| | Cancer | Testicular Cancer
Understanding Abnormal Testicles: Symptoms, Causes & What to Do
Any change in testicular size, shape, consistency, or sensation warrants medical evaluation. Early detection is critical—especially for testicular cancer, the most common solid malignancy in men 15–35.
Signs & Symptoms
- Size change: One testicle noticeably larger/smaller.
- Shape irregularity: Nodules, flattening, asymmetry.
- Consistency change: Hardness, firmness, rubbery feel.
- Pain/discomfort: Dull ache, heaviness, sharp pain (torsion = emergency).
- Scrotal swelling/lump: Hydrocele, spermatocele, hernia, tumor.
- Gynecomastia/nipple discharge: Rare; hCG-secreting germ cell tumors.
- Back/abdominal pain: Late sign of metastatic spread.
Common Causes
| Condition | Key Features | Urgency |
|---|---|---|
| Testicular cancer | Painless hard lump; 95% germ cell tumors | High — urgent urology referral |
| Epididymitis | Painful, swollen epididymis; often STI (chlamydia/gonorrhea) or UTI | Prompt — antibiotics |
| Testicular torsion | Sudden severe pain, high-riding testis, absent cremasteric reflex | Emergency — surgery <6 hrs |
| Hydrocele | Painless fluid-filled scrotal swelling; transilluminates | Low — observe or repair if large |
| Varicocele | "Bag of worms" feel; left-sided; may affect fertility | Elective — repair if symptomatic/infertility |
| Spermatocele | Cyst on epididymis; benign, transilluminates | Low — observe |
| Undescended testis | Absent from scrotum; cancer risk if not orchiopexy'd | Pediatric — surgery by 18 mo |