Lump on Testicle: 7 Causes and When to See a Doctor

What Does a Lump on the Testicle Feel Like?

A lump on testicle may be small, like a pea, or larger. It can feel soft, firm, smooth, or irregular. Some lumps are fixed in place, while others move when touched. 

They may be painless or cause discomfort, heaviness, or swelling. Lumps can be located directly on the testicle or in the surrounding scrotal tissue.

7 Common Causes of Lumps on the Testicle

Lumps on the testicle can have many causes, from harmless cysts to serious conditions like cancer.

1. Epididymal Cyst or Spermatocele

These are small, fluid-filled sacs near the testicle, often developing slowly. They usually feel smooth and movable, sitting above or behind the testicle. Most are painless and harmless. 

They form when fluid builds up in the tubes that carry and store sperm. The exact cause isn’t always clear, but small injuries, past infections, or natural changes with age may play a role.

2. Hydrocele

This occurs when fluid collects around the testicle, causing swelling. The scrotum may feel heavy, but pain is uncommon. Hydroceles can develop after injury, inflammation, or without a clear reason.

3. Varicocele

A varicocele is an enlargement of the veins in the scrotum. It often feels like a "bag of worms" and is more common on the left side. It may cause a dull ache, especially after standing for a long time.

4. Hernia

An inguinal hernia happens when a part of the intestine pushes into the scrotum through a weak spot in the abdominal wall. It can cause swelling that becomes more noticeable when standing or straining. Hernias may cause discomfort or pain and require surgical repair.

5. Testicular Cancer

A firm, painless lump inside the testicle that does not move is a possible sign of cancer. Some men also feel heaviness in the scrotum or notice swelling. While the exact cause is unknown, early detection is key to successful treatment.

6. Epididymitis or Orchitis (Infection)

These infections cause painful swelling of the testicle or epididymis (a coiled tube at the back of the testicle that stores and carries sperm). The skin may be red and warm, and fever can develop. They may be linked to urinary tract infections (UTI) or sexually transmitted infections (STI).

7. Trauma

Trauma to the testicle or scrotum occurs when there is a direct injury from sports, accidents, or physical impact. It can lead to swelling, bruising, or a firm lump if blood collects inside the scrotum (hematoma). Pain is usually present, and in severe cases, urgent medical attention is needed to prevent long-term damage.

Can a Lump on a Testicle Turn into Cancer

Every lump in the testicle should be suspected as cancer until proven otherwise. While anyone can develop testicular cancer, certain factors raise the risk. Risk factors for testicular cancer do not cause a benign lump to convert into cancer. They only increase the chance that a lump is cancerous from the beginning.

Here are some of them:

• Undescended testicle (cryptorchidism)
• Family history of testicular cancer
• Previous cancer in one testicle
• Age between 15 and 35
• Caucasian ethnicity
• Possible increased risk with HIV infection

How to Perform a Testicular Self-Exam

Checking your testicles once a month can help you notice changes early:

1. Stand in a warm shower to relax the scrotum
2. Gently roll each testicle between your fingers and thumb.
3. Feel for lumps, swelling, or changes in size.

Remember: one testicle may hang lower, this is normal. But if you feel anything unusual, see a doctor promptly.

When to See a Doctor

Seek medical help if you notice:

• A lump that is hard, fixed, or growing
• Pain, redness, or warmth in the scrotum
• Swelling that does not go away
• Fever or nausea along with testicular swelling
• Any lump in a man aged 15–35

How Is a Lump on the Testicle Diagnosed?

When you come to the doctor, they start with a discussion about your symptoms and medical history. They will examine the scrotum carefully, feeling both testicles for changes. 

In most cases, an ultrasound scan is ordered to check the size, shape, and nature of the lump. If cancer is suspected, blood tests for tumor markers like AFP may be recommended.

Treatment Options for Testicle Lumps

The right treatment depends on the cause:

• Infections are treated with targeted therapy.
• Harmless cysts or hydroceles may be monitored or removed if large.
• Hernias require surgical repair.
• Cancer treatment is handled by a specialist team and may involve surgery.