Finding a testicular lump can cause concern. While many are benign, some indicate serious conditions like testicular cancer. Prompt medical evaluation for any new or changing lump is important.
Common Benign Causes
Many testicular lumps are not cancerous and stem from common, non-threatening conditions.
One frequent cause is an epididymal cyst (spermatocele). These fluid-filled sacs develop in the epididymis, a coiled tube behind the testicle. They are harmless and often require no treatment unless they cause discomfort.
Epididymitis is inflammation of the epididymis, often from bacterial infections. Symptoms include pain, swelling, redness, and sometimes fever. Treatment involves antibiotics and anti-inflammatory medication.
A hydrocele is fluid accumulation around the testicle, causing scrotal swelling. It can be congenital or develop from injury, infection, or inflammation. Hydroceles are usually painless, though larger ones might cause a feeling of heaviness. Many resolve naturally; persistent ones may require treatment.
Varicoceles are enlarged veins within the scrotum, similar to varicose veins in the legs. They usually occur on the left side and are often described as feeling like a “bag of worms.” Varicoceles can lead to discomfort or affect fertility due to increased temperature around the testicle.
More Serious Considerations
While many testicular lumps are benign, testicular cancer is a less common but serious cause. It is most frequently diagnosed in young men between 15 and 35. Testicular cancer is highly treatable, especially when detected early.
A cancerous lump feels firm, hard, and often painless. It might be on the front or side of the testicle, and may or may not cause the entire testicle to enlarge. Painless lumps are not necessarily benign, as many cancerous ones are painless.
Risk factors include an undescended testicle at birth (where one or both testicles do not descend). Family history also increases risk. Previous testicular cancer in one testicle increases risk in the other.
Early detection significantly improves treatment outcomes. Any new or unusual finding warrants professional medical evaluation.
When to Seek Medical Attention
Always seek medical attention for any new testicular lump or change, regardless of pain or other symptoms. Urgent medical evaluation is needed for accompanying symptoms like sudden, severe testicular pain, which could indicate a medical emergency like testicular torsion. Also concerning are persistent pain or a dull ache in the groin or scrotum, unexplained swelling, or scrotal redness.
A feeling of heaviness in the scrotum, or any noticeable change in testicle size or shape, also warrants a doctor’s visit. Fevers or nausea alongside a testicular lump could indicate an infection or other serious condition.
Regular testicular self-examinations help individuals become familiar with their testicles’ normal feel, making changes easier to notice. This involves gently rolling each testicle between thumb and fingers to feel for lumps, swelling, or texture changes. While useful for awareness, self-exams are not a substitute for professional medical diagnosis.
Diagnosis and Treatment
A healthcare provider will perform a thorough physical examination for a testicular lump. This involves palpating the scrotum and surrounding areas to assess the lump’s size, location, and consistency. The abdomen may also be examined to check for any signs of spread if a serious condition is suspected.
Scrotal ultrasound is the primary diagnostic tool. This non-invasive imaging uses sound waves to create detailed images of the testicles and surrounding structures. An ultrasound can effectively differentiate between fluid-filled cysts, solid masses, and areas of inflammation.
If testicular cancer is suspected, blood tests may be ordered for specific tumor markers. These include alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH), which can be elevated. Urine tests might also check for infection.
Treatment varies by diagnosis. For harmless, small benign conditions like epididymal cysts or hydroceles, observation may be sufficient. If an infection like epididymitis is diagnosed, antibiotics are prescribed.
Larger benign conditions that cause discomfort or affect fertility, such as symptomatic hydroceles or varicoceles, may be treated surgically. If testicular cancer is confirmed, primary treatment involves surgical removal of the affected testicle (orchiectomy). Depending on the cancer’s stage, further treatments like chemotherapy or radiation therapy may be recommended.