Testicular lumps and swellings

Lumps and swellings in the testicles (balls) are fairly common in boys, men and anyone who has testicles. So it helps to know what's normal for you, because then you can spot any change in your testicles.

Go to a hospital emergency department if you have sudden, severe pain in a testicle, or testicle pain along with feeling sick, being sick or pain in your tummy, or testicle pain that has lasted more than an hour or continues when you're resting.

These can be signs of a serious problem that needs to be treated in hospital as soon as possible. Find your nearest hospital emergency department.

Speak to your doctor if you have:

• a lump in your testicles
• swollen testicles
• a change in the shape of your testicles
• a change in the way your testicles feel
• 1 testicle that has become bigger than the other
• aching or discomfort in your testicles that does not go away

There isn't one single test for testicular lumps and swellings. Your doctor will talk with you about what's been happening and then examine you.

Your doctor may:

• look at and feel your testicles
• shine a torch through the bag of skin that holds your testicles (the scrotum) to check for a build-up of fluid
• refer you for an ultrasound scan
• take a urine (pee) sample if they suspect an infection is causing the lump or swelling

If the lump or swelling is painful or very big, your doctor may refer you to a specialist for an operation to drain, shrink or remove it.

Lumps and swellings in the testicles can have many different causes. The vast majority are caused by non-cancerous (benign) conditions, and most of these may not need treatment.

If you have a lump or swelling in a testicle, it may be caused by one of these:

• varicoceles, which are soft lumps that develop gradually above the testicle and on the left side of the scrotum
• hydroceles, which are swellings in the scrotum caused by a build-up of fluid
• epididymal cysts, which are small, smooth, fluid-filled swellings that slowly develop in the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm)
• epididymo-orchitis, which is inflammation in the epididymis and the testicle caused by bacterial infections such as urinary tract infections (UTIs), sexually transmitted infections (STIs) and mumps
• inguinal hernias, which happen when fatty tissue or part of the bowel pokes through into the groin at the top of the inner thigh
• testicular torsion, a benign but serious condition caused by the spermatic cord (the cord that supplies blood to the testicles) becoming severely twisted
• testicular cancer, which is a more serious health condition

How testicular lumps and swellings are treated depends on what's causing them.

You can take painkillers such as paracetamol to ease any discomfort or pain.

Some lumps and swellings may need surgery. Depending on the procedure, it's done under either local anaesthetic or general anaesthetic.

If the cause is a bacterial infection, the doctor may prescribe antibiotics.

If you're diagnosed with testicular cancer, a team of clinicians will look after you and help decide the best treatment for you. In most cases, they will recommend surgery to remove the affected testicle. Sometimes a course of chemotherapy or radiotherapy follows.