A testicular lump is an abnormal mass that can form in your testicles. The testicles, or testes, are egg-shaped male reproductive organs that hang below the penis in a sac called the scrotum. Their primary function is to produce sperm and a hormone called testosterone.
A testicular mass, or lump, is a fairly common condition that can have many different causes. Testicular lumps can occur in men, teenage boys, or younger children. They may be located in one or both of your testicles. Testicular lumps are signs of problems with your testicles. They may be caused by an injury, but they can also indicate a serious underlying medical problem.
Not all lumps indicate the presence of testicular cancer. Most lumps are caused by benign, or noncancerous, conditions. These usually require no treatment. Still, your doctor should examine any changes in your testicles, especially lumps or swelling. There are no studies that show benefits or harm to clinical or personal testicular exams. Whether or not men should do monthly testicle self-examinations is a controversial issue. However, if you happen to notice anything unusual, make an appointment with your doctor for a testicular exam. They can treat you early for potential problems.
Nearly all testicular lumps cause noticeable swelling and changes in the texture of your testicle. Other symptoms vary, depending on the underlying cause of your testicular lump:
- A varicocele rarely causes symptoms. If it does cause symptoms, the affected testicle may feel heavier than the other testicle or the lump may feel like a small sac of worms.
- A hydrocele is painless in infants, but it can cause a feeling of abdominal pressure in older boys and men. It also causes visible swelling of the testicles.
- Epididymal cysts are also generally painless. In some men, one testicle may feel heavier than normal.
- An infection may cause pain, swelling, or tenderness in one or both of your testicles. It can also cause fever, nausea, and vomiting.
Though it can occur spontaneously, testicular torsion is a condition that’s typically caused by a scrotal injury. It’s a medical emergency. It can be extremely painful and may involve the following symptoms:
- a fever
- frequent urination
- abdominal pain
- swelling of your scrotum
- unusual positioning of a testicle, which may be higher than normal or oddly angled
A lump caused by testicular cancer can produce the following symptoms:
- a dull ache in your abdomen or groin
- swelling or tenderness in your breasts
- heaviness in your scrotum
- a sudden collection of fluid in your scrotum
Types and causes
There are multiple possible causes of testicular lumps, including injury, birth defects, infection and other factors.
This type of testicular lump is the most common type. It occurs in about one in every seven men, according to Weill Cornell Medical College. Enlarged veins in your testicles cause varicocele lumps. They become more noticeable after puberty, which is when blood flow increases in your fully developed testicles.
A buildup of fluid in your testicles causes a hydrocele. The Mayo Clinic estimates that this type of testicular lump occurs in one to two out of every 100 newborn males. Premature babies have a higher risk of developing a hydrocele.
An epididymal cyst occurs when the long, coiled tube behind your testicles called the epididymis becomes filled with fluid and can’t drain. If it contains sperm, it’s known as a spermatocele. This form of testicular lump is very common. It most often resolves on its own.
Testicular torsion occurs when your testicles become twisted, typically due to an injury or accident. This condition most often occurs in boys between the ages of 13 and 17 years old, but it can affect men of all ages. This is a medical emergency that requires urgent investigation and possible treatment.
Epididymitis and orchitis
Your epididymis is the structure above your testicle that stores sperm. Epididymitis is an inflammation of your epididymis. A bacterial infection often causes it. This includes some sexually transmitted infections (STIs), such as gonorrhea or chlamydia.
An infection also causes orchitis, which is an inflammation of your testicle. Bacteria or the mumps virus can cause the infection.
A hernia occurs when part of your bowel pokes through your groin. This can cause your scrotum to become enlarged.
Some lumps indicate the growth of testicular cancer. Only a doctor can determine if a lump is cancerous. Testicular cancer isn’t common overall, but it’s the most common type of cancer among American men between the ages of 15 and 34.
Your doctor can properly diagnose the cause of a testicular lump. Make an appointment with your doctor if you notice a lump during a self-exam or you’re experiencing the symptoms described above. If you’re experiencing symptoms of testicular torsion after an injury, go to an emergency room immediately. If it’s left untreated, testicular torsion can cause testicle death and infertility.
Before your appointment, write down any symptoms you’re experiencing and how long you’ve felt them. Tell your doctor if you’ve had any injuries recently. You should also be prepared to talk about your sexual activity.
Your doctor will put on gloves and physically examine your testicles to note their size and positioning and to check for swelling and tenderness. Most testicular lumps can be diagnosed during a physical examination. However, your doctor may order other tests to confirm the diagnosis.
These tests may include:
- an ultrasound, which uses sound waves to create an image of your testicles, scrotum, and abdomen
- a blood test in which a sample of your blood is tested for the presence of tumor cells, infections, or other signs of problems
- an STI screening in which a sample of fluid is collected from your penis with a swab and analyzed in a laboratory for gonorrhea and chlamydia
- a biopsy, in which a small tissue sample is removed from your testicle with specialized equipment and sent to a laboratory for testing
Your treatment plan will vary, depending on the cause of your testicular lump.
Pain from a varicocele usually subsides without treatment. However, your doctor may prescribe pain medication or advise you to use over-the-counter pain relievers. In cases of recurring episodes of discomfort, you may need surgery to reduce the congestion in your veins. The surgery may involve tying off the affected veins or diverting blood flow to those veins through other methods. This causes blood to bypass those veins, which eliminates the swelling.
Treatment for a hydrocele lump may also involve surgery, but it most often clears up on its own by age 2. The surgery involves making a small incision in the scrotum to drain excess fluid.
An epididymal cyst doesn’t require treatment unless it causes pain or discomfort. You may need surgery. During this procedure, your surgeon will remove the cyst and seal your scrotum with stitches that usually dissolve within 10 days.
Testicular torsion requires immediate surgery to untwist your testicle and restore blood flow. Your testicle can die if you don’t get treatment for the torsion within six hours, warns the American Cancer Society. If your testicle dies, your doctor will have to remove it surgically.
Epididymitis and orchitis
Your doctor can treat infections in your epididymis or testicles with antibiotics if bacteria are the cause. In the case of an STI, your partner may also need to be treated.
A hernia is often treated with surgery. Your doctor may refer you to a hernia specialist for treatment.
Testicular cancer is treated using surgery, chemotherapy, radiation, and other methods. Your specific course of treatment will depend on how early your cancer is detected and other factors. Surgical removal of your testicle may help stop the cancer from spreading to other parts of your body.
Your outlook will depend on the underlying cause of your testicular lump.
Most cases of testicular lumps aren’t serious or cancerous. Testicular cancer is rare. It’s also highly treatable, and it’s curable if you find it early.
Since it’s difficult to figure out the cause of a testicular lump based on your symptoms alone, it’s important to visit a doctor if you notice any changes. Make an appointment with your doctor if you notice any lumps, swelling, or pain in your testicles. Regular testicular self-exams can help you find these changes early.