The scrotum

Definition - What is the scrotum?

The scrotum is also known as the scrotum. It envelops the male sexual organs, which are made up of testicles, epididymis, spermatic cord and spermatic duct. As a result, in men, the scrotum is located between the legs under the penis. The scrotum is a muscular covering, which, however, consists of several layers. The skin of the scrotum is a little darker than the rest of the complexion. In addition, the scrotum is covered with pubic hair from puberty onwards.


The scrotum is a covering for the male sexual organs and consists of a total of six layers.

The development of the genital organs, especially the testicle, begins in the abdomen. By the time the male newborn is born, the genital organs migrate downwards and ultimately break through the abdominal wall. As a result of this migration of organs, among other things, the testes are located outside the abdominal cavity and are only surrounded by the scrotum. This consists of six layers, which correspond to different structures in the abdomen.

The outermost layer is the skin, also called the scrotal skin. After reaching sexual maturity (from puberty) it is hairy. This is followed by a thin layer of connective tissue with embedded muscle cells. This layer is known as the tunica dartos. Next comes the outer fascia layer (Fascia spermatica externa), which is a continuation of the abdominal fascia (Fascia abdominalis). The fourth layer is formed by the testicular lifter muscle (Musculus cremaster). According to its name, it is responsible for lifting the testicle. This can also be provoked by stroking the corresponding inner thigh side. In this way the so-called cremaster reflex can be triggered. The inner fascia layer (Fascia spermatica interna) now follows, matching the outer fascia layer. This structure corresponds to the deep fascia (fascia transversalis) in the abdomen. Fasciae are structures that envelop and thus limit a muscle, in this case the testicular lifter muscle. The last and innermost layer is the tunica vaginalis testis, a direct covering of the testicle. This again consists of two thin layers.

The scrotum is supplied by the testicular artery (arteria testicularis), which is a direct branch of the aorta in the abdomen. The testicular elevator muscle is innervated by the genitofemoral nerve.

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The scrotum envelops the male sexual organs and thus represents an important protection. Due to its elasticity, it follows the movements of the testicles, for example when running or doing sports. This ensures that no direct friction is exerted on the testicles or the spermatic duct.

In addition to this protective function, the scrotum is also involved in temperature regulation. The male sperm cells are produced in the testicles. This requires an approximate temperature of 34 ° C. Accordingly, the testicles are not located in the abdomen, but have been moved outside. However, when it is warmer or colder than 34 ° C in the scrotum, the scrotum is able to compensate for this temperature difference. If it's too cold, the scrotum contracts and becomes firmer. This pulls the testicles closer to the body and adjusts them to body temperature. Our body temperature is 37 ° C on average. In contrast, the scrotum becomes more elastic when it is warm, so that the testicles have a greater distance from the body. In this way, they are less heated up by body temperature and reach the desired 34 ° C. This natural mechanism, which runs completely automatically, guarantees optimal sperm cell formation.

Diseases of the scrotum

Scrotum itches - what's behind it?

An itchy scrotum is painful for the affected patient and represents a burden in everyday life. In addition to the frequent urge to scratch your intimate area, this symptom is often associated with a great feeling of shame. The causes of burning or itching on the scrotum can be very diverse.

First of all, the patient should consider whether he has changed any habits recently. This includes, for example, using a new shower gel or changing a detergent. These may have triggered an allergic reaction, which then manifests itself as burning, itching or even reddening.

Increased sweating in the genital area can also lead to the same symptoms. This is supported by a strong growth of intimate hair on the scrotum. Particularly long hair can become uncomfortable in the long run, as it rubs the skin on the scrotum with movement and in combination with sweat. This leads to red spots on the skin, which are further scraped up by the increased scratching, which in the worst case can lead to inflammation.

Another cause of itching on the scrotum can be a fungal attack. Mushrooms grow mainly in places where it is dark and damp. Both apply to the genital area. If you suspect you have a fungus, it is best to consult a dermatologist. He prescribes an ointment that is directed against fungi (antimycotic). After regular application of this ointment, the symptoms have usually disappeared and the patients are symptom-free.

