Scrotal Lumps and Swelling

Scrotal lumps and swelling 

There are many causes of lumps or pain in the scrotum. Most lumps are not cancer, and many are not serious. However, you should always see a doctor if you have pain or a lump in this area. 

Severe pain that develops quickly - within a few hours, often much more quickly can be due to twisting (torsion) of the testicle (testis). This is an emergency. If the blood supply to your testis is cut off for more than about six hours then permanent damage is likely to occur. A small emergency operation is usually done and the affected testis and spermatic cord are untwisted.

Self-Examination of the Testis

The best time to feel your testes is after a bath or shower when you are relaxed. Hold each testicle (testis) in turn in the palm of a hand and use your finger and thumb gently to feel the testes and nearby structures. 

It is normal for one testis to be slightly bigger than the other and for one to hang slightly lower than the other. The testes themselves feel like smooth, soft balls inside the baggy scrotum. At the top and to the back of each testis is the epididymis (this stores the sperm). This feels like a soft swelling attached to the testis; it can be quite tender if you press it firmly. Leading from the epididymis is the vas deferens. You can feel each vas deferens at each side at the back and top of the scrotum. They feel like soft, narrow tubes which pass up and into the groin. (The vas deferens carries the sperm to the penis.) Some people confuse the normal epididymis or vas deferens with an abnormal lump. 

What changes should I look out for?

If you notice any change in size or weight of a testicle (testis), or any abnormal lumps, swellings, or tender spots, see your doctor. Doctors are used to examining testicles (testes) and will be able to advise if the abnormality is serious or not. 

Note: most abnormalities are not cancer. For example: collections of fluid, infections, and harmless cysts are common and treatable. Testicular cancer usually starts as a small, hard, painless lump on one testis, which you can feel away from the normal soft lump of the epididymis. 

What if it is cancer?

Treatment of cancer of the testicle (testis) is often effective. In more than 9 in 10 cases, treatment can result in a complete cure. However, the earlier it is detected, the easier it is to treat. More than a third of people with this cancer consult their doctor after the cancer has spread, which makes treatment more difficult. Often this is because of unfounded fears, or just hoping it will go away. 

More information

Getting to know your testicles

Testicular Examination

About testicular cancer