Always visit your GP if you notice any lumps or swellings in your testicles. In very rare cases, a lump can be a sign of testicular cancer (less than 4 in 100 lumps).
Your GP will ask you whether you have:
- felt any pain – and if so, where it was, how severe it was and how long it lasted for
- any other symptoms, such as pain when you urinate (which is a sign of a urinary tract infection) or any discharge from your urethra (the tube that carries urine from the bladder to outside of the body)
- a history of trauma, such as a sports injury to your groin
Your GP will also physically examine your testicles to check:
- the size of your testicles
- the position of the lump or swelling
- whether the lump causes any pain when it is touched
- whether the lump is firm or soft
If your GP cannot confirm a diagnosis from the examination alone, you may need to have an ultrasound scan. This uses high-frequency sound waves to create an image of the inside of your body.
Varicoceles
A varicocele can usually be diagnosed by your GP asking about your symptoms and carrying out a physical examination. Further testing is not usually necessary.
Referral
In some cases, you may be referred to a urologist (a doctor who specialises in treating conditions that affect the urinary system). For example, if:
- a varicocele suddenly develops
- you have a single varicocele on the right side
- there is uncertainty about the cause of your lump
- you are in pain
- it is causing you embarrassment
In these circumstances, you may be referred for an ultrasound scan to confirm the diagnosis and check for any problems.
Hydroceles
As with varicoceles, a hydrocele can usually be diagnosed through a physical examination.
If a hydrocele develops in your child, your GP will feel your child's scrotum (the loose sac of skin that contains the testicles) to check that the swelling is caused by fluid and not something solid. The fluid is usually clear, so your GP may shine a torch through the scrotum. If a hydrocele is present, the outlines of the testicles should appear against the background of the fluid.
If you have a hydrocele, your GP will examine your scrotum as described above. If you are 20 to 40 years old, your GP may refer you for an ultrasound scan to rule out testicular cancer.
If your GP suspects that your hydrocele may be caused by an infection, they may ask for a urine sample and test it. Alternatively, your GP may use a swab (small piece of absorbent material, such as gauze, attached to the end of a stick) to collect a sample of cells and fluid from your urethra. This sample can then be tested to see if you have an infection.
Epididymal cysts
An epididymal cyst can usually be diagnosed through a physical examination. Further tests are not usually required.
Testicular torsion
Testicular torsion is usually diagnosed by the distinctive symptoms of severe testicular pain and swelling.
The diagnosis can be confirmed by using an ultrasound scan or a magnetic resonance imaging (MRI) scan. This uses a strong magnetic field and radio waves to produce detailed pictures of the inside of your body. However, these tests may delay the urgent surgical treatment and so are often not carried out.
