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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Scrotum trauma -- symptoms (lump) after the fact

 Gair69 - Mon Jul 26, 2010 11:41 am

About 5 months ago, I was hit by a 90mph fastball. I was standing behind the catcher, the pitcher released the ball, it tookl on hop and then nailed in the scrotum from directly underneath -- I dropped like a rock.

That evening I was in some pain, but nothing more than "some" discomfort. The following day there was some slight bruising on the left-most bottom side of the scrotum. The discomfort lasted about three or four days lessening each day. The bruising was gone by the following week.

I've recently noticed a disfiguration on the top of the left testicle. I'm hesitent to describe it as a lump, but it could be classified as such. The testicle is normal in feeling/shape. However, when running along the edges toward the top where it begins to slope (like and egg or grape), the underlying tissue is softer than the rest of the testicle. It almost feels like the top of the testicle has been pinched -- creating a slight bulge at the top. But it could be a lump on top of that testicle. It's hard to tell by feeling.

Another observation, is that the testicle in question is about 20% large when compared to the right testicle.

History from date of incident to current symptoms:
1) There was no blood in the urine or other discharges after the incident
2) No notice in decline of sexual funtion -- everything is working as it has
3) Neither testicle will move:
a) As an example, when getting a physical and the doctor would have you "turn your head and cough" there is no movement in either testicle.
b) When tightening the muscles, like stopping the flow of urine, there is on movement.
c) Prior to the incident, I could tighten those muscles and cause the penis to move when erect. That does not happen anymore.
d) The testicle seem to sag more than previously
e) The scrotum does tighten during intercorse or periods of arrousal.

I plan to see my doctor, but I would rather wait a couple more months as I have some family and work obligations, that are extremely important right now. Getting the time off/away is difficult.

Also, I would like to know any possible diagnosis, or any other self-exams I could do to narrow the possible problem.

Thanks in advance.
 Dr.M.Aroon kamath - Tue Jul 27, 2010 12:47 pm

User avatar Hi,
In the not too distant past, the existence of the entity "traumatic epididymitis or orchitis" was not universally accepted.With the widespread use of scrotal ultrasound and color doppler studies, cases of traumatic epididymis and orchitis are being reported.

Trauma can cause several complications related to the scrotal contents, including testicular rupture, intratesticular hematoma, testicular infarction, traumatic hematocele, and lacerations of tunica albuginea.

Epididymitis following trauma has also been observed to occur as an isolated finding, particularly in less-severe scrotal injury. A point of note is that epididymitis after trauma can be associated with an underlying infection, with the trauma being an aggravating factor.

If you had got yourself examined by a urologist soon after the trauma, a diagnosis could have been fairly easily arrived at.

Although in your case there is a definite history of significant trauma, most clinicians would prefer to test such individuals for STDs and UTIs none the less. As explained earlier, trauma may just be an inciting event.

Rather than speculating, it may be a lot wiser and safer to consult a urologist and get thoroughly investigated.
Best wishes!

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