Most lumps in the testicles are harmless, but some can be a sign of a more serious medical condition, such as testicular cancer.

The majority of lumps found in the testicle are not caused by cancer. Testicle lumps are more commonly caused by fluid collecting, an infection, or swelling of skin or veins.

However, it is not possible to diagnose the cause of a lump at home. A person should always seek medical advice.

In this article, we look at the possible causes of a testicle lump, self-examination, and when to see a doctor. We also cover diagnosis and treatment.

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A physician should evaluate any testicular lump or swelling to check for a serious condition, such as cancer, and to advise about next steps. Illustration by Jason Hoffman.

Testicle lumps typically cause swelling or changes in the texture of the skin or veins of one or both testicles.

Depending on the specific cause, testicle lumps may also be accompanied by other symptoms. These may include:

  • pain or discomfort
  • firmness or heaviness in the scrotum
  • nausea
  • vomiting
  • difficulty urinating
  • abnormal discharge from the penis
  • darkening of the scrotum

In some cases, testicle lumps are not associated with any other symptoms and may be harmless.

However, it is still important to talk with a doctor to determine the cause and best course of treatment.

Lumps and swellings inside the testicles or on the skin around them can have a range of causes.

Cyst

A cyst is a fluid-filled sac that can feel like a small, hard lump when touched. Cysts can develop almost anywhere on the body and are usually harmless.

Generally, these cysts don’t cause any symptoms. However, they may cause feelings of heaviness or a dull ache in the scrotum.

There are no known risk factors for cysts, and they rarely require treatment. In cases where cysts cause symptoms, such as pain, surgery may be recommended. This could cause temporary swelling.

Varicocele

A varicocele is a lumpy area caused by swollen veins in the testicles. This is similar to a varicose vein forming in a person’s leg. It is not clear what causes a varicocele.

While most people with a varicocele don’t experience any symptoms, it can cause complications like infertility and slowed growth of the testicles during puberty.

It’s estimated that around 15 out of 100 men have varicoceles. Anyone can be affected, regardless of race, ethnicity, age, or place of birth.

Hydrocele

Fluid collecting around a testicle can cause a swelling known as a hydrocele.

This often happens after an infection or injury to this area of the body. Hydroceles are usually painless and don’t cause any symptoms apart from swelling, which can affect one or both testicles.

Though hydroceles can occur at any age, they are more common in newborns with a low birth weight or breech presentation.

Some possible complications of hydroceles include:

  • infection
  • atrophy of the testes
  • infertility
  • rupture
  • scrotal pyocele, or a pus-filled collection of fluid in the scrotal sac
  • hematocele, or a collection of blood in the scrotal sac

Testicular torsion

Testicular torsion is a serious medical condition that needs immediate treatment. This can happen when the cord connected to the testicles twists and cuts off the blood supply.

In addition to swelling of the testicles, people with testicular torsion may also experience symptoms that include:

Testicular torsion can affect anyone, but it is not common. In fact, it only occurs in about 1 in 4,000 males under the age of 25.

Risk factors can include:

  • trauma
  • having an undescended testicle
  • having a prior history of testicular torsion
  • having bell clapper deformity, which occurs when a person is born without any tissue holding the testes to the scrotum

Without treatment, testicular torsion can cause infection, infertility, and atrophy, causing the testicle to shrink in size. In some cases, the testicle can also become severely damaged and may need to be removed surgically.

Epididymitis

Epididymitis is a condition that can cause the epididymis to become painful and swollen. The epididymis is a tube that sits behind each testicle and carries the sperm.

The swelling can feel like a lump. People with epididymitis may also experience pain, tenderness, and warmth in the skin around the testicles.

Other possible symptoms of epididymitis can include:

  • difficulty urinating
  • white, green, or yellow discharge from the tip of the penis
  • sudden or gradual pain in one or both testicles

Epididymitis is associated with chlamydia, a sexually transmitted infection.

A person may also have a higher risk of developing epididymitis if they:

  • are uncircumcised
  • have sexual intercourse without using a condom or other barrier method
  • have an enlarged prostate or other structural abnormality within the urinary tract
  • have recently undergone a medical procedure that affects the prostate or urinary tract, such as catheter insertion
  • have a history of sexually transmitted infections or urinary tract infections

If left untreated, epididymitis may lead to infection, which can cause an epididymal or testicular abscess. It could also increase the risk of infertility or sepsis, which can be serious.

Testicular cancer

A lump or swelling can be one of the first symptoms of testicular cancer. Most tumors do not cause any pain.

The lump will usually form on the front or side of a testicle. It will often feel hard, and the entire testicle may feel firmer than usual. A lump can develop inside the testicle, or just under the skin. One testicle may become larger or swollen.

