What Causes Painless vs. Painful Testicular Lumps?

Understand your testicular lump symptoms, including 8 causes & treatment options for your testicular lump.

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Contents

  1. Symptoms
  2. Causes
  3. 8 Possible Testicular Lump Conditions
  4. Treatments and Relief
  5. Questions Your Doctor May Ask
  6. Statistics
  7. Related Articles
  8. References

Testicular Lump Symptoms

A testicular lump is an abnormal mass that forms in the testicles. The testicles (also known as testes) are the round, egg-shaped male reproductive organs that hang behind the penis. The testicles are encased by a sac of skin called the scrotum, and the main function of this system is the production of sperm and testosterone, a hormone important for male sexual and reproductive development.

See this image for a visual representation of the testicle and scrotum, and its spatial relationship to the penis here.

Common accompanying symptoms of a testicular lump

Testicular lumps can often be painless and without symptoms [1]. However, in addition to the palpable mass, you may experience:

Lumps of the testes are always abnormal and should always be followed-up by a doctor. Even if you do not experience any testicular lump symptoms, it is still important to make an appointment with your doctor because sometimes testicular lumps can signal serious, underlying medical problems.

Testicular Lump Causes

The causes of testicular lumps can range from benign to malignant conditions, thus medical follow-up is always necessary in order to find the exact cause. The scrotum not only contains the testicles but also the various arteries, vessels and nerves that supply the testicles. The scrotum is also attached to the abdomen by a structure called the inguinal canal. The inguinal canal contains the spermatic cord, a structure that contains a bundle of nerves, ducts, and blood vessels. Complications in any of these components can cause testicular lumps.

Inflammatory causes

Testicular lumps may arise due to inflammation from the following.

  • Infection: Bacteria can easily infect the testicles (orchitis) and other structures encased in the scrotum [2]. Infections often cause pain and generalized swelling. The swelling can often manifest as a testicular lump. This lump can be tender but not hard to the touch.
  • Fluid build-up: When blood, sperm fluid or generalized fluid accumulates in the scrotum, the scrotum enlarges and swelling results [1,3]. A lump filled with blood is a hematocele; a lump filled with sperm fluid is a spermatocele; and a lump filled with generalized fluid is a hydrocele. These types of lumps are often painless and can make the affected scrotum feel heavier than the other. Veins to the scrotum can also become enlarged, especially after puberty when blood flow to the testicles increases. This type of lump (varicocele) often has a "bag of worms" appearance see this photo for a visual representation.

Structural causes

Structural causes of testicular lumps include the following.

  • Torsion: Torsion occurs when the testicle rotates around the spermatic cord. This condition can result in a lump because the twisting can block blood flow to the scrotum [4]. This blockage will result in buildup and swelling that can appear as a testicular lump. Torsion is extremely painful and extremely dangerous. If you experience sudden, severe pain in the testicle area, call 911 and go to the emergency room immediately.
  • Hernia: Hernias occur when fatty or intestinal tissues protrude through a weakness in the abdominal wall close to or through the inguinal canal. Hernias that protrude through the inguinal canal are called inguinal hernias. Because the inguinal canal is in direct communication with the scrotum, these hernias can appear as protruding bulges in that area. This bulge will feel hard and solid. Sometimes the bulge can increase in size when a person stands up or coughs. At other times, this lump can be pushed back up into the abdomen.

Systemic causes

Lumps in the testicle can signal malignant and non-malignant types of cancer. These lumps often feel hard, solid and fixed in place. Testicular cancers are rare but easily treatable [5]. A physician can diagnose if your lump is cancer; thus, it is very important to make an appointment with your doctor as soon as you notice any testicular lump symptoms.

8 Possible Testicular Lump Conditions

The list below shows results from the use of our quiz by Buoy users who experienced testicular lump. This list does not constitute medical advice and may not accurately represent what you have.

Testicular cancer

The testicles, or the male sex glands, are two egg-shaped glands located in a sac of skin (scrotum) beneath the penis. Most testicular cancers originate in the germ cells of the testicles, which produce immature sperm that then matures in order to fertilize a female egg and start a pre...

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Testicular torsion

In torsion, the testicle is inadequately attached to the scrotum, allowing it to rotate freely within. This can lead to twisting of the testicle about the blood vessels to which it is connected, cutting off blood flow and leading to severe pain and the eventual death of the testicl...

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Genital warts

Genital warts are one of the most common sexually transmitted infections. It is caused by infection by Human Papilloma Virus (HPV). While it cannot be cured, treatment may help.

Rarity: Uncommon

Top Symptoms: small groin lump, skin-colored groin bump, marble sized groin lump, painless groin lump, scaly groin bump

Symptoms that always occur with genital warts: scaly groin bump

Urgency: Primary care doctor

Intermittent testicular torsion

Intermittent testicular torsion is also called ITT or chronic testicular torsion. Torsion refers to an abnormal twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.

In intermittent cases, the testicle becomes untwisted on its own and the symptoms spontaneously resolve. The condition nearly always returns, however, and may continue to come and go.

The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.

