Swelling and lumps in the scrotum
A swelling or nodule in the scrotum can have several causes. Often it is a benign condition, such as a varicocèle (varicous veins around the seedball), hydrocele (fluid accumulation), spermatocele (fluid-filled cyst in the prom) or a cyst of the prom . Also infections of the prom or sperm can cause swelling.
The symptoms vary greatly. Some swellings cause little discomfort, while others are accompanied by a heavy or twitching feeling, pain or tenderness. A varicocèle can also affect the quality of the sperm and therefore fertility.
Acupuncture and Chinese herbal medicine can be used for certain benign and already medically assessed scrotal complaints. In addition, it looks not only at the swelling itself, but also at pain, warmth or cold, possible urinary problems, digestion and other characteristics.
A new or unexplained nodule in or around the testicle must always be assessed by a doctor. This is important because swelling can also be caused by a condition requiring regular medical treatment.
Common symptoms
Depending on the cause may include:
- a palpable nodule or swelling in the scrotum;
- enlargement of one side of the scrotum;
- a heavy or pully feeling;
- nagging or oppressive pain;
- sensitivity to touch;
- a soft or firm swelling;
- a swelling that can change in size;
- dilated or winding veins around the testicle;
- heat, redness and pain when inflammation is present;
- sometimes impaired fertility, for example with a varicocèle.
Not every swelling causes symptoms. For example, a spermatocele or hydrocele may be present almost painlessly for a long time.
Possible Western disorders
Varicocèle
The veins around the seedball are dilated. This may feel like a soft, winding mass and may cause a heavy or nasty feeling. A varicocèle is more common on the left and may be associated with decreased sperm quality in some men.
Hydrocele
A hydrocele is a build-up of fluid around the seedball. This allows the scrotum to gradually increase. The swelling is usually not painful.
Spermatocele or epididymal cyst
This is a fluid-filled swelling at the prom. It is usually benign and often gives little complaints.
Inflammation of the ball or seedball
In epididymitis or orchitis, pain, swelling, heat and redness may occur. Sometimes there are also fever or urinary problems.
Other causes are also possible. Therefore, it is important that a new swelling is examined regularly first.
What can acupuncture do?
Acupuncture can be applied additionally when it is clear what causes the swelling and there is no condition that requires other medical treatment.
The treatment is tailored to the type of swelling and the underlying TCM pattern. For one person, for example, stagnation of Qi and Blood is at the forefront, while another Dampness, Dampness-Heat or an underlying deficiency plays a greater role.
Depending on the picture of complaints, treatment may be directed at:
- support the flow of Qi and Blood into the abdomen and genital area;
- reduce stagnation when feeling heavy, tense or painful;
- Reduce Dampness when fluid accumulation is at the forefront;
- Reduce Dampness Heat in case of heat, redness or irritation;
- Spleen-Qi support when moisture accumulates easily;
- Support kidney-Qi, kidney-Yang or kidney-Yin when a deficiency patterns is present.
For structural abnormalities, such as a larger hydrocele or varicocèle, it is not natural that acupuncture can make the swelling disappear itself. Treatment may then be mainly directed towards additional complaints and the underlying pattern.
What can Chinese herbal medicine do?
Chinese herbs are also chosen based on the underlying pattern. As a result, treatment can vary considerably between two men who have the same type of swelling medically.
For example, in the case of soft swelling with fluid build-up, the emphasis may be on regulating the fluid balance. In case of a hard or painful swelling, improving the flow of Qi and Blood can be more important. In case of warm, red and sensitive swelling within TCM, Dampness Heat is more likely to occur.
Depending on the pattern herbal medicine may be aimed at:
- Control Qi in the lower abdomen;
- Decrease blood stasis;
- Reduce Dampness and Phlegm;
- Clear Dampness-Heat;
- support moisture circulation;
- Enhance Spleen-Qi;
- Supporting Kidney-Yang or Kidney-Yin.
In case of acute inflammatory symptoms or an unexplored swelling, Chinese herbal medicine does not replace regular diagnostics or necessary medical treatment.
How does Chinese medicine view scrotal swelling?
Within Chinese medicine, a swelling in the scrotum is not only assessed on the basis of medical diagnosis. It looks at the overall picture and the processes that according to TCM contribute to the swelling or additional complaints.
For these complaints, the Liver , Kidneys and Spleen are particularly important. These are functional systems within TCM and not exactly the same as the anatomical organs with the same name.
The Livermeridian runs through the genital region. If the flow of Liver-Qi is disturbed, according to TCM tension or stagnation may occur in the abdomen and around the scrotum. Long-term stagnation may be associated with Blood stasis, reducing blood flow.
The Spleen plays an important role in the processing and distribution of bodily fluids within TCM. When this function is weakened, Dampness can develop. Dampness can further compact to Phlegm, which means not only mucus within TCM, but is also used to describe certain thickening and masses.
The Kenyans support, among other things, reproduction, fluid management and the functions of the lower abdomen. Especially in the case of long-term complaints, a shortage of kidney-Yang or kidney-Yin can be part of the pattern.
A recognizable combination of these disturbances and associated symptoms is called a TCM pattern.
