Testicular Mass

The testicles are part of the male reproductive system that produce sperm and testosterone. A mass or swelling may develop in one or both testicles due to injury, birth defect, fluid collection, infection or testicular cancer.

A testicular mass may indicate one of the following problems:

• Varicocele: Enlarged vein in the testicle
• Hydrocele: Fluid collection in the testicle
• Testicular torsion: Twisting of the cords that suspend the testicles, which may cut off blood supply to the testis
• Epididymal condition: Swelling in the epididymis (coiled tube behind the testicle) either by a sexually transmitted disease, infection, or entrapment of fluid (cyst) or sperm (spermatocele)
• Inguinal hernia: A bulge that forms when a part of your intestine protrudes into your scrotum through a weak spot in the abdominal wall
• Testicular cancer: Usually a painless persistent lump that can be cancerous

The symptoms of a testicular mass depend on the underlying condition. Testicular torsions are usually painful, with fever, nausea, vomiting and frequent urination, while the other conditions may either be painless or associated with dull pain in the abdomen or groin. Often, the affected testicle feels heavier than the other. Testicular cancer can be associated with other symptoms such as tenderness or swelling in the breasts and sudden build-up of fluid in the scrotum.

When you present with a testicular mass, your doctor will review your history and examine your testicles. An ultrasound, blood tests, biopsy (sample of tissue is examined under the microscope) or transillumination (bright light is shone on the scrotum to illuminate the mass) may be ordered to confirm the diagnosis.

Hydroceles, varicoceles or epididymal cysts usually resolve on their own. Pain medication may be prescribed to keep you comfortable. If persistent, surgery may be required to drain fluid, tie off the vein or direct blood flow away from the affected vein, or remove the cyst. A testicular torsion requires emergency surgery to restore blood supply and prevent tissue death. Treatment of a hernia involves surgery to push the intestine back into the abdominal cavity and repair the weakened area.