How is the condition diagnosed?

Usually a healthcare provider can tell which kind of scrotal mass is involved by doing a physical exam.

An epidermal cyst is not mobile, and its location within the skin of the scrotum can be felt.

A hydrocele is usually located behind and above the testicle. Both hydroceles and spermatoceles, which are located along the epididymis, can be transluminated. This test is done in a darkened room. A bright light is shone onto the skin of the scrotum. If the light can be seen passing through the mass, the mass is probably filled with fluid.

A hematocele will not transluminate because the blood is opaque.

A varicocele feels to the doctor like a "bag of worms" when the person is standing. When the person lies down, the blood drains out of the veins and a varicocele is no longer apparent.

A testicular tumor is usually a hard mass within the testicle that cannot be transluminated. If there is any doubt, an ultrasound of the scrotum can be done. Ultrasound is very reliable for determining the kind of mass.