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What are the Most Common Symptoms of a Scrotal Cyst?

By Marisa O'Connor
Updated Mar 03, 2024
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The most common symptoms of scrotal cysts are lumps on the scrotum that can be seen or felt. These may be painful, but in many cases they also go all but unnoticed until they’re discovered, and cause no discomfort whatsoever. Swelling and feelings of heaviness in the testicles are common, though, and some may also cause nausea. In nearly all instances scrotal cysts are “benign,” which means that they aren’t harmful in and of themselves. Smaller varieties will often go away on their own, though larger growths may need to be drained, usually to relieve pressure and pain. In more serious cases the cysts may need to be removed surgically, but this is an extreme treatment most often reserved for situations where the growth is putting pressure on nerves or is recurring, meaning that drains in the past haven’t actually solved the problem.

Changes in Appearance

The scrotum is usually understood to be the fleshy area just below the penis that houses the testicles. One of the first things men usually notice when they have this sort of cyst is a bulge or small lump somewhere within the folds of the scrotal tissue. These can vary tremendously in size, from as small as a pinhead to as big as a marble or even larger. Many types of cysts will grow if not treated, so small lumps that didn’t seem consequential one day may be much larger and more concerning the next.

Cysts can occur almost anywhere on the body, and in most cases there’s nothing particularly special about those that occur on or near the scrotum. They are sacs of tissue that fill with some type of fluid, usually water or pus. They can occur for a number of different reasons, most often a blocked duct or swollen hair follicle, though they are rarely a sign of any serious health complication. Still, noticing them can be unsettling.

Pain

Not all cysts are painful, and many men report having no idea that they had one until they felt it. Unless the cyst is pressing against nerve tissue, it may not cause any pain or tenderness. A dull ache or radiating pain is sometimes experienced in the lower back, abdomen, or groin, though, depending on where the cyst is located as well as its size. The growth can agitate and cause inflammation of the testicle, scrotum, or epididymis, which is a narrow, coiled tube connecting each testicle to the vas deferens. The vas deferens is what carries sperm from the testicles to the penis for ejaculation.

Swelling and Pulling

Swelling of the scrotum is another symptom. Some of the most common types of scrotal cysts are called spermatoceles, and these are typically formed by excessive fluid buildup in the epididymis. The excess fluid, which often contains dead sperm, can cause swelling and tenderness, particularly during arousal.

Heaviness or the sensation of testicular “pulling” is also frequently reported. In most instances this is caused by the added weight of the cyst. These symptoms are more likely to be experienced if there is also swelling in the testicles or scrotum. The added weight of the fluid and skin surrounding the cyst, which is called the capsule, is sometimes noticeable, too.

Nausea

In rarer cases, the pain from the cyst can result in nausea. This is similar to the nausea experienced from blunt trauma to the testicles. The spermatic plexus is the primary nerve connecting each testicle to the spine, and it travels through the abdomen. Pain experienced in the testicles will often travel up to the abdomen, causing nausea and sometimes also vomiting. It’s important to note here that it’s not exactly the cyst itself that is causing this reaction, but rather the pressure it is putting on nearby nerves.

Treatment Options

Men who are concerned that they might have a scrotal cyst are usually encouraged to visit a healthcare provider for an examination. Though cysts aren’t usually harmful, it can be hard for untrained people to distinguish between benign growths like cysts and more problematic growths like tumors. Smaller cysts that aren’t causing any pain may not require any treatment, and patients may be advised to take a sort of “wait and see” approach. During this waiting phase men are often advised to keep the area very clean, and to trim all hairs to prevent bacteria or other debris from gathering around hair follicle sites.

Larger growths or growths that are causing discomfort are typically drained, often with a specialized syringe, which in most cases will solve the problem. People who suffer from recurring cysts might opt for surgical removal. This is far more invasive, which makes it rarer and usually only recommended in serious situations. Permanent removal is often more effective than other treatment methods, though, at least in the long term.

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Discussion Comments
By anon992736 — On Sep 28, 2015

I have one large cyst and a smaller one. There is some discomfort, but no real pain. But I have had very low testosterone since it appeared. My energy levels have changed dramatically.

At first the doctors said it was not related, although the cyst has gone away briefly two times over the last six months. During the time the cyst was gone, my energy came back and I felt great during those two brief moments. The doctor currently I meet with now believes the two are related. Has anyone else noticed lack of energy or low testosterone?

By stoneMason — On Aug 18, 2012

@turquoise, @ZipLine-- I don't know about you guys but my scrotal cysts are gross. I don't have just one or two testicle cysts but many smaller ones. They usually start out tiny and get bigger over time and fill with pus. I don't squeeze them any longer since that can lead to infection. But I have in the past and a clear to yellowish pus and liquid comes out. It's not a pretty sight.

I don't have pain either, but I'm actually very conscious of my sexual organ because of these cysts. It's even affecting my sexual life, so aside from physical symptoms, my psychology is being negatively affected too.

I'm scheduled to have several of the larger cysts removed in a couple of weeks. Hopefully things will look better afterward.

By ZipLine — On Aug 17, 2012

@turquoise-- Yea, I have a couple of scrotal cysts too. I actually don't have any soreness, pain or anything like that. I don't even have swelling, just the appearance of bumps which made me go to the doctor in the first place.

There really isn't much that can be done with the cysts, unless it's really big in which case they would remove it like you said. I was told to keep the area clean and it will probably disappear by itself.

I wonder if you have soreness from touching it? I don't touch the cysts at all and don't have any soreness.

By turquoise — On Aug 16, 2012

I haven't seen a urologist yet nor have I had an ultrasound, but I was told by my family doctor that I have a scrotal cyst. I went in because of swelling and soreness on my scrotum. It's not painful per se , but if I slightly touch the area or put pressure on it, it feels sore. There is also a little bit of swelling. Not too much, but definitely noticeable.

I've been advised to keep an eye on it and see a urologist if I have more symptoms. I'm hoping that it just goes away on its own. I don't know what's going to happen if it keeps swelling and getting bigger though. I guess I would have to get it removed right?

Does anyone else have a scrotal cyst? Do you swelling and soreness like I do?

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