Testicular lumps and scrotal swellings

Lumps and swellings in the testicles (balls) or scrotum (ballsack) aren't usually caused by anything serious, but you should get them checked by your GP.

When to see your GP

You should see your GP if you have:

  • a lump in or on your testicles
  • swollen testicles or scrotum
  • a change in the shape of your testicles
  • a change in the way your testicles feel
  • one testicle that's become bigger than the other
  • aching or discomfort in your testicles that doesn't go away

Lumps in the testicles can be a sign of testicular cancer. This is easier to treat if it's found early.

When to get urgent medical help

You should go to your nearest emergency department if you get sudden, unbearable pain in your testicles or tummy.

This could be caused by your testicle becoming twisted, which needs to be treated in hospital as soon as possible.

What happens at your GP appointment

To find out what the cause of your lump or swelling is, the GP may:

  • look at and feel your testicles
  • shine a torch through the bag of skin containing your testicles (scrotum) to check for a build-up of fluid
  • refer you for an ultrasound scan

Treatment for a lump or swelling depends on the cause. You might not need treatment if it doesn't cause any problems and isn't getting worse.

If it's painful or very big, your GP may refer you to a specialist for an operation to drain, shrink or remove it.

Causes of testicular lumps and scrotal swellings

Lumps and swellings in the testicles and scrotum can have lots of different causes. Most are caused by something harmless, such as a build-up of fluid (cyst) or swollen veins.  Sometimes they can be a sign of something serious, such as testicular cancer.

Don't try to self-diagnose the cause of your lump – always see a GP.

Causes of testicular lumps or scrotal swelling include:

  • testicular torsion (torsion of spermatic cord) - you should go to your nearest emergency department if you have this condition. It happens when the spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted. The twisting cuts off the testicle's blood supply and causes sudden pain and swelling
  • testicular cancer
  • inguinal hernia - is the most common type of hernia. It can appear as a swelling or lump in your groin, or as an enlarged scrotum (the pouch containing the testicles). The swelling may be painful. The lump often appears when you're lifting something and disappears when you lie down. You will need surgery to repair it
  • epididymitis - epididymitis is where a tube (the epididymis) at the back of the testicles becomes swollen and painful. It's often caused by an infection and is usually treated with antibiotics
  • orchitis - is an inflammation of the testicles. It can be caused by either bacteria or a virus. Both testicles may be affected by orchitis at the same time. However, the symptoms usually appear in just one testicle. This kind of testicular inflammation is often associated with the mumps virus. If your GP thinks it is being caused by a bacteria you will need an antibiotic to clear it up
  • epididymal cyst - is a fluid-filled sac that grows in the epididymis - a tube at the back of the testicles. It does not need treatment if it is small or causes no significant symptoms. If it needs treatment, usually surgery is needed to remove it, though this may affect fertility
  • varicocele - is a scrotal swelling caused by swollen veins (called the pampiniform plexus) in the spermatic cord (the cord attached to the testicle). Most of the time, varicoceles cause no problems and are harmless. Less often varicoceles can cause pain, problems with reduced fertility, or cause one testicle to grow slower or shrink. Surgery can be used to treat a varicocele if it is reducing fertility or causing problems with growth
  • hydrocele - occurs when fluid collects in the thin sheath surrounding a testicle. Hydrocele is common in newborns babies and usually disappears without treatment by age 1. Older boys and adult men can develop a hydrocele due to inflammation or injury within the scrotum. Treatment is with surgery

The information on this page has been adapted from original content from the NHS website.

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