Scrotal Hematoma

Scrotal hematoma is the collection of blood inside the sac (scrotum) that contains the testicles, the blood vessels that serve the testicles, and the structures that help deliver sperm and semen. The rich blood supply in this area makes it easy for a significant amount of blood to collect in the scrotum even after a minor injury or a small operation like a vasectomy. In addition, the tissues in the scrotum are very loose. There is no pressure from the surrounding tissue to help stop bleeding once it starts.

SYMPTOMS

Common symptoms may include:

  • Bruising and blue color on the skin of the scrotum.

  • Pain in the scrotum.

  • Pain in one or both testicles.

  • Swelling of the scrotum.

  • Abdominal or pelvic pain.

  • Nausea or vomiting.

DIAGNOSIS

The diagnosis is usually obvious when the testicles are swollen and bruised following a vasectomy. Scrotal hematoma often occurs following trauma or an injury. In these cases, additional tests may be done to make sure other contents of the scrotum are not injured. These could include injuries to the:

  • Testes.

  • Epididymis.

  • Spermatic cord contents.

  • Urethra.

If a minor injury leads to a large hematoma, this could be due to a tumor in a testicle. This condition is very rare.

TREATMENT

Most hematomas of the scrotum gradually reabsorb. This means the collection of blood gradually dissolves into the surrounding tissues. A very large hematoma may require drainage, but this is uncommon. This will improve over 1 to 2 months.

HOME CARE INSTRUCTIONS

Conservative treatment includes:

  • Ice packs (cubes or crushed ice placed in a seal-able plastic bag and then covered with a thin cloth or towel).

  • Scrotal support.

  • Appropriate pain medications prescribed by your caregiver.

  • Minimize physical activity and avoid any activities that would place direct pressure on the scrotum and penis (such as bicycling and horseback riding).

  • Avoid sexual activity until advised otherwise by your caregiver.

  • If your caregiver has given you a follow-up appointment, it is very important to keep that appointment. Not keeping the appointment could result in a chronic or permanent injury, pain, or disability. If there is any problem keeping the appointment, you must call back to this facility for assistance.

SEEK MEDICAL CARE IF:

  • You have cloudy or dark urine.

  • You have frequent urination.

  • You develop scrotal swelling that does not improve as expected over 3 to 4 days.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop recurrent or severe pain that is not controlled by prescribed medicine.

  • You have nausea or vomiting.

  • There is increased swelling of the scrotum.

  • You have increased abdominal pain.

  • You have a fever or chills.

  • You have difficulty starting urination.

  • You have painful urination.

  • Your urine flow is slow.

  • There is blood in your urine.

  • You are unable to urinate.