If you feel a lump or bump on a testicle, you’re probably scared, and rightfully so. Something that doesn’t belong, especially on a testicle, is unsettling. The good news is that these usually are not dangerous. That’s not always the case though, so you need to take any changes in your testicles seriously.
So what causes lumps, bumps or firmness down there?
Okay, first let’s talk about the scary “worst case” possibility.
Hard lumps, bumps, or changes, as well as increased size of one testicle can be a sign of a testicular cancer. Typically, pain is not a symptom. Testicular cancer is still pretty rare, with only 8,500 men diagnosed a year. Young males, from age 15 to 35, are the most commonly diagnosed, but guys at any age are at risk. If someone in your family had testicular cancer or if you had an undescended testicle (on either side), your risks are higher. Testicular cancer, even when spread, is still one of the most treatable cancers, and many men live out a normal life (think of Lance Armstrong who had widely spread testicular cancer many years ago). Many men are cured simply by having the testicle removed, but some men need additional surgery or cancer treatments depending on the type and size of the cancer. Of course no one wants to lose a testicle, but it is important to keep in mind that you don’t need both of them – you can produce sperm and testosterone with only one.
Testicular cancer is not something you can self-diagnose. If you notice a lump or abnormality, you need to see a doctor, preferably a urologist. A simple exam alone can often miss something serious, so make sure your doctor gives you a testicular ultrasound, where sound waves are reflected through and show if there is anything abnormal or dangerous.
Of course, there are other, more common – and non-dangerous – causes of testicular lumps and bumps. Here are a few:
- Cysts: These are small little bubbles of clear fluid that can be found in the wall of the testicle or adjacent tissues. They can be single or multiple, are usually painless, and feel like a small lump. If they become large or painful then your urologist can remove these with a simple outpatient procedure.
- Calcifications: These are small structures in the testicle or along the main sperm pipeline (vas) can become hard, almost rock like. These are always painless and rarely need to be removed.
- Collection of fluid (hydrocele): Clear fluid can collect around the testicle after injury, surgery, or most commonly, for no reason at all, making the testicle seem much larger. If these become very large, they can become tender or painful which can be treated with outpatient surgery to drain the fluid.
- Inflammation: Any injury or infection of the testicle or surrounding tissues can be felt as a hard area. Sometimes tender, these areas can remain for months and should be seen by your doctor to be sure there is nothing else going on. If it is just from an old problem, the area usually goes away with time.
- Varicocele: This is an enlargement of the collection of veins inside your scrotum. This can be tender, especially with standing or straining. If it causes pain, then it can be surgically fixed by tying off the tiny veins in the groin under a surgical microscope, also as outpatient surgery.
- Hernia: This is a small loop of intestine that pushes through a hole in the groin muscles and squeezes into the scrotum. This feels like a soft, sometimes tender mass. It often feels better when you get off your feet. If it is tender, these may need to be fixed by a general surgeon to prevent future problems – if the intestine were to get stuck, it could cause significant pain and fever.
Just as women do monthly self-exams on their breasts, it is smart for guys to check their testicles in the shower once a month. If you find a new or changing lump, firmness, or mass in a testicle, you need to see a doctor and be sure to ask for a testicular ultrasound. This is not the time to assume it is nothing or hope it will go away. This can’t wait – you need to go ahead and take action. Early detection dramatically increases your chances for a normal life. And if it turns out to be nothing, then you don’t have to worry.