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Testicle Lumps - What You Need to Know

Testicle Lumps – What You Need to Know

July 19, 2021 (updated July 20, 2021) Published by

A testicle lump, or testicular lump, is an abnormal mass that can form in the testicles.

The testicles, or testes, are egg-shaped male reproductive organs that hang below the penis in a sac called the scrotum. Their primary function is to produce sperm and a hormone called testosterone.

A testicular lump is a fairly common condition that can have many different causes. Testicular lumps can occur in men, teenage boys, or younger children. They may be located in one or both of the testicles.

Testicular lumps can be a sign of problems with your 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. Most lumps are caused by benign, or noncancerous, conditions. These usually require no treatment.

Still, your doctor should examine any changes in your testicles, especially lumps or swelling.

Symptoms of a testicular lump

Nearly all testicular lumps cause noticeable swelling and changes in the texture of your testicle. Other symptoms vary, depending on the underlying cause of your testicular lump:

  • A varicocele rarely causes symptoms. If it does cause symptoms, the affected testicle may feel heavier than the other testicle, or the lump may feel like a small sac of worms.
  • A hydrocele is painless in infants, but it can cause a feeling of abdominal pressure in older boys and men. It also causes visible swelling of the testicles.
  • Epididymal cysts are also generally painless. In some men, one testicle may feel heavier than normal.
  • An infection may cause pain, swelling, or tenderness in one or both of your testicles. It can also cause fever, nausea, and vomiting.

Though it can occur spontaneously, testicular torsion is a condition that’s typically caused by a scrotal injury. It’s a medical emergency. It can be extremely painful and may involve the following symptoms:

  • a fever
  • frequent urination
  • abdominal pain
  • nausea
  • vomiting
  • swelling of your scrotum
  • unusual positioning of a testicle, which may be higher than normal or oddly angled

A lump caused by testicular cancer can produce the following symptoms:

  • a dull ache in your abdomen or groin
  • swelling or tenderness in your breasts
  • heaviness in your scrotum
  • a sudden collection of fluid in your scrotum
  • pain

Types and causes of testicular lumps

There are multiple possible causes of testicular lumps, including injury, birth defects, infection and other factors.

Varicocele

This type of testicular lump is the most common. It occurs in about 15 to 20 percent of men. Enlarged veins in the testicles cause varicoceles. They become more noticeable after puberty, which is when blood flow increases in fully developed testicles.

Hydrocele

A buildup of fluid in the testicles causes a hydrocele. This type of testicular lump occurs in at least 5 percent of newborn males. Premature babies have a higher risk of developing a hydrocele.

Epididymal cyst

An epididymal cyst occurs when the long, coiled tube behind the testicles called the epididymis becomes filled with fluid and can’t drain.

If the cyst contains sperm, it’s known as a spermatocele. This form of testicular lump is very common. It most often resolves on its own.

Epididymitis and orchitis

Epididymitis is an inflammation of the epididymis. A bacterial infection often causes it. This includes some sexually transmitted infections (STIs), such as gonorrhea or chlamydia.

An infection also causes orchitis, which is an inflammation of the testicle. Bacteria or the mumps virus can cause the infection.

Testicular torsion

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 years old, but it can affect men of all ages.

This is a medical emergency that requires urgent investigation and possible treatment.

Hernia

One type of hernia occurs when part of your bowel pokes through your groin and into the scrotum. This can cause your scrotum to become enlarged.

Testicular cancer

Some lumps indicate the growth of testicular cancer. Only a doctor can determine if a lump is cancerous.

Testicular cancer isn’t common overall, but it’s the most common type of cancer among American men between the ages of 15 and 35.

Diagnosing testicular lumps

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 you’re experiencing the symptoms described above.

If you’re experiencing symptoms of testicular torsion after an injury, go to an emergency room immediately. If it’s left untreated, testicular torsion can cause testicle death and infertility.

Before your appointment, write down any symptoms you’re experiencing and how long you’ve felt them. Tell your doctor if you’ve had any injuries recently. You should also be prepared to talk about your sexual activity.

Your doctor will put on gloves and physically examine your 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:

  • an ultrasound, which uses sound waves to create an image of your testicles, scrotum, and abdomen
  • a blood test, which involves testing a sample of your blood for the presence of tumor cells, infections, or other signs of problems
  • an STI screening, in which a sample of fluid is collected from your penis with a swab or from urine to be analyzed in a laboratory for gonorrhea and chlamydia
  • a biopsy, which involves removing a small tissue sample from your testicle with specialized equipment and sending the sample to a laboratory for testing

Treatment for testicular lumps

Your treatment plan will vary, depending on the cause of your testicular lump.

Varicocele

Pain from a varicocele usually subsides without treatment. However, your doctor may prescribe pain medication or advise you to use over-the-counter pain relievers.

In cases of recurring episodes of discomfort, you may need surgery to reduce the congestion in your veins.

The surgery may involve 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.

Hydrocele

Treatment for a hydrocele lump may also involve surgery, but it most often clears up on its own by age 2. The surgery involves making a small incision in the scrotum to drain excess fluid.