Also read: Itching on the anus - these are the causes

The scrotum hurts

A painful scrotum is very uncomfortable for those affected. In any case, a doctor should be consulted, as different clinical pictures come into question. The pain is more precisely characterized and localized through a detailed questioning by the doctor (anamnesis). It is very important to know whether the pain occurred suddenly or whether it developed over a long period of time.

If the pain came on suddenly, quick action should be taken. A typical clinical picture that is accompanied by sudden severe pain in the scrotum is testicular torsion. By twisting the testicle, the blood flow to the testicle is interrupted and rapid intervention is required. Other symptoms that indicate testicular torsion are redness in the area of ​​the testicles, extreme tenderness and nausea with vomiting.

Another cause of scrotum pain is inflammation. This can affect different structures, such as the testicles (inflammation of the testicles, orchitis) or the epididymis (inflammation of the epididymis, epididymitis). Inflammation is also painful, but the pain is not as sudden as with testicular torsion.Inflammation is treated with anti-inflammatory drugs and, if necessary, antibiotics.

You can find out more about this at:

  • Testicular torsion
  • Inflammation of the testicles

Inflammation of the scrotum

The scrotum, like all other male genital organs, can become inflamed. Inflammation describes a reaction in the body that can be triggered by various factors. Signs of inflammation include redness, swelling, overheating, pain, and a functional limitation. In principle, every organ in the body can become inflamed and is identified by the word ending "-itis" (for example inflammation of the testicle = orchitis). An inflammation of the scrotum can be caused by pathogens such as viruses, bacteria or fungi. Inflammation of the skin on the scrotum is often triggered by bacteria that can be assigned to the cocci (especially staphylococci). This type of inflammation should be treated as soon as possible, as these bacteria can lead to an abscess if left untreated.

Another cause of inflammation in the genital area is fungus. These prefer humid and warm places to grow. This form of inflammation should also be treated to avoid complications. Usually an ointment with an anti-fungal agent is enough. However, the scrotum does not always have to be affected. Inflammation can also originate in the testicles (orchitis) or the epididymis (epididymitis) and spread to the scrotum. One possible complication of inflammation in this area is the uncontrolled formation of tissue fluid. This collects in the scrotum and can clamp vessels, so that the blood supply is impaired.

Please also read our article on this Inflammation of the testicles.

Fungus on the scrotum

A fungus on the scrotum manifests itself with severe itching and reddish spots on the skin. A fungal attack often occurs on certain parts of the body that meet certain criteria. This includes parts of the body that are damp, warm and dark, so that the fungus can spread in peace. A classic for a fungal attack is the genital area in both men and women. In men, the scrotum can also be used in addition to the penis. In this area, all requirements are met so that the fungus can grow in a moist, warm and dark environment. In some cases this growth is aided by poor hygiene. In addition, there is a high level of friction in the genital area of ​​men, as tight-fitting boxer shorts, for example, compress the scrotum and penis.

If this person is now also active in sports, there is increased sweating in the genital area. Friction and sweat cause sore areas of the skin where fungi feel particularly good. Typical symptoms of a fungal attack on the scrotum are permanent burning or itching, reddened areas of the skin and the constant need to scratch the genital area. In such a situation, you should go to a dermatologist who will examine you and, if necessary, take a smear. As a rule, he prescribes an ointment that kills the existing fungi and thus quickly leads to an improvement. The therapy usually takes effect after a few days and leads to a complete recovery.

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My scrotum is enlarged - what's behind it?

An enlarged scrotum is always a reason to see a doctor, even if the scrotum itself is painless. There can be several causes behind this symptom. An acute emergency is the so-called testicular torsion, in which the blood supply to the testicles is partially or completely interrupted. The reason for this is that the testicles or the spermatic cord rotate around their own axis and thus constrict the vessels. On the one hand, the testicle is no longer supplied with blood, on the other hand, the venous blood can no longer drain and accumulates in the testicle. The scrotum swells in a very short time, turns red, and is extremely sensitive to pressure. In addition, there is severe pain that can radiate into the stomach, as well as nausea and vomiting.

