Testicular cancer is the name for cancers that arise in the tissues of the testicles, the organs that produce sperm in the male reproductive system. Abnormal cells can form a tumour and spread throughout the body, particularly to the lungs.…
What is a testicular lump?
Lumps are a common finding in the testicle or scrotal area that can be caused by swelling, fluid buildup, cysts, infection or inflammation. Most of the time, these lumps are not testicular cancer. However, they need to be assessed to exclude this rare cause.
A testicular lump or lumps can be caused by a number of conditions related to the testicles and scrotum. These include:
Epididymitis involves swelling of the epididymis, the duct leaving the testis. Orchitis is inflammation or swelling of the testicles. When both of these occur together the condition is known as epididymo-orchitis. This condition was commonly caused by the mumps virus when vaccination against mumps was less common. Today, it is more commonly caused by other viruses or bacteria, such as sexually-transmitted infections (STIs) including gonorrhea and chlamydia. The symptoms of epididymo-orchitis are usually testicular pain and swelling (more commonly just on one side) and fever. Some men also experience symptoms of a urinary tract infection including painful and frequent urination, an urgent feeling of having to urinate and sometimes blood in the urine.
Torsion of the testis
Torsion, or twisting of the testis in the scrotum, can cause the blood supply to be cut off, leading to swelling of the testis. This is a serious condition and can be identified by a sudden pain in the testicle. It is usually only on one side and can also be associated with abdominal pain and nausea or vomiting. The skin overlying the testicle may become reddened and is usually very tender. It is important to have the testicle untwisted, which usually involves undergoing surgery. If the testicle is not untwisted, usually within 4-6 hours, it can die and will have to be removed.
A hydrocele is a fluid buildup around the testes in the scrotum. These are usually painless at first, but can become large over time and lead to a dull ache. They can occur at any age, but are common among older men and can be caused by injury or inflammation.
A varicocele is the formation of varicose veins in the scrotum. This occurs when the veins around the testis become swollen and expanded. They are usually painless, although occasionally they can produce a heavy feeling in the scrotum. This can occur during puberty, usually on the left side and commonly affects three out of every 20 men. It can be associated with lowered fertility.
A cyst is a fluid-filled sac. Epididymal cysts form in the epididymis, are about the size of a pea and can be felt by an experienced doctor. They are not dangerous, but in some cases the cysts can become larger and cause pain or discomfort.
Testicular cancer can show up as a firm mass (tumor) growing within the testicle. Usually there are no other symptoms, but in a minority of men there can be pain and swelling of the testicle.
Risk factors associated with some testicular lumps include:
- Undescended testis at birth;
- Unprotected sex leading to a sexually-transmitted infection, and;
- Accidents (e.g., car, cycling or sport).
Methods for diagnosis
Your doctor will likely conduct a physical exam of the scrotum and testes to make a diagnosis. Other tests can include a blood cell count, urine analysis, STI tests and ultrasound.
Types of treatment
Depending on the cause of the testicular lump, treatments can vary:
Treatment for viral epididymo-orchitis is aimed at managing your symptoms using pain-relief medications, such as acetaminophen and ibuprofen. Treatment involves antibiotics if the cause is gonorrhea, chlamydia or another bacteria.
Torsion of the testis
Torsion, or twisting of the testis in the scrotum, is treated by surgery. There is a high risk of losing the testicle due to lack of blood flow if the problem is not rectified. This is best performed within six hours of the onset of pain.
A hydrocele is a fluid buildup around the testes in the scrotum. This can be treated with a minor operation to remove the hydrocele. Fluid can also be removed with a syringe, but is not always permanent and can lead to refilling.
A varicocele is the formation of varicose veins in the scrotum. If there is no discomfort, no treatment is necessary. Surgery can be performed if there is discomfort, or if it is associated with reduced fertility.
Generally surgery is not required for pea-sized cysts, but is possible if the cyst becomes larger and uncomfortable.
The presence of a testicular lump can be daunting. It is important to remember that most testicular lumps are not serious. In some cases, no treatment is required for the lump; it is something that you just live with. In other cases, antibiotics or minor surgery may be required.
To help prevent testicular lumps caused by STIs, it is important to practice safe sex by wearing a condom with new sexual partners.
Testicular cancer cannot be prevented. Also, there are no routine screening tests for testicular cancer. Regular self-examination of the testes and getting acquainted with the way they normally feel may help you to detect any changes. However, self-examination has not conclusively been proven to detect cancers early or improve outcomes. If any abnormalities are detected, it is best to promptly see your doctor.
- Andrology Australia. Male Infertility. Text. Accessed July 25 2014. https://www.andrologyaustralia.org/reproductive-problems/male-infertility/.
- Epididymitis. Better Health Channel. Accessed July 25 2014. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epididymitis.
- RACGP - The Male Reproductive System an Overview of Common Problems. Accessed July 25 2014. http://www.racgp.org.au/afp/2013/may/the-male-reproductive-system/.
- Testicle Injuries and Conditions. Better Health Channel. Accessed July 25 2014. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Testicle_injuries_and_conditions.
- Testicular Cancer. Better Health Channel. Accessed July 25 2014. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Testicular_cancer.
- Testicular Self Examination. Better Health Channel. Accessed July 25 2014. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Testicular_self_examination
FAQ Frequently asked questions
What is a testicular lump?
Lumps are common findings in the testicle or scrotal area that can be caused by swelling, fluid build-up, cysts, infection or inflammation. Most of the time, these lumps are not testicular cancer.
What are the symptoms of a testicular lump?
Depending on the cause of the lump, signs and symptoms can include: A new lump or abnormality forming; a dull ache or sudden pain; swelling of one or both testicles; swelling of the scrotum (the sac that houses the testicles); warmth, redness or …
What causes a testicular lump?
Testicular lumps can be caused by a number of conditions related to the testicles and scrotum. These can include epidiymo-orchitis, torsion, hydrocele, varicocele, epididymal cysts, and testicular cancer.
Who gets testicular lumps?
Testicular lumps can affect all males. There is an increased risk for people born with undescended testes, who have had an accident involving the testicles, or have had a sexually-transmitted infection (STI).
How is a testicular lump diagnosed?
Your doctor can diagnose a testicular lump with a physical examination. Additional tests including a blood cell count, urine analysis, STI tests and ultrasound can also be used to help determine the cause of the lump.
How is a testicular lump treated?
Depending on the cause of the testicular lump, different treatments are required. In most cases of hydroceles, varicoceles and epididymal cysts, no treatment is required. Minor surgery may be performed if the swelling becomes uncomfortable or painful. …
Can a testicular lump be cured?
In some cases a testicular lump can be removed. In other cases, no treatment is required and it is something that you can simply live with.
Will a testicular lump clear on its own?
If you have found a lump in your testicle, it is best to have it checked by your doctor, who will be able to identify the cause and what treatment, if any, is required.
Is it safe to have sex with a testicular lump?
It is best to consult your doctor to identify the cause of the lump. If the cause is STI-related, there is a risk of passing on an infection to your sexual partner.