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
With Liver-Qi stagnation, Qi's circulation through the abdomen and genital area according to TCM is less free. The swelling and discomfort can change and clearly respond to stress or stress. Long-term Qi stagnation can contribute to the development of Blood stasis or Phlegm.
Common symptoms
- varying swelling or a heavy, twitching sensation in the scrotum;
- nagging or tense pain;
- symptoms that increase with stress or emotional stress;
- tension or discomfort in the abdomen;
- irritability or frustration;
- sometimes visible dilated veins.
Examples of Western disorders
Varicocèle, hydrocele and chronic epididymal or testicular symptoms.
Phlegm-Dampness
Brief explanation
When body fluids are not sufficiently processed according to TCM, Dampness can occur. If this Dampness is further compacted, Phlegm is spoken of. This may manifest itself as a soft, rubbery or clearly limited swelling.
Common symptoms
- round, soft to firm or rubbery swelling;
- little or no pain;
- feeling heavy in the body;
- tendency to fluidize;
- fatigue;
- bloating or other digestive problems;
- Sometimes overweight.
Examples of Western disorders
Hydrocele, spermatocele and epididymal cyst.
Blood stasis
Brief explanation
Blood stasis within TCM means that blood flow is locally impaired. This pattern is especially relevant in a varicocele and in complaints after trauma, surgery or prolonged stagnation.
Common symptoms
- firm or hard swelling;
- local, often clearly identifiable pain;
- pain or sensitivity to pressure;
- visible, winding or dilated veins;
- a swelling that may feel like a collection of winding vessels;
- dark red or purple discolorations may occur.
Examples of Western disorders
Varicocèle, hematocele and chronic epididymal symptoms.
Damp-Heat
Brief explanation
Dampness-Heat combines fluid accumulation with characteristics of heat or inflammation. The pattern may develop acutely, but may also remain present for longer periods. In case of acute complaints heat and pain are usually more prominent; in case of chronic Dampness-Heat the symptoms can be milder and return.
Common symptoms
- warm, sensitive or painful swelling;
- redness of the scrotum;
- heavy or oppressive sensation;
- burning or painful urination;
- darker or concentrated urine;
- possible fever in case of acute symptoms;
- in chronic symptoms recurrent swelling or irritation.
Examples of Western disorders
Epididymitis, orchitis, testicular or scrotal abscess and other inflammatory swellings.
Spleen-Qi-deficiency with sinking Qi
Brief explanation
According to TCM, both the processing of body fluids and Qi's ability to maintain tissues in place has been weakened. This can result in a soft or moist swelling that becomes clearer when standing tall or tired.
Common symptoms
- soft or fluid-filled swelling;
- feeling heavy or pulling down;
- symptoms worse after long standing or when tired;
- improvement by laying or resting;
- fatigue and low energy;
- decreased appetite;
- bloated belly and loose stools.
Examples of Western disorders
Hydrocele, varicocèle and groin fracture with extension towards the scrotum.
Liver- and Kidney-deficiency
Brief explanation
In case of long-term complaints, according to TCM, a weakening of Liver and Kidneys can play a role. Yang deficiency is mainly cold and reduced circulation and moisture management. Yin deficiency tends to dominate dryness and relative heat.
Common symptoms
Yang deficiency may occur:
- chronic swelling with a heavy or pulling sensation;
- cold genitals;
- cold hands and feet;
- low back and knee discomfort;
- fatigue;
- increased urination;
- decreased libido or erectile dysfunction.
Yin deficiency may occur earlier:
- prolonged or difficult recovery swelling;
- dry mouth or throat;
- feeling of warmth in palms or soles of the feet;
- night sweats;
- restlessness;
- low back or knee pain.
Examples of Western disorders
Prolonged hydrocele and chronic epididymal or testicular symptoms.
Outlook
The course of treatment strongly depends on the cause and type of swelling. Complaints that are mainly functional, such as pain, tension or varying heavy feeling, may react other than a clear structural disorder such as a hydrocele, cyst or larger varicocèle.
For chronic or structural swellings, a longer treatment course is usually required and complete swelling removal is not always a realistic treatment goal. In addition, a varicocèle may require regular treatment when there is apparent pain, testicular changes or impaired fertility.
In the initial phase acupuncture is often applied approximately once a week. For acute or pronounced complaints, temporary more frequent treatment may be appropriate. In herbal medicine it is assessed over time whether the symptoms and any measurable deviations change enough to continue the treatment.
When do you want to see a doctor?
Always have a new nodule or swelling in the scrotum medically assessed, even if it does not cause pain.
Contact a doctor more quickly if:
- sudden severe pain in a sperm ball or scrotum;
- rapidly increasing swelling;
- a hard lump in the seedball;
- redness, heat and fever;
- nausea or vomiting in combination with acute pain;
- blood in urine or semen;
- persistent or increasing complaints.
Sudden severe pain in a sperm ball may fit, among other things, with a torrio testis (testicle twist). This is a medical emergency and should be assessed immediately.
Contact
If you have a swelling or nodule in the scrotum and the cause has been medically investigated, it will be possible to examine during an initial appointment which symptoms are present, which TCM pattern fits and whether acupuncture and/or Chinese herbal medicine can be an appropriate supplement in your situation.