Another cause of a swollen scrotum is inflammation of the testicle or epididymis. Inflammation is always painful and is treated with medication.

However, there are also enlargements of the scrotum that go hand in hand with no pain and are therefore not always immediately noticeable. A possible clinical picture is the water breakage (hydrocele). This causes fluid to collect between two layers of the scrotum, causing the testicle to swell.

The reason for an enlarged scrotum is also a tumor on the testicle (testicular carcinoma). A tumor is a benign or malignant mass that has its origin in degenerate cells. A testicular tumor is usually painless, but it can manifest itself as hardening of the testicle and blood in the semen. The chances of treatment are good and increase the earlier you start therapy.

You can find important information here:

  • Water in the testicle
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Abscess on the scrotum

An abscess on the scrotum is an encapsulated collection of pus in the man's genital area. The causes of such an abscess are small injuries on the surface of the scrotum that can occur, for example, from shaving. If bacteria enter this small sore, it can lead to an abscess. An abscess is a localized collection of inflammatory pus and can cause pain in the testicle area. Under certain circumstances, an abscess can be mistaken for a pimple, which is why you should see a doctor if you suspect an abscess. This appraises (inspection) and scans (palpation) the testicle. If an abscess is diagnosed on the scrotum, it is surgically removed.

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Pimples on the scrotum

Pimples on the scrotum are usually harmless and go away on their own after a few days. Painless pimples are small, reddish bumps that may contain some pus in the middle. Often they are not noticed by the person concerned. Causes of pimples on the scrotum can be, for example, synthetic underwear or poor hygiene. In addition, it may be sufficient to touch the scrotum with unwashed hands, for example when using the toilet or during sexual intercourse. If you notice a pimple in the genital area, you should only observe it at first. In most cases, pimples will go away on their own and won't require treatment. If the pimple starts to hurt and persists for a long time, you should consult a doctor for clarification.

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What's the best way to shave my scrotum?

The scrotum is located in the genital area of ​​the man and is hairy from puberty. These pubic hairs are the secondary sex characteristic in both men and women. They have a protective function as they keep pathogens and foreign particles away and protect them from excessive cold. However, these aspects are no longer too relevant these days due to hygiene and clothing. Especially in Islamic culture, but also increasingly in western areas such as Europe, it is considered an ideal of beauty to shave your pubic hair. Men also shave their pubic hair on the scrotum in addition to their breasts.

The scrotum is a stretchy covering for the testicles and is therefore not easy to shave. The best and safest method is to pull the skin of the scrotum taut at the area to be shaved. This increases the tension on the skin and makes it easier to remove pubic hair with a disposable razor. It is advisable to shave with the line first in order to remove most of the hair. Then you can shave against the grain again if you want to shave off very short hairs and get a smooth result. To keep the risk of injury as low as possible, it is advisable to shave and use shaving foam while showering. This makes the pubic hair a little softer and also makes shaving easier.

What happens during a scrotum lift?

A scrotum lift is a surgical procedure that can be classified as genital surgery. The reasons for this operation can be physical complaints or aesthetic reasons. In some men, the muscles of the scrotum are too weak, so that the scrotum hangs too limply. This can also be due to increasing age. The scrotum causes increased friction, which can lead to pain.

However, some operations are performed for aesthetic reasons, as the affected man feels uncomfortable. With a scrotum lift, excess skin is removed from the scrotum and the scrotum is sewn back closer to the body. A thread is used that dissolves by itself after a while. The procedure can be carried out under general anesthesia or sedation (twilight sleep with the help of a sedative), depending on the initial situation (depending, for example, on age and previous illnesses). If the operation is performed for aesthetic reasons, the patient bears the entire cost. In general, this procedure should be carefully considered and the entire procedure should be discussed with a doctor, as the normal surgical and, if necessary, anesthetic risks are present.