Although most testicular lumps are non-cancerous, with only around 4% of these lumps leading to a diagnosis of testicular cancer, it remains important to check for any unusual swellings in your testicles and to always get these reviewed by a doctor. This makes sure that you get the right diagnosis and if you need treatment, you can access this as soon as possible.
Causes of Testicular Lumps
Although there are a range of causes lumps in your testicles, the most common causes of testicular lumps are as follows:
- Varicoceles. These may arise due to a problem with the veins draining your testicles, either due to a blockage or an abnormality in the valves. As a result, blood doesn't circulate as effectively as usual, leading to an accumulation of blood, which causes your veins to swell. Varicoceles may become noticeable during puberty when blood flow to your testicles increases.
- Hydroceles. When your testicles first develop before you are born, they form inside your abdomen and make their way to your scrotum via a passage. Although most of the time this passage closes up before you are born, it sometimes remains open. If this occurs, fluid moves from your abdomen to your scrotum, causing swelling and you can feel this as testicular lumps. Usually this fluid is taken up by the surrounding tissues during the first couple of years of life, allowing the hydrocele to disappear. However, if you develop a hydrocele when you are older, this is most likely due to inflammation, caused by either an infection, injury or tumour.
- Epididymal cysts. Your sperm is stored and transported by your epididymis, which sits behind your testicles. Sometimes your epididymis can develop swelling, leading to what feels like a testicular lump, though the exact cause of this is unknown.
- Testicular torsion. This occurs most often in teens and men in their twenties. Your testicles are attached to the spermatic cord, but if your cord is particularly loose, your testicles may move too much, leading to your spermatic cord twisting. In severe cases, this twisting can affect the blood supply to your testicles. This is a medical emergency, as unless the blood supply is restored, your testicle could die.
- Testicular cancer it is extremely important to identify testicular cancer early. A testicular lump is the commonest early sign of cancer, and needs to be investigated promptly.
Signs of Testicular Lumps
The particular symptoms you get with testicular swellings vary depending on the cause. For the most common causes of testicular lumps, these are the signs to look out for:
- Lumps caused by a varicocele usually occur in the left of the scrotum and feel soft. Varicoceles vary in size and larger ones are usually visible on inspection. Although other symptoms usually aren't present, around 10% of men with these lumps may develop a heavy ache in their scrotum or groin.
- With hydroceles the only sign is usually a painless lump; sometimes this affects just one testicle, other times it affects both. However, when hydroceles occur in older boys and adults, discomfort in your scrotum is sometimes present.
- A small swelling that is filled with fluid and develops higher than and behind your testicles is usually an epididymal cyst. These cysts are usually painless, though an aching or heavy feeling in your testicles is not uncommon. However, sometimes pain may occur when a cyst presses against structures in your testicles or close by.
- With testicular torsion you are in severe pain and you may also have a swollen scrotum, nausea, vomiting, abdominal pain, a raised temperature and frequent urination. These symptoms should never be ignored and you should seek urgent medical help.
Diagnosing Testicular Lumps
Besides asking about your symptoms and performing a physical examination of your scrotum, you may need diagnostic tests to confirm the diagnosis for your testicular lumps. For instance, an ultrasound scan will help to diagnose varicoceles and hydroceles, as well as discounting testicular cancer. If your hydrocele may be related to an infection, a urine sample or swab sample can be tested for the presence of infective agents.
Treating Testicular Lumps
Although testicular torsion always requires surgery, you will not always need treatment for other causes of testicular lumps. However, if varicoceles, hydroceles or epididymal cysts are causing your discomfort, surgical options are available. If you are found to have testicular cancer, after surgical removal of the growth, you may need chemotherapy and radiotherapy. If you have testicular lumps and wish to receive an accurate diagnosis and effective treatment, make an appointment to see Mr Mark Feneley today.