This is an overview of 10 common testicular conditions. But, let’s start with a definition.
What are the Testes?
Testes (or testicles) are the primary male sex organs. They are two small, egg-shaped glands located outside the body in a pouch of skin called the scrotum.
Their two main jobs are to produce sperm (for reproduction) and to produce testosterone (the male sex hormone)
What it is: A medical emergency where the testicle rotates, twisting the spermatic cord that brings blood to the scrotum.
Common signs: Sudden, severe pain in one testicle, swelling, nausea, vomiting, and a testicle that sits higher than normal.
When to Worry:
Any sudden, severe testicular pain
Pain accompanied by nausea or vomiting
When to See a Doctor:
Immediately. Go to the nearest A&E (or Emergency Room, ER). Surgery is required within hours to save the testicle.
What it is: Inflammation of the epididymis (the coiled tube at the back of the testicle), usually caused by a bacterial infection or an STI.
Common signs: Gradual onset of pain, swelling, redness or warmth in the scrotum, pain during urination, or discharge.
When to Worry:
Persistent or worsening testicular pain over days
Swelling accompanied by fever or chills
When to See a Doctor:
Promptly. Antibiotics are typically needed to clear the infection and prevent complications.
What it is: An abnormal growth of cells within the testicular tissue, which is highly treatable when caught early.
Common signs: A painless (usually) lump or swelling in either testicle, a feeling of heaviness in the scrotum, or a dull ache in the lower abdomen.
When to Worry:
A new, hard, or fixed lump on the testicle
A noticeable change in the size or shape of one testicle
When to See a Doctor:
Soon. Any new lump should be evaluated by a healthcare professional as soon as possible.
What it is: A collection of fluid around the testicle, causing the scrotum to swell.
Common signs: Painless swelling of one or both testicles, often feeling like a small fluid-filled balloon.
When to worry:
New or sudden swelling in the scrotum
Swelling that causes discomfort or a heavy sensation
When to See a Doctor:
Soon. For an accurate diagnosis to rule out more serious causes of swelling.
What it is: An enlargement of the veins within the scrotum, similar to varicose veins in the legs.
Common signs: Often no symptoms, but can cause a dull, aching pain (especially after standing for long periods) or look/feel like a “bag of worms.”
When to Worry:
A dull ache that worsens throughout the day
Concerns about fertility, as varicoceles can affect sperm production
When to See a Doctor:
For routine evaluation or if the ache becomes bothersome.
What it is: A benign, fluid-filled sac in the epididymis that often contains sperm.
Common signs: A smooth, firm lump near the top or back of the testicle that is generally painless.
When to Worry:
A new lump discovered during a self-examination
The cyst grows large enough to cause discomfort or pressure
When to See a Doctor:
Routinely. To confirm the lump is benign and rule out other conditions.
What it is: Inflammation (or infection) of one or both testicles, frequently linked to the mumps virus or resulting from a progressing bacterial infection.
Common signs: Severe testicular pain, swelling, fever, fatigue, and tenderness.
When to Worry:
Severe pain and swelling that comes on alongside fever
Testicular pain following a viral illness like mumps
When to See a Doctor:
Promptly. For accurate diagnosis and symptom management.
What it is: A condition where part of the intestine pushes through a weak spot in the groin muscles, sometimes descending into the scrotum.
Common signs: A bulge in the groin or scrotum that becomes more noticeable when coughing, bending, or standing; a dull ache.
When to Worry:
A bulge that becomes suddenly painful, firm, or cannot be pushed back in
Signs of a trapped hernia, such as severe pain, nausea, or vomiting
When to See a Doctor:
Routinely for standard hernias; immediately if the hernia becomes trapped or intensely painful.
What it is: Direct physical impact to the groin area, common in sports, accidents, or falls.
Common signs: Immediate, sharp pain, bruising, swelling, or minor bleeding under the skin.
When to Worry:
Severe, unremitting pain that lasts longer than an hour
Nausea, vomiting, visible bruising, or blood in the urine after an injury
When to See a Doctor:
Urgently. If symptoms are severe or do not improve quickly, as internal tearing may require repair.
What it is: Chronic or intermittent testicular discomfort where no specific physical abnormality or infection can be found.
Common signs: A persistent, vague, or intermittent dull ache in one/both testicles or groin area.
When to Worry:
Pain that lasts for weeks or months and disrupts daily activities
When to See a Doctor:
Routinely. For a comprehensive evaluation and to explore long-term pain management options. Often no cause is found.
Note. If accompanied with low back pain, there may be a spinal cause (i.e. it is referred pain) – e.g. a spinal disc prolapse.
Regular testicular self-examination – is vital for noticing early changes.
Do not ignore rapid, severe testicular pain – is a surgical emergency that requires immediate attention.
Most testicular issues are benign and highly treatable – but early diagnosis is key.
Testicular symptoms are standard medical concerns – never let embarrassment delay a visit to the doctor.
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