Testicular lumps or swelling of the scrotum are very common and affect all ages. The first thing that always comes to mind is what if the lump is dreaded cancer. A testicular ultrasound scan, a quick ultrasonic examination procedure using sound waves, will be able to accurately tell you what the lump or swelling is. In our private ultrasound clinic in London, we offer same day affordable testicular scan appointments so you don't have to spend time waiting for your NHS appointments that can be as long as 6+ weeks.
The anatomy bit
The testicles are the primary male reproductive organs housed in the scrotal sac and produce the sperm and testosterone.
You also have, what is called the epididymitis in the scrotal sac. Epididymitis is full of interrelated tubules where the sperm matures.
What are the most common testicular lumps?
Epididymis – it is very common that we can feel the head of the epididymis which gives the impression of a lump. In most cases, we can feel the head of the epididymis on one side but not the other.
Epididymal cyst – very common and harmless. An epididymal cyst is a sack with fluid found mainly on the head of the epididymis. Epididymal cysts, in general, do not need any treatment but do have the potential of getting bigger.
Epididymitis – this is an infection of the epididymis and sometimes the testis (when both epididymitis and testis are infected is called epididymo-orchitis). The epididymis gets swollen and in most cases associated with pain. If you have epididymitis, antibiotic treatment will be necessary so the sooner this has been confirmed the sooner it can be treated.
Intratesticular cyst – this is again a little sac of fluid but this time inside the testis and not in the epididymis. These cysts are more commonly benign.
Varicocoeles – the blood vessels (pampiniform venous plexus) inside the scrotal sac get dilated to various degrees. Varicoceles are common and very similar to varicose veins on the legs. They do have the potential of affecting sperm quality as they increase the temperature inside the scrotal sac and also have the potential of causing some discomfort. They do feel like worms but it can be difficult to differentiate between varicoceles and lumps.
Hernia – There are different kinds of herniae but the most common is the inguinal hernia which happens in the groin region. Sometimes the hernia can slip through the inguinal canal into the scrotal sac and this can cause swelling.
Hydrocoele – this is extra fluid around the testicle. Sometimes floating debris can be seen within this fluid. This floating debris is related to protein or cholesterol content. Hydrocoeles are again benign but sometimes will need treatment when they are very large. Although the existence of hydrocoele is obvious in most cases, an ultrasound scan will be needed to exclude any other abnormalities such as cancer.
Cancer – testicular cancer is common and according to Cancer Research UK, the incidence of testicular cancer will rise to 10 cases per 100,00 males by 2035. Testicular cancer has various appearances on ultrasound but most commonly is a dark rounded, well-defined circle which is highly vascular. If the ultrasound scan is suspicious of testicular cancer an urgent referral to the urologist under two-week way will be required.
Scrotal lumps and swellings are very common and affect all ages of the male population. In most cases these lumps are benign and sometimes we just feel normal anatomy. A cancerous lump, however, needs to be excluded and a testicular ultrasound scan will be able to confirm what the lump is.
NHS waiting times, however, are long and getting longer (although the health Minister reassures us that NHS is working as clockwork). At SonoWorld London you are able to book a testicular ultrasound scan on a day and time that suits you for quick diagnosis and reassurance.