A testicular mass describes a lump or swelling felt in the testicle or scrotum. This page outlines common causes, what to look for during initial assessment, when to seek urgent care, and which specialists usually manage these findings.
A mass may be felt as a small nodule, a firm painless lump, or a softer, fluctuant swelling. Some masses are movable under the scrotal skin; others are fixed. Pain can be absent or present, and the overlying skin may be normal, red, or swollen. Size ranges from barely noticeable to filling much of the scrotum.
Many different conditions can produce a scrotal lump. Benign options include epididymal cysts, hydroceles, and varicoceles; inflammatory causes include epididymitis or orchitis; an inguinal hernia can also present as a scrotal bulge. Testicular cancer can appear as a painless, firm nodule, while infected or torsed tissues often cause sudden severe pain, redness and systemic symptoms. The combination of onset, pain, and associated signs helps narrow likely causes.
Evaluation starts with a focused history (onset, growth, pain, fever, recent injury) and physical exam. Scrotal ultrasound is the primary, noninvasive imaging test to characterize a mass. Blood tests or further imaging may be recommended based on findings. Urologists typically coordinate assessment; radiology and oncology may be involved if imaging or further workup is needed.
Seek urgent medical assessment or go to emergency services if you have sudden, severe testicular pain, rapid and marked scrotal swelling, high fever with scrotal redness, or associated nausea/vomiting and feeling very unwell. These features can indicate conditions that need prompt treatment, such as testicular torsion or severe infection.
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