The scrotum is a sac of skin that hangs from the body at the front of the pelvis, between the legs. It sits next to the upper thighs, just below the penis. The scrotum contains the testicles. These are two oval-shaped glands responsible for producing and storing sperm. They also produce several hormones, the main one being testosterone.
The scrotum hangs outside the body because it needs to maintain a slightly lower temperature than the rest of the body. This lower temperature helps to maintain sperm production. Scrotal tissues help protect the structures inside the testicles, where sperm and important hormones are produced.
In addition, the scrotum protects the testicles and major blood vessels, as well as tubes that release sperm from the testicles into the penis for ejaculation.
The scrotum is a sack of skin divided in two parts by the perineal raphe, which looks like a line down the middle of the scrotum.
The raphe joins the internal septum with the scrotum. The septum splits the scrotal sac into two parts with similar anatomy.
Each side of the scrotum usually consists of a:
All of these structures are surrounded by the scrotal wall. This wall is lined with smooth muscle called the dartos fascia muscle. This muscle, along with the cremaster muscles, help to expand or tighten the skin of the scrotum as it moves up and down.
Explore the interactive 3-D diagram below to learn more about the scrotum.
Many conditions can affect your scrotum and its contents. Here’s a list of some of the most common ones.
An inguinal hernia happens when part of your small intestine pokes through an opening in your abdominal wall into your scrotum. Some inguinal hernias follow the path of the spermatic cord into the scrotum, while others stay outside it.
Symptoms of an inguinal hernia can include:
Some inguinal hernias can be dangerous if left untreated. You may need surgery to repair an inguinal hernia and prevent tissue death due to lack of blood flow.
A hydrocele happens when excess fluid builds up in the cavities around one of your testicles. This is sometimes present at birth, but it can also result from an injury or inflammation.
Hydrocele symptoms include:
Hydroceles usually don’t require treatment unless they’re very large or painful. Most go away on their own, but more severe cases might require surgical repair.
A varicocele is a swollen collection of veins in your scrotum. It doesn’t always cause symptoms. When it does, symptoms include:
You can have a varicocele your entire life and never need treatment. However, they can sometimes cause infertility or testicular shrinkage, so it’s best to have it checked out by your doctor.
A spermatocele, or spermatic cyst, happens when a fluid-filled sac forms in the epididymis. These cysts aren’t cancerous or life-threatening, but they can cause pain and discomfort if they’re large.
Larger, more painful spermatoceles may need to be removed with surgery.
Testicular torsion means that your testicle has rotated in the scrotum. This twisting of the spermatic cord cuts off blood supply, nerve function, and sperm transport to your testicle. This condition is considered a medical emergency.
Symptoms of testicular torsion include:
Seek emergency medical care for any of these symptoms.
Several things may increase the risk of testicular torsion, including:
Testicular torsion occurs more frequently in young children, teens, and young adults. Your doctor can temporarily treat testicular torsion by repositioning the testicle by hand. However, it frequently reoccurs. Experts recommend surgery to permanently fix the problem, ideally within 12 hours from the start of symptoms.
Epididymitis happens when the epididymis becomes infected or inflamed. It’s often the result of a sexually transmitted infection (STI), such as chlamydia or gonorrhea.
Symptoms of epididymitis can include:
Depending on the type of infection, you may need to take antibiotics or antiviral medication.
Orchitis refers to an infected or inflamed testicle. Like epididymitis, orchitis often results from an infection caused by an STI. Other causes can include tuberculosis, viruses like mumps, fungi, and parasites, along with other diseases that lead to inflammation.
Orchitis symptoms include:
Treatment depends on the cause. Ultrasound of the scrotum and testicles can help determine the diagnosis and severity of the condition. Serious infections may require hospitalization or surgery.
Testicular cancer happens when cells abnormally multiply within the tissue of your testicles. It commonly starts in the cells that make sperm.
The cause of testicular cancer isn’t always clear. According to the American Cancer Society, testicular cancer is the most commonly diagnosed cancer in males between the ages of 15 and 44.
Symptoms of testicular cancer can include:
Treatment depends on your stage of cancer. Sometimes, your doctor will surgically remove the testicle. Radiation therapy or chemotherapy may also be part of the treatment plan. Stem cell transplant may also be used.
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