testicular CT scan preparation

Overview

A testicular CT scan is a detailed imaging test that uses X-rays and a computer to create cross-sectional pictures of the testicles and the surrounding area. It helps doctors look for problems such as lumps, swelling, or injury, and can guide further treatment.

A testicular CT scan is a common and safe procedure used when a doctor needs more detail than an ultrasound can provide.

It may be recommended for anyone with testicular symptoms, from teenagers to older men, depending on their doctor's advice.

Symptoms

Common symptoms

• A lump or hardness in a testicle
• Dull or sharp pain in the scrotum
• Swelling or heaviness in the scrotum
• Changes in the shape or size of a testicle

Symptoms in children

• A painless lump in the scrotum
• Swelling or redness
• A feeling of a 'bag of worms' in the scrotum (possible varicocele)

Symptoms in older adults

• Same symptoms as any adult, but may be overlooked due to other conditions
• New or worsening discomfort in the scrotum or groin

Causes

Main causes

• To investigate a mass or lump found during a physical exam or ultrasound
• To evaluate pain or swelling not explained by an ultrasound
• To check for injury after trauma to the scrotum
• To stage a diagnosed testicular cancer and see if it has spread

Risk factors

• A family or personal history of testicular cancer
• An undescended testicle at birth
• Previous testicular injury or infection
• Being in your teens to 40s (the most common age range for testicular cancer)

When to see a doctor

See a doctor urgently if:

• If you feel a new lump or hardness in a testicle, see a doctor within a few days
• If you have persistent pain or swelling in the scrotum, book an appointment as soon as possible
• If you notice a change in the size or shape of a testicle

Book a routine appointment if:

• You may be referred for a CT scan as a follow-up from an ultrasound, even if you feel fine
• If you are having a CT scan for another reason, your doctor may include the testicles as a precaution

Diagnosis

A CT scan is not the first step. Usually, a doctor will examine you and might order an ultrasound first. If the ultrasound does not give enough information, or if a specific condition is suspected, they may recommend a CT scan of the scrotum and pelvis.

Tests that may be done

• Physical examination of the testicles and scrotum
• Ultrasound of the scrotum (often done before a CT scan)
• Blood tests to check tumour markers
• CT scan of the chest, abdomen, and pelvis to check for spread (if testicular cancer is confirmed)

What to expect at your appointment

During the CT scan, you will lie on a table that slides through a large ring-shaped scanner. The scanner takes pictures from different angles. You may be given a contrast dye through an IV (a small tube in your arm) to make certain tissues show up more clearly. You will be asked to hold still for a few seconds while the images are taken, but the whole scan is usually over in less than half an hour.

Treatment

The CT scan itself is not a treatment. It is a way to see what is causing your symptoms. Treatment depends entirely on the underlying condition. Your doctor will explain the results and discuss the next steps with you, which may include monitoring, medication, or surgery.

Self-care at home

• Before the scan, follow your hospital's instructions about eating and drinking — usually you may need to avoid food for a few hours but can drink water.
• If you are given contrast dye, drink plenty of water afterward to help flush it out of your system.
• Wear loose, comfortable clothing and leave metal items (belts, jewellery) at home.
• Tell the radiology team about any allergies, especially to iodine, and if you are pregnant or breastfeeding.

Medical treatments

Treatment will depend on your results. For example, if an infection is causing your symptoms, you may be prescribed antibiotics. If a tumour is found, treatment might involve surgery, chemotherapy, or radiation therapy. Your healthcare team will give you clear information and support if any treatment is needed.

When is surgery considered?

If a CT scan reveals a suspicious mass, your doctor may recommend surgery to remove the testicle (orchidectomy). This is the most common treatment for testicular cancer and is usually curative. Discuss all options with your specialist.

Living with this condition

After your CT scan, you can normally return to your usual activities immediately. If you had contrast dye, you may be advised to drink extra fluids for the next 24 hours to help your system clear it. You will receive a report with your results, and a follow-up appointment to discuss them.

Lifestyle tips

• Know the normal look and feel of your testicles so you can notice any changes early
• Perform self-examinations monthly, around when your body feels relaxed
• Avoid tight-fitting underwear if it causes discomfort, but there is no link between underwear type and testicular health

Diet and exercise

There are no special dietary or exercise requirements before or after a CT scan. During the scan, you may be asked to hold your breath briefly, but you can resume normal eating and exercise straight away unless your doctor tells you otherwise.

Mental health and emotional wellbeing

Waiting for scan results can be stressful. It is normal to feel anxious. Try to focus on one day at a time, and talk to your partner, friends, or a counsellor if you need support. Your healthcare team is there to answer your questions.

Prevention

Testicular conditions cannot always be prevented, but early detection is key. Being aware of your testicles and checking them regularly can help you notice any changes early, when treatment is most effective.

Screening programmes

Routine screening for testicular cancer is not recommended for all men, and self-examination is not proven to reduce death rates. However, knowing what is normal for you and seeing a doctor if you notice any change is sensible. If you have a higher risk, your doctor may suggest regular check-ups.

Complications

If left untreated

• If an infection is causing your symptoms and is left untreated, it could spread or cause a collection of pus (abscess).
• If testicular torsion (a twisted spermatic cord) is left untreated, it can lead to loss of the testicle.
• If testicular cancer is not treated, it can spread to other parts of the body, such as the lymph nodes, lungs, or liver.

Long-term outlook

The outlook depends on the underlying cause. Most testicular problems are not cancer, and even testicular cancer is one of the most treatable and curable forms of cancer, especially when caught early. Follow your doctor's advice and keep your appointments.

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