Testicular lumps: what you need to know

Lumps in the testicles are not usually anything serious, however, you should always get them checked by a GP. As testicular lumps can be a sign of testicular cancer, getting them checked will rule this out or allow for early diagnosis, which can lead to better treatment outcomes. 

What are testicular lumps?

Testicular lumps are fairly common and can affect men, teenagers and even young boys. They have a range of different causes and can occur in one or both testicles, which is why it’s important to regularly check your testicles. 

A lump may be nothing serious, however, it can also be a sign that there is a problem with your testicles or be a symptom of an underlying illness. You may also develop a lump if you have sustained an injury. 

The majority of lumps are not caused by anything serious; most are caused by non-cancerous (benign) conditions. These often don’t need treatment, however, it’s still best to have your GP examine any changes in your testicles. 

What are the symptoms of testicular lumps?

There are several symptoms associated with testicular lumps, as well as other symptoms that may accompany them if the lump is caused by a specific illness. Typically, testicular lump symptoms can include:

• A change in the shape of your testicles
• A change in the way your testicles feel
• A lump in one or both testicles
• Aching or discomfort in your testicles that doesn’t go away
• One testicle becoming bigger than the other
• Swollen testicles

If you have an infection, you may also experience fever, nausea and vomiting alongside pain, swelling or tenderness in one or both of your testicles. This may need to be treated with antibiotics. 

Symptoms of testicular torsion

Injuries to your scrotum and groin can cause changes in your testicles. One of the most severe scrotal injuries is testicular torsion. This can also occur spontaneously and is incredibly painful. It’s a medical emergency and should be treated as soon as possible. Symptoms of testicular torsion include:

• Abdominal pain
• Fever
• Frequent urination
• Nausea and vomiting
• Swelling of the scrotum
• Unusual positioning of the testicle eg at a strange angle

Symptoms of testicular cancer

Although not always the case, testicular lumps can be caused by testicular cancer. These types of lumps can cause a range of symptoms including:

• Aching in your abdomen or groin
• Heaviness in your scrotum
• Pain
• Swelling or tenderness in your breast area
• The sudden collection of fluid in your scrotum

While these are common symptoms of testicular cancer, they are not always present. Even if you have none of these symptoms but have noticed a lump or change in your testicles, you should get checked by your GP as soon as possible. 

What causes testicular lumps?

There are several causes of testicular lumps. Some need treatment and others don’t. Causes include:

Cysts

Cysts can develop almost anywhere on the body, including the testicles. They are usually harmless but can be uncomfortable. Cysts are fluid-filled sacks that can feel like a small, hard lump when touched.

Epididymitis or orchitis

The epididymis is a tube behind each testicle that carries sperm. Epididymitis is a condition that causes this tube to become swollen and painful. It’s often the result of a bacterial infection or a sexually transmitted infection (STI), such as chlamydia.

Bacteria can also cause orchitis. This is an inflammation of the testicle and can cause swelling and pain.

Hernia

An inguinal hernia is one of the most common types of hernia. It occurs when part of your bowel pokes through a weakness in your abdominal muscle wall and into your groin. This can cause your scrotum to feel swollen or enlarged.

Hydrocele

Hydrocele is caused by the build-up of fluid in your testicles. In men and older boys, this often happens after an injury or infection but is usually painless. It can also occur in newborn males and is more common if the baby is premature.

Testicular cancer

Swelling or lumps in your testicles can be one of the first signs of testicular cancer. Typically, these lumps are not painful but are often hard and can cause your entire testicle to feel firmer than usual.

Testicular torsion

Testicular torsion is caused when the cord connected to your testicles twists and cuts off its blood supply. This results in extreme pain and testicular swelling. It can also cause vomiting.

Testicular torsion is a serious medical emergency and needs immediate treatment.

Varicocele

The most common type of testicular lump, a varicocele, is a lumpy area caused by swollen veins in your testicles.

When should you see a doctor about testicular lumps?

Even though most testicular lumps are nothing serious, their cause can’t be diagnosed at home. As such, it’s important that you have any lumps, swelling or changes in your testicles looked at by your GP.

Your GP will examine the lump and see if further testing is needed to reach a diagnosis. They may also be able to prescribe you a course of treatment or refer you for further tests or to a specialist, if needed.

How are testicular lumps diagnosed?

To start with, your GP will look at and feel your testicles to assess the lump. They may also shine a light through the skin of your scrotum to check for signs of fluid build-up.

While the cause of many testicular lumps can be diagnosed during this examination, further tests may be needed. These tests can include:

• Biopsy — a small sample of tissue is collected from your testicle for examination in a lab
• Blood tests to check for infections, tumour cells or other issues
• STI tests to check for STIs such as chlamydia and gonorrhoea 
• Ultrasound scan to get an image of the inside of your testicles, scrotum and abdomen

What is the treatment for testicular lumps?

The treatment, if needed, will depend on the cause of your lumps.

Cysts

Often, cysts don’t need treatment. However, if they’re painful, they may need to be removed. This is done during a minor surgical procedure.

Epididymitis or orchitis

As epididymitis and orchitis are caused by bacterial infections, they can be treated with antibiotics. It’s important to remember that if they’re caused by an STI, your sexual partners will need to be informed as they may also need treatment.

Hernia

Hernias are usually treated with surgery. You may be referred to a hernia specialist who will decide on the right course of treatment.

Hydrocele

In the case of a hydrocele lump, surgery may be required to drain the excess fluid. However, this condition can also clear up on its own.

Testicular cancer

The specific course of treatment for testicular cancer will depend on how early it’s caught. It’s often treated by a combination of surgery, chemotherapy, radiotherapy and other methods. 

Testicular torsion

Immediate surgery is required to treat testicular torsion. The surgery will untwist the testicle and restore blood flow. This surgery is needed as quickly as possible as your testicle can die if blood flow isn’t restored within six hours, which can mean your testicle needs to be removed.

Varicocele

Varicoceles usually don’t require treatment. However, if they cause pain and discomfort, your GP may suggest taking painkillers. If you experience recurrent varicoceles and these cause discomfort, you may need surgery.