Finding a small ball or lump in a testicle can be a concerning discovery. While many causes are benign, some require prompt medical attention. Understanding potential reasons and knowing when to seek professional medical advice is important.
Common Reasons for Lumps
Several conditions can lead to the formation of a lump in a testicle, ranging from minor issues to more serious health concerns.
Epididymitis involves inflammation of the epididymis, a coiled tube at the back of the testicle that stores and transports sperm. This condition typically results from a bacterial or viral infection. A lump caused by epididymitis may feel swollen, tender, and warm, often accompanied by pain in the testicle or scrotum.
A spermatocele, also known as a spermatic cyst, is a fluid-filled sac that develops near the top of a testicle. These cysts are usually benign and often painless, feeling like a smooth, distinct lump that may contain fluid or sperm. Larger spermatoceles might cause a feeling of heaviness or fullness behind and above the testicle.
Hydroceles involve a buildup of fluid around a testicle, leading to scrotal swelling. This swelling often feels like a water balloon and is typically painless, though it can cause discomfort or a feeling of heaviness as it increases in size. Hydroceles are common in infants but can occur in adults due to injury, infection, or inflammation.
Varicoceles are enlarged veins within the scrotum. These can feel like a “bag of worms” above the testicle, and while often asymptomatic, they might cause a dull ache or a feeling of heaviness, particularly after standing. Varicoceles typically develop gradually and are more common on the left side.
An inguinal hernia occurs when abdominal tissue pushes through a weak spot in the abdominal wall into the groin or scrotum. This can manifest as a bulge that may increase with straining, and might cause pain, pressure, or a burning sensation. The lump might disappear when lying down or when gently pushed back.
Testicular torsion is a medical emergency where a testicle twists on its spermatic cord, cutting off its blood supply. This causes sudden, severe pain in the scrotum, often accompanied by swelling, abdominal pain, and nausea or vomiting. The affected testicle may also appear higher than normal or at an unusual angle.
Testicular cancer is a less common but serious cause of a testicular lump, often presenting as a painless lump or swelling in one testicle. The lump can vary in size, and the testicle may feel firm or heavy. Other symptoms might include a dull ache in the groin or lower abdomen.
When to Seek Medical Care
Immediate medical attention is necessary if you experience sudden, severe pain in the scrotum, especially if accompanied by swelling, nausea, or vomiting. These symptoms could indicate testicular torsion, which requires emergency surgery to prevent permanent damage. A testicle positioned higher than normal or at an unusual angle also suggests urgent care.
Any new lump or swelling, even if painless, warrants a doctor’s visit. Changes in the size, shape, or consistency of a testicle should also be evaluated. Persistent discomfort or pain in the testicle or scrotum, or any fluid buildup, indicates a need for professional assessment.
What Happens During a Medical Exam
When you consult a healthcare provider about a testicular lump, they will typically follow a structured approach to understand the issue and arrive at a diagnosis. The process begins with a detailed discussion about your medical history and the symptoms you are experiencing. The doctor will inquire about when you first noticed the lump, its characteristics, and any associated pain or discomfort.
Following the discussion, a physical examination will be performed. The doctor will carefully examine your scrotum, testicles, and surrounding areas, checking for the presence, size, and texture of any lumps or swelling. During this examination, the doctor might shine a light through the scrotum to observe if the mass is fluid-filled, as light can pass through fluid but not solid masses.
To further investigate the cause of the lump, additional diagnostic tests may be ordered. An ultrasound is a common imaging test that uses sound waves to create detailed images of the testicles and scrotum, helping to differentiate between fluid-filled cysts and solid masses. In some cases, blood tests may be conducted, particularly if there is a suspicion of infection or certain types of cancer, as some testicular cancers can elevate specific tumor markers in the blood.
Approaches to Treatment
Treatment for a testicular lump depends entirely on the underlying diagnosis. A healthcare provider will discuss the appropriate course of action once the cause of the lump has been identified.
For some benign conditions, such as small, asymptomatic spermatoceles or hydroceles, observation may be the primary approach. These conditions often do not require active intervention unless they cause significant discomfort or grow considerably. Over-the-counter pain medications might be suggested for mild discomfort.
Infections like epididymitis are typically managed with medication, primarily antibiotics, to clear the infection and reduce inflammation. Surgical intervention may be necessary for conditions that cause pain, grow large, or pose a risk to testicular health. This includes surgical removal for symptomatic spermatoceles, repair for hydroceles that do not resolve, or correction for varicoceles.
Surgical procedures are also performed for inguinal hernias to push the bulging tissue back into place and strengthen the abdominal wall. Testicular torsion requires emergency surgery to untwist the spermatic cord and restore blood flow to the testicle. For testicular cancer, treatment usually involves surgery to remove the affected testicle, and depending on the stage and type of cancer, chemotherapy or radiation therapy may also be used.