Checking The Balls

By Glossy Magazine

Mr Karyee Chow, Consultant Urological Surgeon and Mr Aziz Gulamhusein, Consultant Urological and Robotic Surgeon.

Checking The Balls

Mr Karyee Chow, Consultant Urological Surgeon and Mr Aziz Gulamhusein, Consultant Urological and Robotic Surgeon.

I can feel a lump in my testicle, should I be worried?

Most lumps or swellings in the scrotum are not actually within the testicle. They either arise from structures close to the testicle or are just on the surface of the testicle. These are mostly benign and not cancerous. 

Healthy testicld
Testicular cancer

What could it be?

There are a variety of non-cancerous conditions that can cause a swelling. These include:

– Hydrocele: a collection of fluid in the sac around the testicle. This is often pain free but can grow and cause symptoms.

– Varicocele: a cluster of enlarged veins in the scrotum, which can feel like ‘a bag of worms’. It can be associated with a dull ache. 

– Epididymal cyst: fluid-filled swelling found in a structure called the epididymis, just next to the body of the testicle. The size can vary from a few mm to a few cm.

– Hernia: a swelling that comes from the groin. When it is large, it can go into the scrotum. It may come and go.

– Epididymitis: infection within the epididymis can cause a painful swelling. It can spread to the testicle and scrotum called epididymo-orchitis. 

– Testicular torsion: a sudden onset painful swelling caused by a twisted testicle. This will need immediate emergency surgery, otherwise the testicle may die due to the blood supply being cut off.

A lump may also, however, be a sign of testicular cancer. Testicular cancer is a rare but very treatable cancer typically found in younger men but not always. It commonly presents with a hard lump or increased firmness in the testicle. Pain is not typically a symptom, but it may be present in about one out of four men. You should always seek urgent advice from a medical professional, as you do not want to miss anything more serious. 

What will the doctor do?

The doctor will ask you some questions about the lump, such as how long it has been there, whether there has been a change in size and whether there is any pain or tenderness. They will ask you about your general health and any relevant information, such as a history of an undescended testicle, infections, surgery or trauma to the area. The doctor will want to examine the lump and testicle to determine what it is. Further tests may be required, such as urine and blood tests on the day, and an ultrasound may be arranged, usually for another day. 

Will I need surgery? 

Not everyone needs surgery, in fact, most do not. Small, benign lumps that are not causing any symptoms do not require surgery. If there is a strong suspicion of cancer, then surgery to remove the testicle and cancer is the usual treatment. For benign lesions, the reasons for surgery include symptoms such as pain, a large size causing inconvenience or for cosmetic reasons. Surgery or treatment may also be advised for large varicoceles when there is also infertility as there is an association between a significant varicocele and poor semen quality, which could improve with treatment.

How do I carry out testicular self-examination?

This is best done after a bath or shower, when you are relaxed. It should be done in the standing position. Always compare one side to the other. You should try and feel the weight of the testicle. You should feel all around the entire surface of the testicle with both hands. You should note the smoothness and consistency of the testicle. Attached to the back and extending from the top to the bottom of the testicle is a structure called the epididymis. It consists of tubes that may be slightly irregular in nature, but they are usually soft. Benign cysts are common in the epididymis, but sometimes it is difficult to distinguish between a lump arising from the epididymis and one arising from the testicle, so we would advise that this be determined by a professional. 

By carrying out regular examinations, you will get to know your own body, so when there is a change, it will be more noticeable and you will know when to seek medical attention appropriately. 

By Mr Karyee Chow and Mr Aziz Gulamhusein 

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