Epididymal cyst

An epididymal cyst doesn’t require treatment unless it causes pain or discomfort. You may need surgery. During this procedure, your surgeon will remove the cyst and seal your scrotum with stitches that usually dissolve within 10 days.

Testicular torsion

Testicular torsion requires immediate surgery to untwist your testicle and restore blood flow. Your testicle can die if you don’t get treatment for the torsion within 6 hours.

If your testicle dies, your doctor will have to remove it surgically.

Epididymitis and orchitis

Your doctor can treat infections in your epididymis or testicles with antibiotics if bacteria are the cause. In the case of an STI, your partner may also need to be treated.

Hernia

A hernia is often treated with surgery. Your doctor may refer you to a hernia specialist for treatment.

Testicular cancer

Testicular cancer is treated using surgery, chemotherapy, radiation, and other methods. Your specific course of treatment will depend on how early your cancer is detected and other factors.

Surgical removal of your testicle may help stop the cancer from spreading to other parts of your body.

What is the outlook?

Your outlook will depend on the underlying cause of your testicular lump.

Most cases of testicular lumps aren’t serious or cancerous. Testicular cancer is rare. It’s also highly treatable, and it’s curable if you find it early.

Whether or not men should do monthly testicle self-exams is a controversial issue. There is no good evidence that a self-exam leads to a reduction of mortality from testicular cancer.

Since it’s difficult to figure out the cause of a testicular lump based on your symptoms alone, it’s important to visit a doctor if you notice any changes. Make an appointment with your doctor if you notice any lumps, swelling, or pain in your testicles.

References

Spermatocele Causes Symptoms and Treatments

Spermatocele – Causes, Symptoms & Treatment

July 18, 2021 (updated July 18, 2021) Published by

A spermatocele is an often pain-free benign cyst that occurs close to a testicle. It may also be known as a spermatic or epididymal cyst.

The cyst forms in the epididymis. The epididymis is a coiled tube behind each testicle. The cyst is filled with fluid and may contain dead sperm. Read on to learn more about identifying and treating this condition.

Symptoms

Spermatoceles cannot be seen during a visual exam. That’s because they’re contained within the scrotum. They can be felt, however. A spermatocele feels like a smooth, but separate, firm lump. The lump is found near the top of, or behind, a testicle.

Spermatoceles are most likely to be discovered during your yearly physical when your doctor checks for any signs of a testicular growth. Spermatoceles are benign and only appear in the scrotum. That means they’re not a sign of testicular cancer.

If the cyst grows too large, you may feel discomfort or pain in the testicle. You may also experience heaviness, as well as a feeling of fullness in the testicle.

A mass in your scrotum could signal another issue as well. Talk to your doctor about any unexplained lumps in your scrotum. That way they can rule out more serious causes and come up with a treatment plan.

Do spermatoceles cause infertility?

Doctors don’t consider spermatoceles a cause of infertility. It may reduce the quantity and quality of sperm produced if the spermatocele is large, however. If you’ve been trying to conceive for over a year and are concerned about your fertility, talk to your doctor. There are several possible causes for male infertility. The first step is having a semen analysis to determine the health of your semen.

Causes

Researchers don’t know what causes spermatoceles. Spermatoceles are neither cancerous nor do they increase your risk of testicular cancer.

Diagnosis

A spermatocele can be diagnosed through a detailed examination of the genital area. Your doctor will feel your testicles to search for masses, or areas that are tender or painful to the touch. You can expect to feel some pain when your doctor touches the affected areas.

Your doctor may also do the following tests:

  • Transillumination. By passing a light through the scrotum, your doctor can examine the entire area. Any spermatocele should be clearly seen.
  • Ultrasound. If transillumination isn’t successful, an ultrasound can be used by your doctor to look inside the scrotum to search for a cyst.

Treatment

Spermatoceles aren’t cancerous and are usually pain-free. Most people won’t need treatment. Instead, your doctor will monitor the cyst during regular doctor appointments.

Spermatoceles may require medical attention if they grow too large or begin to cause pain.

Medical therapy

Medical therapy is limited to oral medications to fight pain and reduce swelling. No drug has been developed to cure or prevent spermatoceles.

Minimally invasive therapies

There are two minimally invasive therapies available, but these are rarely used.

  • Aspiration. Your doctor will use a needle to puncture the spermatocele and then drain the fluid.
  • Sclerotherapy. Your doctor will inject an irritating agent into the cyst. This promotes healing and discourages the fluid from accumulating again.

These therapy options have been shown to work, but they aren’t usually recommended. That’s because there’s a risk that the epididymis may be harmed, leading to fertility problems. Another common problem is that the spermatoceles can come back.

Surgical therapy

Surgical therapy known as spermatocelectomy is the most common treatment for asymptomatic spermatocele. The aim is to remove the cyst from the epididymis while, at the same time, preserve the genital system. This surgery is done as an outpatient procedure. That means you won’t need to stay in a hospital overnight. It may be done with either local or general anesthesia, and it’s usually complete in under an hour.

Sometimes part or even all of the epididymis may need to be removed along with the cyst.

