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24 Jan 2003

Testicular lump
I detected a firm (not hard) pea-sized lump inside the sack on top of my left testical. It has not appeared to grow in size but has recently begun to hurt (a dull, aching pain). This testical also feels "heavier" then the right. I went to my family doctor and she said that it was probably spermatoceles, since the lump was on the top of the testical and not directly inside of it. Nevertheless, she suggested an appointment with a urologist, but could not get me in for a few months. Now, what I would like to know is how much should I worry? It does not sound like variocele or hydrocele, and I don't know my family history (other than many have had cancer just not testicular cancer). I am 23, in good health, and have been losing wieght recently, although I can't understand why because of late I have not been very active or eating very well. Please give me any advice or information you may have. Thank you.

Answer 381 views

01 Jan 0001

Testicular lumps at your age need thorough investigation. Location of a lump does help in differentiating the nature of the swelling, but is a scientific guess at its best. The most important feature differentiating these swellings is wether they are fluid filled or solid. Fluid filled cystic swellings can either be a spermatocele, hydrorocele,
varicocele, or hernia. All of these can be better characterised on physical exam. Solid swellings on the other hand can be some kind of growth arising from testicle, epididimis or surrounding structures.

You need a detailed physical examination and possible scrotal ultrasound for the differential diagnosis. You definitely need to be seen by an urologist or an oncologist who can perform a physical examination and arrange for possible ultrasound and other blood tests for a definitive diagnosis.

Good luck
Dr Elna McIntosh
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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