A testicular lump is an abnormal mass in the testicles. The testicles are—the egg-shaped male reproductive glands. They hang below the penis in a sac called the scrotum. Their primary function is to produce sperm and testosterone.
A testicular mass, or lump, may be located in one or both testicles, and is a fairly common condition. Lumps can occur in both men and teenage boys. Testicular lumps are signs of problems with the 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. Nevertheless, a medical professional should examine any changes in the testicles, especially lumps or swelling. Men over the age of 14 should do monthly testicle self-examination to help spot any lumps early so that they can be properly examined and treated.
Most testicle lumps occur because of an injury. However, birth defects and other factors can also cause lumps in the testicles.
This type of lump is the most common, occurring in about one in every seven men. Enlarged veins in the testicles cause varicocele lumps. They become more noticeable after puberty when blood flow increases in the fully developed testicles.
A hydrocele testicular lump is caused by the buildup of fluid in the testicles. This type of testicular lump occurs in one to two out of every 100 newborn males.
An epididymal cyst or spermatocele occurs when the long, coiled tube behind the testicles (epididymis) becomes filled with fluid and cannot drain. If it contains sperm, it is known as a spermatocele. This form of testicular lump affects up to one in three men, and most often resolves on its own.
Testicular torsion occurs when the testicles become twisted, typically due to an injury or accident. This condition most often occurs in boys between the ages of 13 and 17, but can affect men of all ages. This is a medical emergency and requires urgent investigation and possible treatment.
Some lumps indicate the growth of testicular cancer. Only a doctor will be able to determine if a lump is cancerous. Testicular cancer is the most common type of cancer for American men between the ages of 15 and 34, according to the Mayo Clinic (Mayo Clinic, 2011).
Symptoms of a testicular lump vary depending on the underlying cause. However, nearly all lumps cause noticeable swelling and changes in the texture of the testicles.
- A varicocele rarely causes symptoms. If it does, the affected testicle may feel heavier than the other, or the lump may feel like a small sac of worms.
- A hydrocele is painless in infants, but older boys or men may feel abdominal pressure. It causes visible swelling of the testicles.
- Epididymal cysts are also generally painless; one testicle can feel heavier than normal in some men.
Because it is typically caused by a scrotal injury, testicular torsion can be extremely painful. It is a medical emergency that causes the following symptoms:
- abdominal pain
- frequent urination
- swelling of the scrotum
- a testicle that’s higher than normal or oddly angled
A lump caused by testicular cancer can produce the following symptoms:
- dull ache in the abdomen or groin
- swelling or tenderness in the breasts
- heaviness in the scrotum
- sudden collection of fluid in the scrotum
Only 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 are experiencing the above symptoms. If you’re experiencing symptoms of testicular torsion after an injury, get to an emergency room immediately. If left untreated, testicular torsion can cause testicle death and infertility.
Prior to your appointment, write down any symptoms you are experiencing and how long you’ve felt them. Tell your doctor if you’ve had any injuries recently. Also, be prepared to talk about your sexual activity.
Your doctor will put on gloves and physically examine the 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:
- ultrasound: an imaging technique that uses sound waves to create an image of the testicles, scrotum, and abdomen
- blood test: a small amount of blood can be tested for the presence of tumor cells, infections, and more
- biopsy: involves removing a small tissue sample from the testicle with specialized equipment; the sample is then sent to a laboratory for testing
Pain from a varicocele usually subsides without treatment. However, your doctor may prescribe pain medication or advise that you use over-the-counter pain relievers. In cases of recurring episodes of discomfort, surgery may be required to eliminate the congestion in the veins. The surgery may involve either 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 two. The surgery involves making a small incision in the scrotum to drain excess fluid.
An epididymal cyst does not require treatment unless it causes pain or discomfort. Surgery may be required to remove the cyst. The procedure involves surgically removing the cyst and sealing the scrotum with dissolvable stitches that typically disappear within 10 days.
Testicular torsion requires immediate surgery to restore blood flow to the testicle, preventing tissue death.
Testicular cancer is treated in the same way as other types of cancer: through surgery, chemotherapy, radiation, and other methods. Treatment method depends on how early the cancer is detected. Surgical removal of the testicle may be an option to prevent the cancer from spreading to other parts of the body.