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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Lump under right testicle

 lazarex - Tue Feb 06, 2007 1:17 am

I'm 27 years old. One month ago, while playing basket I felt a sharp pain in my testicle, but didn't think about it because i though i just pulled a muscle. Then, while I was performing self exam i found a lump under my testicle, but it is not connected to the testicle itself. It feels like a tube and it gets hard when i'm standing and soft when i'm laying down. I feel discomfort (emotional and physical) because it's something down there. This got me worried, so I went to see my doctor and he performed a thorough physical exam. He told me that i should not worry about it because its not on my testicle and he suspect that it is hydrocele or spermatocele. He also said that it looks like its swollen, but some part of it was healing. He suggested to wear scrotal support and put ice pack on it when it hurts. I ask for treatment, but he said it's best to leave it alone.

I was relieved, but then when i looked it up online i saw some different things that may cause this problem and It made me worried again especially TC. So, the following week, I saw a different doctor and told him my situation and told him the what the first doctor told me. He again performed the same physical exam and he said the same thing and told me if it gets bigger like a walnut, I should come back and see him, but he said i should not worry about it because men get this type of thing and he said he sees this type stuff all the time.

My main concern is that while doing research online, most site recommend to get ultra sound, but my doctor never recommended that. Should i worry about it ? Should I see a third opinion? Oh yeah, they are military doctors. I know how comparable their experiences are from a regular civilian doctors.

 Dr. Safaa Mahmoud - Tue Feb 06, 2007 1:26 pm

User avatar Hello,

Possible causes of scrotal swelling include inguinal hernia, , hydrocele, varicocele and cancer. Other causes that are less common in adults include lymphedema, and a spermatocele.

- Hernia: It Occurs when the local support tissues weaken, allowing loops of the bowel to slip from the abdomen into the groin. Usually, the pain and may be a bulge when standing upright, movement, or bearing down are present.

- A varicocele is a dilatation of the veins within the scrotum. Varicoceles are commonly seen on the left side than in the right due to different anatomic factors. Varicocele can lead to discomfort around the testicle, rather than actual pain in the testicle itself.

- A hydrocele is a bag of clear fluid that collects in a sac around the testicle and may be the result of a direct injury. Alternatively, it can occur spontaneously in the remnants of an embryonic sac that remains formed around the testicle from birth.

Small hydroceles may hardly be noticed and often resolve without treatment.

- Testicular cancer usually affects only one testicle. It rarely presents with pain or discomfort in a testicle or the scrotum.

Clinical examination is essential for the diagnosis.
Hydroceles and spermatoceles are diagnosed by "transillumination," a technique in which a light is applied to one side of the scrotum the scrotum.

If the mass transilluminates, this means it is filled with a clear serous-fluid and a hydrocele or spermatocele are the cause. Other causes like varicocele and cancer do not transilluminate.

Testicular ultrasound may be needed to confirm the diagnosis.

I advise you to follow up with your doctor.
Best regards.

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