Scrotal & Testicular Conditions
Assessment and treatment pathways for testicular lumps, undescended testes, hydroceles, epididymal cysts, testicular prostheses and other scrotal or testicular concerns. The appropriate pathway depends on the diagnosis, symptoms, fertility goals and previous surgery.
Acute severe scrotal or testicular pain can have causes that require time-sensitive treatment and should not wait for a routine outpatient appointment.
What can we help with?
Select the problem that most closely matches what you have noticed or what you have previously been diagnosed with.
Testicular Lump, Mass or Cancer
Assessment of a new testicular lump or ultrasound-detected lesion, including testicular cancer, fertility preservation and testis-sparing surgery in selected situations.
Explore testicular masses & cancer → 02Undescended Testis
Adult assessment of a persistent or previously treated undescended testis, including fertility, hormone function, cancer-risk considerations and surgical options.
Explore undescended testis → 03Hydrocele
A fluid collection surrounding the testicle can cause enlargement, heaviness or discomfort. Assessment helps confirm the diagnosis and whether treatment is necessary.
Learn about hydrocele → 04Epididymal Cyst & Spermatocele
Benign cysts around the epididymis are common. Management depends on symptoms, size, diagnostic certainty and fertility considerations.
Learn about epididymal cysts → 05Testicular Prosthesis
Information about testicular prosthesis surgery following orchidectomy, testicular loss or an absent testis, including timing, positioning and realistic expectations.
Explore testicular prosthesis surgery → 06Testicular Implant Revision
Assessment of pain, high position, asymmetry, migration, size concerns or another problem involving a previous testicular prosthesis.
Explore implant revision → 07Paratesticular Masses
Lumps arising beside rather than within the testicle can have different causes and require a different diagnostic and surgical approach from conventional testicular tumours.
Learn about paratesticular masses → 08Scrotal Lymphoedema & Complex Scrotal Surgery
Persistent scrotal swelling, thickening or tissue enlargement may require assessment for lymphatic, inflammatory, reconstructive or other underlying causes.
Learn about scrotal lymphoedema →
A scrotal lump does not always arise from the testicle itself
Scrotal swelling and lumps can arise from several different structures. Establishing whether an abnormality is within the testis, beside it or within the surrounding scrotal tissues helps determine the appropriate pathway.
Hydrocele
A hydrocele is a collection of fluid around the testicle. It may cause gradual enlargement, heaviness or discomfort. Not every hydrocele requires surgery.
Hydrocele information →Epididymal Cyst & Spermatocele
These are usually benign fluid-filled lumps arising beside the testicle. Persistent symptoms can prompt discussion of treatment and fertility considerations.
Epididymal cyst information →Paratesticular Masses
Masses may arise from the epididymis, spermatic cord or surrounding tissues rather than the testicle itself. Imaging helps establish the site of origin.
Paratesticular tumour information →Scrotal Lymphoedema
Persistent enlargement or thickening of the scrotal tissues may require reconstructive assessment, particularly when hygiene, mobility, urination or surrounding genital tissues are affected.
Scrotal lymphoedema information →Fertility can be relevant to testicular treatment planning
Testicular disease can overlap with sperm production, testosterone function and future fertility. These considerations can be particularly important before testicular cancer treatment, in men with an undescended testis, and when surgery involves the testis or epididymis.
Future family plans may influence the investigations and treatment pathway.
Semen analysis may be relevant in selected men before treatment.
Sperm banking or selected surgical retrieval techniques may be discussed where clinically appropriate.
Selected testicular masses may have different surgical options from a typical suspected germ-cell tumour.
What happens next?
The first priority is to establish what the problem is before deciding whether treatment is required.
Understand the concern
Symptoms, previous surgery, fertility history and relevant medical history are reviewed.
Examine & investigate
Examination and selected investigations such as scrotal ultrasound are arranged when clinically appropriate.
Clarify the diagnosis
Findings help distinguish benign scrotal conditions, testicular disease and problems requiring further investigation.
Discuss your options
Observation, further investigation or treatment can then be discussed according to the diagnosis and individual priorities.
Some testicular conditions overlap with other pathways
Cancer care, fertility and reconstructive surgery may sometimes need to be considered together rather than as separate problems.
Testicular Cancer
Testicular masses, cancer assessment, testis-sparing surgery and fertility preservation.
Explore testicular cancer →Male Fertility
Semen abnormalities, impaired sperm production, fertility preservation and reproductive surgery.
Explore male fertility →Genital Reconstruction
Complex scrotal surgery, genital reconstruction and testicular prosthesis or implant-related concerns.
Explore reconstructive urology →Scrotal & Testicular FAQ
Does every testicular lump mean cancer?
No. There are several benign causes of scrotal and testicular lumps. However, a new lump should be assessed because its cause cannot always be reliably determined by feel alone.
Should a painless testicular lump still be checked?
Yes. A persistent new lump, focal firmness or change in the size or consistency of a testicle should be assessed even when it does not cause pain.
What is the difference between a hydrocele and an epididymal cyst?
A hydrocele is a collection of fluid around the testicle, whereas an epididymal cyst is a cyst arising from the epididymis beside the testicle. Examination and ultrasound can help distinguish them.
Can testicular conditions affect fertility?
Some can. Previous undescended testes, testicular cancer, testicular surgery, varicocele and other conditions affecting testicular function may be relevant to sperm production. Fertility assessment can be incorporated where appropriate.
Can a testicle sometimes be preserved when a mass is found?
In selected circumstances, testis-sparing surgery may be considered. It is not appropriate for every testicular mass, and cancer control remains the priority when a germ-cell tumour is suspected. Read about testicular masses and testis-sparing surgery.
Can I have a testicular prosthesis after losing a testicle?
A testicular prosthesis can potentially be considered at the time a testicle is removed or as a later reconstructive procedure. Whether this is appropriate depends on individual circumstances and previous surgery. Read about testicular prosthesis surgery.
What if I already have a testicular implant but I am unhappy with it?
Problems such as discomfort, a high position, asymmetry, migration or other concerns can be assessed individually. Read about testicular implant revision.
I feel embarrassed about having a scrotal examination. Is it okay to delay?
Scrotal and testicular examination is a routine part of urological assessment. A new lump, persistent swelling or another concerning change should not be ignored because of embarrassment.
Not sure which testicular or scrotal condition applies to you?
You do not need to determine the diagnosis before arranging an appointment. Assessment can help establish the cause of a lump, swelling, discomfort, testicular abnormality or concern following previous surgery and identify an appropriate next step.
Medical information on this page is general in nature and does not replace individual medical advice. Assessment, investigation and treatment recommendations depend on the diagnosis, examination findings, previous treatment and individual circumstances.