Small Painful Lump on Testes- Epididymitis Vs Other Causes and Their Treatment
Q : I am a 28 year old male. I have been feeling some dull aching pain in my right testicle for the last three days. I thought it was probably because of my tight underpants. Just a day ago, I realized there was a very painful small mass on the right testis. When I touch, it hurts so much and I feel the pain all along the right side of the lower abdomen. I have no problem with urination, and my other testicle does not hurt. I have been having protected sex, and I did so more than 4 months ago. I am quite worried, and would be happy if you help me to find out what the problem could probably be. Thanks.
Though it would not be easy to say what exactly that lump is without actual physical exam, I’ll let you know about the common condition with this presentation.
Common Causes of a Small Lump Over the Testes
This is infection of the epididymis, a curved structure at the back of the testicle, in which sperms get matured and stored. Infection of this part presents with the onset of testicular pain. A lump is often found at the top of the testes.
The condition is often accompanied by swelling, redness, and warmth in the scrotal area. Fever can be present.
This is the most frequent cause of acute onset scrotal pain in your age group. The cause is bacterial infection. The bacteria in the urethra (urinary tube) back-track through the urinary duct and cause the condition. Moisture retention in the area can speed up the mechanism.
Sometimes, epididymitis can be related to orchitis in which the inflammation spreads to the testicles. Treatment is usually by antibiotics if an infection is suspected. The treatment of choice is often azithromycin and cefixime to cover both gonorrhea and chlamydia.
Torsion of the Testes
The spontaneous twisting of a testicle cutting off its own blood supply is called torsion. It is very painful. Swelling and tenderness in one testicle are often seen. This pain will not subside unless the testicle is manipulated into the correct position with surgery, which needs to be done within an hour or irreversible damage to the testicle can occur.
This is a painless cystic lump on the testes. I’m listing it here because it can sometimes be painful. This is when it gets infected. It is formed by retention of watery fluid that contains spermatozoa in the head of the epididymis. It develops gradually. Examine yourself to see if the lump is cystic (fluid containing).
A testicle lump formed by cancerous process are mostly painless. So you need not worry about this condition unless you see any other sign/ symptom of cancer.
This is another probable condition with similar presentation. It is formed by abnormal enlargement of the vein that is in the scrotum, draining the testicles. You can self examine to see if the lump has a vascular (bloody) look. Lumps of varicocele are painful. There is a dragging-like pain within the scrotum.
Any injury or trauma to that region
Injury may also lead to swelling of testes due to inflammation, hematoma and edema.
Treatment of Lumps on Testes
Treatment would depend on the cause of the lump. You can get yourself examined by a doctor for diagnosis.