Surgery for benign scrotal lumps

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What is a benign scrotal lump?

A benign scrotal lump is a lump in your scrotum that is not caused by cancer.

There are 3 types of benign scrotal lump.

  • A hydrocele is a build-up of fluid around a testicle.
  • An epididymal cyst is a collection of fluid in the epididymis (a tube-like structure that stores sperm).
  • A sperm granuloma is a small painful swelling caused by sperm sometimes leaking following a vasectomy.
Illustration showing a normal testicle and a hydrocele.
a) A normal testicle
b) A hydrocele

What are the benefits of surgery?

If the lump is large, surgery will ease any discomfort you may have and make it easier for you to walk.

If you want to have children, it is best to leave an epididymal cyst alone.

Are there any alternatives to surgery?

The fluid can be removed using a needle but the fluid usually builds up again. It is possible to inject a drug that prevents the fluid from coming back but this may be uncomfortable and can cause an infection.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The operation usually takes 20 to 50 minutes. Your surgeon will make a small cut on your scrotum. For a hydrocele, your surgeon will remove the fluid from the sheath. To prevent the fluid from coming back, your surgeon will either remove the sheath or stitch it together.

Your surgeon will remove an epididymal cyst. This will usually involve removing part of or all the epididymis.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

  • bleeding
  • allergic reaction to the equipment, materials or medication
  • chest infection

Specific complications of this operation

  • difficulty passing urine
  • infection of the surgical site (wound)
  • reduced fertility

Consequences of this procedure

  • pain

How soon will I recover?

You should be able to go home the same day or the day after.

Do not do strenuous exercise, like running and riding a bicycle, for 5 to 7 days. Most men can return to normal activities after 2 to 4 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most men make a good recovery.

Sometimes the lump comes back.

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