Symptoms include sudden, severe groin and testicular pain with nausea and vomiting, followed by spontaneous relief of symptoms even without treatment.

Eventually, testicular torsion can result in loss of circulation followed by tissue death and loss of the testicle. Any type of testicular torsion is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and sometimes ultrasound.

Treatment involves emergency surgery to untwist the spermatic cord and anchor the testicle in its proper place within the scrotum.

Rarity: Rare

Top Symptoms: nausea, testicle pain that comes and goes, vomiting, pain in one testicle, testicular swelling

Symptoms that always occur with intermittent testicular torsion: testicle pain that comes and goes

Urgency: Primary care doctor

Testicular Lump Symptom Checker

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Non-hodgkin lymphoma

Lymphoma is a type of cancer that results from the malignant proliferation of white blood cells. White blood cells are a part of our bodies’ immune system and are important for fighting infection. Lymphomas are sub-classified as Hodgkin or non-Hodgkin lymphomas. These subtypes...

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Non-serious testicle injury

Being struck in the testicles is very common, and despite the intense pain that follows, rarely requires professional medical care.

Rarity: Rare

Top Symptoms: testicle pain from an injury, testicle injury

Symptoms that always occur with non-serious testicle injury: testicle injury

Urgency: Self-treatment

Orchitis

Orchitis occurs when one or both testicles are inflamed. This is often caused by sexually transmitted infections like gonorrhea or chlamydia. More rarely, orchitis is caused by a virus.

Rarity: Rare

Top Symptoms: spontaneous testicle pain, fever, tender testicular swelling, muscle aches, new headache

Urgency: Primary care doctor

Groin hernia

A groin hernia, also called an inguinal hernia, means that a structure in the lower abdomen – a loop of intestine or a section of fat – has pushed through the muscles of the abdominal wall. This creates a bulge, or hernia, that can be seen and felt in the groin.

A hernia is caused by a weak spot in the abdominal wall muscles, which can separate under heavy lifting or repeated straining. The weakness may be inherited or may be from previous surgery, injury, or pregnancy.

Symptoms include a bulge low down in the abdomen, most visible when the person stands; and pain in the bulge with any strain on the abdominal muscles, such as lifting a heavy object or bending over.

A hernia will not heal on its own. There is the risk of serious complications if the blood supply to the herniated organ becomes reduced or cut off.

Diagnosis is made through physical examination and x-ray or CT scan.

A small hernia may need no treatment. A larger one can be repaired with surgery.

Rarity: Uncommon

Top Symptoms: pain in the lower right abdomen, pain in the lower left abdomen, groin pain, testicle pain, groin lump

Urgency: Primary care doctor

Testicular Lump Treatments and Relief

When to see a doctor for testicular lumps

You should visit your doctor for any testicular lump in order to receive a proper diagnosis. He or she may recommend the following.

  • Pain medication: Pain and lumps caused by swelling often go hand-in-hand. Your doctor may prescribe over-the-counter pain medications to combat these testicular lump symptoms.
  • Antibiotics: If your symptoms are due to infectious causes. Your doctor will prescribe antibiotics to fight the infection and provide you with relief.
  • Surgery: Testicular torsion requires immediate surgery in order to untwist the spermatic cord and restore blood flow to the testes. Hernias and cancers are also treated using surgery.

Questions Your Doctor May Ask About Testicular Lump

To diagnose this condition, your doctor would likely ask the following questions:

  • Does the bump feel like an area of thickened skin?
  • Do you notice anything going on with your testicles or scrotum?
  • Please say more about the bump on your testicle. Do you feel pain when you touch the bump?
  • Lie down on your right side and have someone press deeply under your left rib cage (on the border between the back and stomach). Do you feel a large lump right below your lowest left rib that isn't normally there?

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your testicular lump. These questions are also covered.

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Testicular Lump Symptom Checker Statistics

People who have experienced testicular lump have also experienced:

  • 14% Testicle Pain
  • 14% Pain In One Testicle
  • 4% Scrotal Itch

People who have experienced testicular lump were most often matched with:

  • 46% Testicular Torsion
  • 30% Testicular Cancer
  • 23% Genital Warts

People who have experienced testicular lump had symptoms persist for:

  • 36% Less than a day
  • 30% Over a month
  • 21% Less than a week

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Testicular Lump Symptom Checker

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References

  1. Crawford P, Crop JA. Evaluation of Scrotal Masses. American Family Physician. 2014;89(9):723-727. AAFP Link
  2. Sobol J. Orchitis. U.S. National Library of Medicine: MedlinePlus. Updated December 3, 2018. MedlinePlus Link
  3. Patil V, Shetty SMC, Das S. Common and Uncommon Presentation of Fluid Within the Scrotal Spaces. Ultrasound International Open. 2015;1(2):E34-E40. NCBI Link
  4. Pentyala S, Lee J, Yalamanchili P, Vitkun S, Khan SA. Testicular Torsion: A Review. Journal of Lower Genital Tract Disease. 2001;5(1):38-47. NCBI Link
  5. Understanding Testicular Cancer. Testicular Cancer Society. Testicular Cancer Society Link