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Symptoms to look out for with testicular problems

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As November moves on we continue our series looking into men’s health. Dr Christos Michael on testicular problems


Testicular problems are common in men, with over one in five having some sort of testicular lump. The vast majority of these are benign with no symptoms. But what symptoms should you look out for to be aware of various testicular problems, including cancer.

Most testicular conditions have no symptoms, particularly if mild or in the early stages.

Sensations of aching or a dragging, a heavy sensation, particularly if there is a lump which feels like a ‘bag of worms’ can be an indication of a varicocele, an enlargement of the veins in the scrotum.

Aching pain in the testicles, particularly following unprotected sex can be a sign of an infection which needs urgent treatment.

Sudden intense pain, particularly after injury or exercise which lasts longer than five minutes should be seen very urgently as there is a risk of testicular torsion – a condition where the testicle twists on itself and the blood supply is cut off. This needs urgent surgery.

Lumps can occur in, around or next to the testicle – most are benign, but if a testicle is irregular or lumpy then this needs a doctor’s review within two weeks for a scan.

Big lumps which start higher up in the groin and extend down into the scrotum can be hernias.


How do I self examine?

Self-examination is recommended monthly even if you have no symptoms. This will also allow you to recognise what is normal for you and make it easier to notice if there are any changes.

Examine each testicle separately by rolling or sliding it between you fingers, then feel your way behind the testicle and up the cords. Feel for any lumps, irregularities, pain or enlargement from the usual.



These are like ‘varicose veins’ in the scrotum. When they are small they don’t cause trouble. Larger ones may need surgery as they can affect fertility – your doctor may refer you for a scan or a sperm count and depending on the results to a urologist for surgery.

Epididymal cysts

These are little cysts of the sperm storage area behind the testicle. They are benign and don’t need treatment. If they are painful they may be infected – this may need investigation and treatment with antibiotics.


This means inflammation of the testicle. It is painful and usually caused by an infection such as a urinary infection or a sexually transmitted infection. It will need further tests and antibiotics.

Testicular cancer

Thankfully this is rare. There are various types and is commonest in young men under 35 years old. When caught early it has an excellent survival rate of up to 99 per cent. This is why regular self-examination is so important.


Dr Michael is a London trained GP. He currently works at the University of Nicosia Medical Centre as a GP and Assistant Clinical Professor. He will be giving an online lecture on men’s health topics on November 25 and sexual health on December 2

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