Another typically painless extra testicular mass is a hernia. Hernias can be so large that they extend into the scrotum. And remember, a hernia simply represents a defect in the abdominal wall and its integrity. So when there's a defect in the lower abdominal wall, bowel contents can emerge through that defect and can then fill the scrotum. This is relatively rare. Hernias are usually seen above the scrotum, but it's not entirely unusual to see a large hernia fill the scrotum. In any case, this is usually a surgical treatment.