Dr Phil: Scrotal lumps

Hello there, I’m Dr Phil. Today we’re going to be talking about scrotal lumps. You’ll be pleased today that I won’t be examining my own scrotum – I think the sight of a 47-year-old GP’s scrotum is probably too much for your cornflakes, so I’m going to use these little accessories – my plums – oooh look, I’ve got a bit of a bruise on my plum already.

Now, the thing about your plums is that they come in a handy carrying sack called the scrotum, and in a healthy man your scrotum should look about 30 years older than you are. If you look roughly the same age as your scrotum, get some sleep: it’s a handy little test (little top tip there).

Now, the scrotal lumps that really matter are the ones that are actually within the plums themselves. If you examine your scrotum, probably best to do it after a hot shower when things are nice and relaxed and hanging down a bit, put them in the palm of your hand and you‘ll find that your plums should roughly weigh the same. In a lot of people one plum is slightly bigger than the other one but they should roughly weigh the same. In most men the left plum hangs down slightly lower than the right one. You sort of weigh them in the palm of your hand and then one at a time, just gently between thumb and fingers, just gently rotate them back: obviously not all the way round as they’ll come off. Most men aren’t very good at multiskilling so I say generally do one plum at a time. What you’re looking for is a lump within the plum itself, so not in the scrotum around the testicle but actually within the body of the testicle. And it will start often like a little grain of sand and you’ll think ‘oooh, little bit tender, that’s not quite right, like a grain of sand’, then it gets to the size of a pea and you think ‘oooh, that’s not quite right’. You should have gone to the doctor by then. What generally happens with blokes is they go ‘aaah, I’ve got a lump in my testicle, it’s embarrassing, it’s in my testicle, it’s a lump, that’s embarrassing’, and they let it get bigger. Then it get so big they think ‘the doctor’s going to think I’m a complete arse for having left it so long’ – I once saw a bloke whose testicle got to size of grapefruit because he was so embarrassed about having a lump. The lump will start as a grain of sand and if you get it at that early stage, it’s an easy job sorting it out: 96% of testicular cancer is cured these days. They bigger it gets, the more likely it is that they might have to remove a bit of your testicle, sometimes the whole testicle, but even then the chance of a cure is pretty good. So certainly grain of sand, great, if it’s the size of a pea, definitely you should be down the doctors.

Outside the testicle you have some tubes, some sperm collecting tubes, the epididymis, which feel a bit like al dente spaghetti. Sometimes it can get a bit like a bag of worms, you can get varicose veins around there and sometimes you get a little cyst there. If it’s very tender around the testicle you can get epididymitis, sometimes happens with a sexually transmitted infection. And then above, behind the epididymis and up, you’ve got the sperm collecting tube, that takes the sperm out. When you get to my age, 47, testicular cancer gets rarer, you get generally hernias in the testicle and your guts can come down into your scrotum. There’s a famous picture in a surgical textbook of a bloke whose entire gut came down through a hole, like a hole in a sock, into his inguinal canal, and he had his entire guts in his testicle. He had to push his entire scrotum around in a wheelbarrow: it’s a great photo, probably on the internet.

The bottom line is look after your plums, examine them once a month or so after a warm shower, any lumps, any little grain of sand, any anything within the testicle itself, get it sorted.

For more amusing top tips on your sexual health I would recommend Sex, Sleep or Scrabble, available at all major outlets, and of course a visit to the embarrassingproblems.com website, which has a whole wealth of information about embarrassing problems. See you soon.

Dr Phil Hammond is a medical doctor, comedian and commentator on health issues. http://drphilhammond.com

Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last edited: Monday, April 26th 2010

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