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Notice a lump in your testicle, and your first thought is bound to be testicular cancer. You may be surprised to hear that there are numerous causes of testicular lumps besides testicular cancer, and that most lumps will not turn out to be cancerous. It is important to note that painful testicular masses are highly unlikely to be caused by testicular cancer, while even lumps that are painless have other causes. Because so many SteadyHealth readers have questions about testicular lumps, we’re going to provide you with an overview of the possible causes, looking both at painful and painless lumps.

Varicocele

A varicocele is a swelling and widening in the veins that accompany the spermatic cord, caused by improper blood flow. Most likely to occur in younger men between the ages of 15 and 25, varicoceles will normally develop gradually. In older men who develop it suddenly, a kidney tumor may be the underlying cause.

Symptoms are enlarged, twisted veins in the scrotum along with a painless testicular lump or bulge. Though mostly harmless, a varicocele can be corrected through surgery or embolization to divert blood flow.

Spermatocele

A spermatocele is a cyst within the epididymis, a structure at the back of the testicle where sperm is stored and matures. Such cysts are common and do not usually affect fertility. Should they grow so big that they cause pain or discomfort, they can be removed surgically in a minor procedure.

Symptoms include a lump behind and above the testicle, a heavy-feeling testicle, and slight pain or discomfort.

Epididymitis

Epididymitis is an inflammation of the epididymis. Epididymitis is the single most common cause of sudden-onset scrotal pain, and typically occurs in men aged between 19 and 35. Causes include sexually transmitted diseases and bacteria such as E Coli.

Symptoms can include a lump near the back of the testicle, scrotal swelling, groin pain on the affected side, pain, especially after bowel movements, urination, or ejaculation, and a fever. Should you recognize these symptoms, you need to see your doctor for proper diagnosis and treatment, which will often include antibiotics and anti-inflammatory medication.

Orchitis

Orchitis is an inflammation in one or both testicles that is usually caused by infections. The mumps virus is a likely culprit in those men who have not been vaccinated for mumps, but orchitis can also be caused by other viral and bacterial infections including sexually transmitted diseases.

Symptoms include scrotal swelling, painful and swollen testicles, discomfort in the groin area, pain during urination and ejaculation, penile discharge, blood in the ejaculate, and fever. Treatments may include antibiotics and anti-inflammatory medications.

Injury Or Trauma

Injury or trauma, sustained during sport or vigorous sexual intercourse for example, can lead to lumps and bumps in the testicle as well. In this case, you will usually be aware that you injured yourself and the cause will be clear to you. That does not mean that you don’t need to see a doctor, however. Should your testicle be swollen and painful, you may have a hematocele, in which blood builds up in the scrotal sac.

Testicular Torsion

When the spermatic cord twists, you have testicular torsion on your hand. This condition halts blood supply to the testicles and surrounding tissues, leading to extreme pain within the testicle that begins suddenly. Along with pain, scrotal swelling, light-headedness and nausea may also occur, and a testicular lump may be felt. Testicular torsion is more likely to strike infants and adolescent boys, but can also happen in older men.

Should you notice these symptoms, a trip to the ER is warranted: extended loss of blood flow to the testicles may necessitate its removal. If surgery is performed within six hours of the twisting, testicles can usually be saved.

Inguinal Hernia

In inguinal hernia, a section of the small intestine pushes through a weak spot into an area where it should not be present. It can sometimes manifest itself as a mass in the scrotum that is accompanied by pain, or a feeling of heaviness in the scrotum. This will require surgical correction.

Hydrocele ​

A hydrocele is a fluid-filled sac around the testicle that causes the testicle to swell greatly. Usually occurring in newborn boys, it can also strike older men, typically as the result of some kind of injury or inflammation, due to excess fluid production, or as the result of an inguinal hernia. Hydroceles are not typically dangerous, and are usually treated only in cases of discomfort. Should you have a hernia, however, surgery is required.

Testicular Cancer

Testicular cancer symptoms, besides a noticeable lump in the testicle, can include fluid build-up and a feeling of heaviness in the scrotum, a dull pain in the abdominal area, back pain, and breast enlargement.

When Should You See A Doctor?

In short: all men should examine their own testicles for lumps on a regular basis, and any time a lump or mass is noticed, they should always see a doctor.

You may be relieved to know that testicular masses and lumps can be caused by a great many different conditions, and that most lumps will not turn out to be cancerous. However, you've also seen that many of the other causes of testicular lumps require medical treatment as well, sometimes very urgently. In almost all cases, you will benefit from early diagnosis and treatment. Should you have a condition that does not require any medical treatment, you will be relieved to know what your diagnosis is and you will be able to set aside your worries about testicular cancer or other serious conditions. 

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