Other symptoms associated with testicular cancer may include:

  • increased firmness of the testicle
  • a heavy feeling in the scrotum
  • pain in the testicles or scrotum, which might come and go

Several factors can increase a person’s risk of developing testicular cancer. These may include:

  • Cryptorchidism: This condition occurs when one or both testicles fails to drop into the scrotum before birth. People with this condition are at a higher risk of developing testicular cancer than those with descended testicles.
  • Age: Though testicular cancer can affect people of all ages, about half of testicular cancers occur in those aged 20-34.
  • Race: White men are 4-5 times more likely to develop testicular cancer than Black or Asian-American men.
  • Family history: Those with a family member who has had testicular cancer may be at a higher risk. Additionally, about 3-4% of people who have cancer in one testicle will develop cancer in the other testicle at some point.

According to the American Cancer Society, testicular cancer is not common. Only around 1 in 250 men will get testicular cancer during their lifetime, and the risk of dying from it is about 1 in 5,000.

Potential complications of testicular cancer may include decreased fertility, difficulty ejaculating, and an increased risk of heart disease following treatment.

For more research-backed information and resources for men’s health, please visit our dedicated hub.

Understanding the body and being aware of any changes can be an essential part of managing health. Checking the testicles for any lumps or swelling and seeking medical advice if needed can make sure any issues are treated as quickly as possible.

It is best to do a self-exam when the body is warm, and a person is relaxed. This can make it easier to feel anything unusual.

Here is how to complete a testicular self-exam:

  1. stand in front of a mirror
  2. look at the testicles for any swelling of the skin
  3. place the first two fingers of each hand under the testicle, with the thumbs on top of the testicle
  4. move each testicle between the fingers and thumbs gently to check for lumps

Examining the testicles monthly from puberty can help to find any medical problems early.

Anyone who finds a lump in their testicles should see a doctor as soon as possible. It is difficult for a person to tell the cause of a lump without an examination by a doctor.

It can help if a person can think of any other symptoms they may have experienced. They may have had an infection, such as chlamydia, or an injury to the testicle. Sharing this information with a doctor can help them to make a diagnosis.

A doctor will need to examine the person’s testicles. They may also need to do tests to find the cause of the lump.

The doctor will look at and feel the testicles. They may also shine a light through the skin to check for any possible fluid buildup.

A doctor may request an imaging scan, such as an ultrasound, to check the lump. An ultrasound uses sound waves to make a picture of the inside of the body.

If a person is not feeling any pain or discomfort, they may not require treatment. Anyone with a testicle lump should regularly check it at home to make sure that it does not get any bigger or change shape.

Cysts will usually go away on their own. If the cyst is painful, applying a warm washcloth can help reduce swelling. If a cyst becomes infected, a person may need medication to treat the infection.

Doctors can remove a cyst under local anesthetic. However, doctors do not usually recommend this as cysts are unlikely to cause health problems. A cyst can also come back in the same place.

People with a varicocele or hydrocele who are not experiencing any symptoms are unlikely to need treatment. The fluid sac where a hydrocele has formed can be repaired, or sometimes, removed.

Someone with a varicocele might also consider surgery. The procedure involves stopping the blood flow to the swollen veins, which allows the veins to shrink.

Doctors usually treat epididymitis with antibiotics for the underlying infection. A person can take pain relieving medication or apply a cold pack wrapped in fabric to the testicles to help with pain and swelling.

A person will need treatment if a lump in the testicle is found to be cancerous. Treatment will be different depending on the stage of the cancer.

Doctors use radiation therapy and chemotherapy to kill cancer cells or stop them from growing. A person may need surgery to remove a lump from the testicle. Sometimes, more than one treatment might be necessary.

It may be necessary for a doctor to remove part or all of the testicle to diagnose cancer and prevent it from spreading. The testicle can often be replaced with an implant. This can affect fertility, so a person may be given the opportunity to save and store sperm before surgery.

There are several possible causes for a lump in the testicle, most of which are harmless. People who are not experiencing any pain or discomfort may not require any treatment.

Rarely, the lump may be a sign of testicular cancer. Doctors may need to treat this with a combination of radiation therapy, chemotherapy, and surgery.

Anyone who finds a lump in their testicles should always see a doctor. Regularly checking the testicles for lumps can help spot the early signs of testicular cancer.

A lump in the testicle can be a sign of several conditions, many of which are harmless and don’t require any treatment.

However, if a person notices a lump in one or both testicles, it’s important to talk to a doctor to determine the cause, as it could be an early sign of testicular cancer and several other serious conditions.

Regularly examining oneself for lumps and paying close attention to any changes in the size or shape of the testicles can also help identify issues early to prevent complications.