What it means
Scrotal lumps and swellings are common and usually benign. The most usual causes:
- Epididymal cysts — small, smooth, often multiple, and painless. Very common and harmless.
- Varicocele — enlarged veins, often described as a “bag of worms” that feels worse standing or straining. Common, usually harmless, occasionally worth treating.
- Hydrocele — fluid around the testicle causing smooth swelling, often from an injury or an infection.
- Infection — epididymitis or orchitis, usually with pain, tenderness and sometimes fever.
- Hernia — a bulge in the groin, sometimes appearing when straining.
- Torsion — an emergency, usually with sudden severe pain.
Testicular cancer is uncommon, particularly before the age of 25, and is highly curable when found early. It usually presents as a hard lump within the testicle itself.
What can vary
- Where the lump is matters. Lumps in the skin, in the wall of the scrotum, or in the cord feel different from a lump inside the testicle.
- Lumps come and go. A cyst that fills and drains will change in size.
- Varicoceles often appear in adolescence and are more noticeable when standing or straining.
- Painless is not the same as harmless, but it is the usual reason people leave these alone for years.
Possible explanations
No home method reliably distinguishes the benign causes from the ones that matter. Self-examination cannot substitute for a clinician comparing both testicles, feeling for a change in consistency, and deciding whether an ultrasound is needed.
Warning signs
Prompt:
- A hard lump inside the testicle, or one that feels different from the other side
- A lump that is new, growing, irregular, or feels fixed
- Painless swelling that is new and persistent
- Swelling with fever
- A hernia that is painful or cannot be pushed back
Emergency:
- Sudden severe pain with swelling
- An erection lasting more than four hours with severe pain
What to do next
Book an appointment. Say what you have noticed, where it is, how long it has been there, and whether it changes with standing or straining.
Ultrasound is the usual next step and it is painless and quick.
Self-care
There is no self-care that resolves a lump.
While waiting: supportive underwear may ease discomfort, and a wrapped cold pack for short periods may help with swelling. Do not squeeze, massage or try to “pop” anything.
When to seek help
Routine: a long-standing, soft, painless lump that has not changed.
Prompt: any hard lump, any lump that is new or changing, or any lump with fever.
Emergency: sudden severe pain with swelling.
How to talk about it
“I’ve found a lump in my right testicle.”
“I’ve had a swelling in my scrotum for a few months and it comes and goes.”
“There’s a lump that feels hard and it wasn’t there before.”
Say which side and how long. Those two details are what a clinician needs to decide how quickly you should be seen.
Related articles
Sources
Public sources are linked so you can read the detail rather than take this site’s word for it. None of this has yet been reviewed by a qualified clinician — see how we handle medical review.
References
Where this comes from
Linked so you can check it against a recognised public health source rather than take this site's word for it.
- Scrotal lumps and swellings — NHS NHS (opens in a new tab)
- Scrotal and testicular problems — RCOG Royal College of Obstetricians and Gynaecologists (opens in a new tab)
These are public sources from recognised health organisations, linked so you can read the detail rather than take this site's word for it. Reading them does not tell you whether any of it applies to you, and none of these articles has yet been reviewed by a qualified clinician. How we handle sourcing and review.