Testicle Lumps

Reviewed by Frank Cockerill, MD, July 21, 2017

Testicular lumps are abnormal masses found on the testicles. The presence of a lump on the testicle can be quite worrisome, but there are plenty of benign (harmless) causes. If a testicular lump is accompanied by symptoms such as pain, swelling, and redness, it could be due to an infection. Torsion or twisting of the testicle can result in swelling and elevation of the testicle and is usually accompanied by acute severe pain; importantly, this condition requires emergent evaluation by a physician. If the lump is the only symptom that is present, the cause is typically due to inflammation, injury, or the development of a mass instead of an infection.

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Hernias can cause a testicular lump

Inguinal hernias can cause a testicular lump or bulge, or a sensation of a fullness in the testicle. Inguinal hernias occur when part of the intestine becomes displaced, slipping through the inguinal canal into the testis. This creates a noticeable bulge in the testicular sac, swelling, and sometimes pain as the intestinal loop is confined in the scrotum.

Other causes of testicular lumps

Testicular lumps can also be caused by inflammation, swelling, or masses, such as a hydrocele, spermatocele, varicocele, or (rarely) testicular cancer. A hydrocele is a collection of fluid around the testicle that occurs due to inflammation or injury. Hydroceles are typically painless, and generally resolve on their own over several days/weeks without intervention.

A spermatocele is a benign cyst that forms in the epididymis and is composed of fluid and sperm cells. Spermatoceles may remain stable in size, or can become larger over time. If a spermatocele becomes bothersome or causes pain, treatment is available.

Varicoceles are abnormal enlargements (dilations) of the veins within the scrotum. They are similar to varicose veins that occur in the legs, and often form during puberty. They can become larger and more noticeable with time. Varicoceles are fairly common, affecting 10–15% of boys; a fraction of those can develop slower testicular growth during puberty.

Epididymitis, or inflammation in the epididymis, a coiled tube that stores and carries sperm to the urethra from the testicle, can cause swelling near the back of the testicle. Causes for epididymitis include bacteria infection and STDs, especially gonorrhea and chlamydia infections.

Testicular cancer

The most worrisome cause of a testicular lump, testicular cancer, often occurs in young men between the age of 15-45, and is the most common cancer in found in young men. Testicular cancer is typically painless, and since it's not as noticeable, can go unnoticed for weeks or months. However, with timely diagnosis, testicular cancer is highly treatable and typically curable.

Because of the similarity in presentation in many of these conditions, and the potential for serious consequences in the case of testicular cancer, it's important not to ignore symptoms such as a testicular lump. If you have a testicular lump, it is important that you go to a doctor for a physical exam and evaluation.

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