Outlook

Most people won’t experience any symptoms from a spermatocele. If you do experience pain or discomfort, spermatocelectomy should provide relief, though there is a risk for complications that may affect fertility. It’s also possible that your spermatocele might come back, even after surgery.

Discuss the risks and benefits of treatment options with your doctor, and let them know about any concerns you have, including the effective treatment will have on fertility.

References

Testicular Ultrasound - What You Need to Know

Testicular Ultrasound – What You Need to Know

July 18, 2021 (updated July 18, 2021) Published by

What is a testicular ultrasound?

A testicular ultrasound is a diagnostic test that obtains images of the testicles and the surrounding tissues in your scrotum. Ultrasound is also called sonography or ultrasound scanning. Your doctor may refer to a testicular ultrasound as a testicular sonogram or scrotal ultrasound.

The two testicles are the primary male reproductive organs. They produce sperm and the male sex hormone testosterone. Your testicles are in your scrotum, which is the fleshy pouch of tissue that hangs under your penis.

An ultrasound is a safe, painless, and noninvasive procedure. The procedure uses high-frequency sound waves to produce images of organs inside your body.

An ultrasound uses a probe or transducer. This handheld device converts energy from one form to another. It’s moved against the targeted part of your body in sweeping motions. The transducer emits sound waves as it moves across your body. The transducer then receives the sound waves as they bounce off your organs in a series of echoes. A computer processes the echoes into images on a video monitor. Normal and abnormal tissue transmit different types of echoes. A radiologist can interpret the echoes to distinguish between benign condition like a collection of fluid around your testicle and a solid mass that could be a malignant tumor.

Why do I need a testicular ultrasound?

A testicular ultrasound is the primary imaging method used to observe and diagnose abnormalities in the testicles. Your doctor may recommend a testicular ultrasound to:

  • verify whether a lump in your scrotum or testicles is solid, which indicates a tumor, or filled with fluid, which indicates a cyst
  • determine the outcome of trauma to your scrotum
  • evaluate for possible testicular torsion, which is a twisted testicle
  • identify sources of pain or swelling in your testicles
  • detect for and evaluate varicoceles, which are varicose spermatic veins
  • assess the causes of infertility
  • find the location of an undescended testicle

Ultrasound echoes can provide real-time still or moving images. Data from moving images is useful in examining blood flow to and from your testicles.

Each testicle connects to the rest of your body by a spermatic cord. This tube contains an artery and a vein. The tube also includes the vas deferens, which carry sperm from the testicles to the urethra. Your doctor can study blood flow in your testicles to find narrowing or blockages interfering with the flow of semen and hindering fertility.

What are the risks involved with a testicular ultrasound?

A testicular ultrasound won’t put you at risk for any health problems. There’s no radiation exposure during the procedure. However, you may have increased pain or discomfort during the procedure if you have certain testicular issues, such as testicular torsion or an infection.

How do I prepare for a testicular ultrasound?

Typically, there’s no special preparation necessary for a testicular ultrasound. There’s no need for dietary restrictions, fasting, or a full bladder before the exam.

Speak with your doctor about any prescription or over-the-counter medications you take. There rarely is a need to interrupt or discontinue medication before a testicular ultrasound.

How is a testicular ultrasound performed?

A testicular ultrasound is usually an outpatient procedure performed in the radiology department of a hospital or at your doctor’s office.

Typically, a testicular ultrasound takes about 20 to 30 minutes. It involves the following steps.

Preparation

You may need to change into a hospital gown. You won’t typically receive sedatives, anesthesia, or topical numbing agents.

Positioning

You’ll lie on your back with your legs spread. The ultrasound technician may place a towel underneath your scrotum to keep it elevated. They may place wide strips of tape across your thighs and under your scrotum to elevate your scrotum.

You’ll need to lie completely still during the procedure.

Imaging technique

The technician will apply a warm, water-based gel to your testicles. This gel will allow the transducer to glide over your body. It also facilitates the conduction of the sound waves.

The technician will glide the transducer around your scrotum, moving back and forth. You may feel pressure as the technician pushes it firmly against your body. You may feel discomfort if there’s pressure on an area where you have tenderness due to an abnormality.

The technician will position the transducer against your body from different angles.

After the procedure

The technician will wipe the gel off your body after the procedure.

After your testicular ultrasound, you can resume your normal activities and diet. No recovery time is necessary.

What do the results mean?

A radiologist will analyze the images obtained during your testicular ultrasound. They’ll then send a report detailing the results of the test to your doctor.

If there are abnormal findings on your testicular ultrasound, they may indicate:

  • an infection in your testicle
  • a benign cyst
  • a testicular torsion, which is a twisted spermatic cord restricting blood flow to your testicle
  • a testicular tumor
  • a hydrocele, which is a benign collection of fluid around your testicle
  • a spermatocele, which is a fluid-filled cyst on the ducts of your testicle
  • a varicocele, which is an enlarged vein in the spermatic cord of your testicle

Your doctor will probably recommend further investigation if the testicular ultrasound identifies a tumor.

References

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