Testicles
Assessment and treatment of testicular conditions including testicular cancer, lumps, pain, hydrocele and varicocele.
Understanding the testicles
The testicles (testes) are two oval glands that sit within the scrotum. They produce sperm and the male hormone testosterone, making them central to both fertility and overall male health. They are also easy to examine, which means many testicular conditions can be picked up early.
Testicular problems can show up as a lump, swelling, a change in size or firmness, or pain. While some causes are completely harmless, others — including testicular cancer — are most successfully treated when found early. For that reason, any new lump, swelling or persistent discomfort is worth having checked promptly.
If you’ve found a lump
Most scrotal lumps turn out to be benign, but it is not possible to tell the cause from feel alone. A simple examination and a scrotal ultrasound can quickly clarify what’s going on, so it’s always best to have a new lump assessed rather than wait and worry.
Conditions we treat
Testicular cancer
Testicular cancer is uncommon overall but is one of the most common cancers in younger men. Importantly, it is also one of the most treatable, with excellent outcomes when caught early.
A painless lump or swelling in a testicle, a change in size or firmness, or a dull ache or heaviness in the scrotum.
A personal or family history, and a history of an undescended testicle, can increase risk.
Assessment includes examination, ultrasound and blood tests. Treatment usually begins with removal of the affected testicle (orchidectomy), often followed, depending on the type and stage, by surveillance, chemotherapy, radiotherapy or further surgery. Fertility preservation can be discussed beforehand.
Testicular pain (including epididymitis)
Pain in the testicle can have many causes, from infection and inflammation (epididymitis) to nerve-related and chronic pain.
Aching or sharp pain, sometimes with swelling, redness or urinary symptoms if infection is present.
Treatment is directed at the cause — for example antibiotics for infection, anti-inflammatory measures, and tailored management for chronic pain. Sudden, severe testicular pain is a medical emergency (it can indicate a twisted testicle, or torsion) and needs immediate assessment.
Hydrocele
A hydrocele is a collection of fluid around the testicle, causing painless scrotal swelling. It is benign.
Soft, painless swelling on one or both sides.
Many need no treatment. If a hydrocele is large or uncomfortable, it can be repaired surgically (hydrocelectomy).
Varicocele
A varicocele is an enlargement of the veins within the scrotum, a little like varicose veins.
A dragging ache, a “bag of worms” feel, and in some cases an effect on fertility.
Treatment is considered when there is pain or a fertility concern, and may involve a minor procedure to address the affected veins.
Epididymal cyst
A harmless fluid-filled cyst near the testicle.
Usually just reassurance; removal is only considered if it becomes bothersome.
A quick word on self-examination
Getting to know what’s normal for you makes it easier to notice changes. A gentle check of each testicle from time to time — feeling for any new lump, swelling or change in firmness — is a simple habit. If you notice something new, book a review.
This page provides general information only and is not a substitute for personalised medical advice. Please consult a urologist about your individual circumstances.