Benign Scrotal Lumps

Scrotal lumps are swellings that occur in the scrotum, the sac that holds the testicles. The most common causes of scrotal lumps are varicoceles, hydroceles, and spermatoceles. In Chinese medicine, these types of lumps are referred to as "bulging qi" and are associated with phlegm, static blood, fluid metabolism dysfunction, damp-heat, or yang qi deficiency. Chronic infections and epididymal cysts can also sometimes cause scrotal lumps. Scrotal lumps should be evaluated by a healthcare provider to determine the cause and appropriate treatment.

Pathology

The scrotum and testicles are thought to be under the influence of the kidneys and liver in traditional Chinese medicine. The testicles are considered to be an "external kidney," and the liver is believed to play a role in the movement and distribution of qi and blood, which can affect the function of the external genitals.

Causes

External Pathogens

Invasion of external damp-heat through the channels and collaterals surrounding the genitals can result in an acute painful scotal lump.

Emotional Factors

The scrotum and external genitals are sensitive to changes in the movement and distribution of liver qi. Reduced flow of qi through the genitals can lead to swelling and discomfort that varies with a person's emotional state. Prolonged constraints on liver qi can also contribute to the development of physical lumps, such as phlegm and blood stasis. Phlegm develops when chronically constrained qi fails to move fluids, leading them to gradually thicken and congeal, especially in the presence of heat or damp-heat. Blood stasis can also develop as a result of impaired qi flow. Repeated invasion by the liver can weaken the spleen, leading to the production of dampness. This dampness can combine with heat generated by liver qi constraint, sinking into the lower burner and settling in the scrotum. Blood deficiency is a common complication of chronic liver qi constraint and can contribute to the formation of lumps by failing to nourish and lubricate the sinews. The resulting dry, tight sinews can clump into palpable knots.

Diet

Excessive consumption of rich, greasy, sweet, or spicy foods and alcohol can lead to an imbalance in the body, known as damp-heat in the middle burner. This can cause the damp-heat to sink and settle into the lower burner, leading to prolonged damp-heat in that area. Over time, this can lead to the accumulation of damp-heat in the scrotum or the formation of phlegm. Overeating, or consuming too many dairy and carbohydrate-rich foods, can also lead to the production of phlegm. Consuming too much cold-natured or raw food can weaken the body's qi and yang, leading to dampness and sinking qi. Prolonged stagnation of dampness can generate heat and damp-heat, and a weak Spleen can eventually drain the Kidneys, leading to problems with fluid metabolism.

Constitutional Factors, Overwork, Exhaustion

The kidneys are important organs in the body that play a role in filtering waste and maintaining overall health. Congenital problems with the kidneys can sometimes manifest as issues with the scrotum, such as lumps. In some cases, these types of scrotal lumps are more common among people who have first-degree relatives with the same condition.

Sitting for long periods of time can disrupt the circulation of blood and energy (qi) to the genitals, potentially leading to a build-up of qi and blood in the area. This can contribute to the development of scrotal lumps. On the other hand, excessive standing, especially on cold floors or at night, can weaken the kidneys and spleen, potentially leading to a collapse of qi into the lower abdomen and problems with fluid metabolism.

Treatment

The goal of treating scrotal lumps is to reduce or eliminate the mass whenever possible. While this may not always be possible, treatment can still provide positive effects by mitigating the effects of the lump on the body. In particular, treatment can relieve local discomfort or paresthesia and may improve fertility and reproductive ability. A varicocele, a type of scrotal lump, can have a negative impact on sperm and fertility.

Scrotal lumps are often found in people without other systemic health issues. In the absence of a clear pattern, a doctor may diagnose a scrotal lump based on its appearance and feel.