testicular specialist tests overview

Overview

These are tests that a specialist (a doctor who focuses on male reproductive health) may use to check for problems with your testicles, such as lumps, pain, swelling, or infertility. They help find conditions like infections, cysts, testicular torsion (twisting), or testicular cancer early.

Testicular problems that need specialist tests are fairly common, especially lumps and pain. Testicular cancer itself is rare, affecting about 1 in 250 men. Other conditions like hydrocele (fluid-filled sac) or varicocele (enlarged veins) are more common.

It mainly affects men and people assigned male at birth, particularly those aged 15 to 49. But testicular issues can occur at any age, including in children and older adults.

Symptoms

Common symptoms

• A lump or swelling in either testicle
• A feeling of heaviness or aching in the scrotum
• Dull pain or discomfort in the testicle or groin
• Sudden severe pain (could be testicular torsion – an emergency)
• Change in the size or shape of a testicle

Symptoms in children

• A lump or swelling that doesn’t go away
• Undescended testicle (testicle not in the scrotum)
• Redness, tenderness, or fever (could be infection)

Symptoms in older adults

• Gradual swelling or lump
• Painless lump (more common in older men)
• Symptoms might be confused with hernia or prostate problems

Causes

Main causes

• Testicular cancer – exact cause is not known, but it starts when cells in the testicle grow abnormally.
• Testicular torsion – the testicle twists, cutting off blood supply.
• Infection or inflammation (like epididymitis or orchitis).
• Fluid buildup (hydrocele) or enlarged veins (varicocele).
• Cysts or benign lumps.

Risk factors

• Having had an undescended testicle at birth (even if corrected).
• Family history of testicular cancer.
• Previous testicular cancer in the other testicle.
• Age (most common from 15 to 49).
• Certain genetic conditions (like Klinefelter syndrome).

When to see a doctor

See a doctor urgently if:

• If you notice any new lump or swelling in a testicle – see a doctor within a day or two.
• If you have sudden, severe pain – call emergency services immediately.

Book a routine appointment if:

• If you have a dull ache or discomfort that lasts more than a few days.
• If you have any concerns about your testicles during a regular check-up.

Diagnosis

A specialist will start with a physical exam: feeling the testicles and checking for lumps, swelling, or tenderness. If anything unusual is found, they will order further tests.

Tests that may be done

• Ultrasound scan – uses sound waves to create images of the testicles. It is painless and can tell if a lump is solid (more likely cancer) or fluid-filled.
• Blood tests – check for tumour markers like AFP, HCG, and LDH, which can be high in some testicular cancers.
• CT scan – may be done if cancer is found, to see if it has spread.

What to expect at your appointment

The ultrasound is quick (about 15–20 minutes) and you will lie down while a gel is applied and a small probe moved over the scrotum. Blood tests take a few minutes. You will usually get results the same day or a few days later.

Treatment

Treatment depends on the cause. For infections, antibiotics may be prescribed. For cancer, the main treatment is surgery to remove the affected testicle (radical inguinal orchiectomy). Depending on the stage, additional treatments may be used. For non-cancer conditions like hydrocele or varicocele, treatment may not be needed unless they cause pain or other problems.

Self-care at home

• Do regular testicular self-exams (once a month after a warm bath or shower).
• Wear supportive underwear if you have a dull ache.
• Apply a cold pack to the area if there is swelling or pain (wrap in a cloth).

Medical treatments

For testicular cancer, surgery to remove the testicle is the first step. After that, you may have chemotherapy or radiation therapy to kill any remaining cancer cells. These treatments are given in cycles and can be very effective. For infections, your doctor may prescribe antibiotics. For testicular torsion, emergency surgery is needed to untwist the testicle and save it. Always follow your specialist's advice.

When is surgery considered?

Surgery is usually recommended if cancer is found, or if testicular torsion occurs. Some non-cancer conditions (like large hydroceles or painful varicoceles) may also be treated with surgery if they cause symptoms.

Living with this condition

After treatment, you will have regular follow-up appointments (including blood tests and scans) to make sure everything is fine. If you had a testicle removed, your remaining testicle usually produces enough hormones and sperm. You can still have children and a normal sex life.

Lifestyle tips

• Try to maintain a healthy weight and avoid smoking.
• Limit alcohol to recommended amounts.
• Wear protective gear during sports to prevent injury to the testicles.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins supports overall health. Regular exercise helps with energy levels and mood. After surgery, wait for your doctor’s okay before returning to strenuous exercise.

Mental health and emotional wellbeing

A diagnosis or even the worry about testicular problems can cause anxiety, stress, or depression. It is normal to feel this way. Talking to a partner, friend, or a professional can help. Many men find it helpful to connect with others who have had similar experiences.

Prevention

Most testicular conditions cannot be prevented, but early detection through self-exams helps catch problems when they are most treatable. There is no known way to prevent testicular cancer.

Vaccines

No vaccine is available for testicular conditions.

Screening programmes

There is no routine screening test for testicular cancer in people without symptoms. However, doctors recommend regular self-exams starting from age 15. If you have risk factors (like an undescended testicle), talk to your doctor about more frequent checks.

Complications

If left untreated

• Testicular cancer can spread to other parts of the body (like lymph nodes, lungs, or liver).
• Testicular torsion can lead to loss of the testicle if not treated within a few hours.
• Chronic infection or inflammation can cause long-term pain or infertility.

Long-term outlook

The outlook is very good for most testicular conditions. Testicular cancer has a cure rate of over 95% when found early. Even if it has spread, it is often curable with chemotherapy. With prompt treatment, other conditions like torsion or infection also have excellent outcomes.

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