and fingers of both hands in order to feel the entire surface.

Speak with a healthcare professional if any lumps or changes are felt.

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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 speak with a healthcare professional.

A healthcare professional can provide a more accurate diagnosis following a physical exam. They may also use tests, such as an ultrasound to confirm if it is a cyst.

If the scrotal cyst is small, and not causing any pain or interfering with any activities, a healthcare professional may not recommend any treatment.

However, if they are large, uncomfortable, or painful the cysts may require medical treatment.

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 healthcare professional 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 be effective, healthcare professionals 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 issues, a healthcare professional may suggest surgical removal. This will usually involve removing the cyst through a small incision on the scrotum. A healthcare professional will often perform this outpatient procedure using local or general anesthesia.

Can a testicular cyst be cancerous?

Cysts are typically benign. However, some lumps on the scrotum and testicles can be a sign of cancer. If a person notices any new lumps or swelling on their testicles or scrotum, they should speak with a healthcare professional.

Do scrotal cysts go away naturally?

Most smaller cysts will go away naturally. However, larger cysts that cause pain or discomfort may require medical treatment.

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 healthcare professional 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 speak with a healthcare professional.