Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
Testicular self-examinations are best performed in the shower and are the most common way testicular masses are found.
If you feel something different than usual or you are concerned, see your doctor. There are many reasons for testicles to swell, hurt, or have changes on or around them. Some of these may be from benign (noncancerous) causes such as hydrocele (fluid around the testicle), varicocele (dilated veins around the testicle), or a cyst, while other reasons may be more worrisome. A medical professional can help determine the cause; a checkup should not be delayed.
If uncertainty exists about what is felt on the testicle or in the scrotum, your doctor may order an ultrasound (noninvasive imaging using sound waves) to detect abnormalities inside the scrotum or the testicles. Blood and urine tests may also be useful.
If a mass is found within the testicle, one of the potential causes is testicular cancer. Testicular cancer is the most common cancer among young men and is one of the most curable types of cancer. The standard of care when testicular cancer is suspected is to remove the affected testicle in a procedure called an orchiectomy—an operation done through a small incision in the groin or lower abdomen. It is typically performed as outpatient surgery with a recovery period that can involve 2 to 4 weeks of lighter activity.
Additional treatment depends on staging (determining the extent of any cancer spread). Staging for testicular cancer is based on
What is found in the testicle by microscopic evaluation
Elevation of serum tumor markers (blood tests measure if certain proteins are at higher than normal levels in the body)
Abnormalities on body imaging that suggest spread of cancer outside of the testicle
Depending on what is found in those 3 evaluations, additional treatment may include continued monitoring with imaging tests (called surveillance), radiation therapy, chemotherapy, or additional surgery. Your doctor will discuss the specifics of any additional necessary treatment, including the risks and benefits of each.
Men with a normal remaining testicle after orchiectomy typically have minimal issues with fertility or male hormone production. However, it is important to discuss your family planning goals with your surgeon before an orchiectomy because sperm banking is an important consideration before any treatment. Some men prefer the cosmetic appearance of 2 testicles, and a testicular prosthesis can be inserted at the time of surgery if this is desired.
American Cancer Societywww.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-signs-and-symptoms
A JAMA Patient Page on testicular cancer was published in the February 13, 2008, issue.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Source: Neoplasms of the testis. In: Campbell MF, Walsh PC, Wein AJ. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2012:837-870.
Topic: Men’s Health
Matulewicz RS, Meeks JJ. Testicular Mass. JAMA. 2016;316(5):557. doi:10.1001/jama.2016.2445