Men’s Health · Testicular

Testicular Lump or Pain — When to Get a Scan

Most testicular lumps are benign. One kind of pain is a surgical emergency. Knowing which is which is the whole point of this page.

Sudden severe testicular pain — go to A&E now

Pain that comes on suddenly and severely, especially with swelling, nausea or vomiting, or a testicle sitting higher than usual, can be torsion — the cord twisting and cutting off the blood supply. Go straight to A&E or call 999. The testicle can usually be saved if surgery happens within a few hours, and that window closes fast.

Do not wait for a scan appointment, and do not wait to see if it settles. This is the one situation on this page where an hour matters.

Man seated in a calm private clinic waiting area in daylight

With that said: the great majority of lumps and swellings men find are benign — cysts, fluid collections and dilated veins. Ultrasound is unusually good here, because everything sits close to the surface, and it can almost always say what a lump is made of in a single 30-minute appointment.

Patterns

What the finding usually turns out to be

What you notice Commonly What to do
Sudden severe pain, swelling, nausea, one testicle higher Torsion A&E or 999 immediately
Painless firm lump on the testicle itself, often found by chance Needs urgent assessment See your GP this week
Smooth soft swelling around the testicle, painless, gradually enlarging Hydrocele — fluid GP; scan confirms
Small firm pea-like lump above or behind the testicle Epididymal cyst Benign; scan confirms
Soft irregular swelling, often described as a bag of worms, more obvious standing Varicocele — dilated veins Usually benign; scan confirms
Gradual ache with swelling, redness, fever or burning on passing urine Infection of the epididymis GP promptly — needs antibiotics

The one to act on without delay: a painless firm lump on the body of the testicle. Testicular cancer is the most common cancer in men aged roughly 15 to 45, it is usually painless, and it is also one of the most treatable — particularly when caught early. See your GP; there is an urgent NHS pathway for exactly this.

The Scan

What ultrasound settles — and where it stops

A scrotal ultrasound is the first-line test and it is very good at the central question: is the lump within the testicle or outside it? Lumps arising outside — cysts, hydroceles, varicoceles — are almost always benign. A solid lump within the body of the testicle is the finding that needs specialist assessment, and the scan describes its size, structure and blood flow.

What it cannot do is give a tissue diagnosis. That comes from specialist assessment including blood markers and, where indicated, surgery — through a urology clinic, not here. We do not offer blood tests, biopsy or surgery, and a scan does not replace the GP appointment that opens the referral.

On torsion specifically, being blunt: ultrasound can support the diagnosis, but a suspected torsion is a surgical decision made on examination, and imaging must never delay it. If that is your story, the right destination is A&E, not our diary.

At IUS London

How the appointment runs

  1. 1
    BookingNo referral needed, no preparation, 30 minutes. Tell us what you have found and how long it has been there.
  2. 2
    PrivacyYou undress privately and are covered throughout. A chaperone is available on request — just ask when you book or on the day.
  3. 3
    The scanWarm gel and a small probe over both sides, including Doppler assessment of blood flow, with the unaffected side scanned for comparison.
  4. 4
    ResultsExplained on screen as we scan, with the written report usually with you within two hours — and if anything needs urology, we say so plainly and write it for them to act on.
FAQs

Your questions answered

I found a lump but it does not hurt. Is that better or worse?
Painless does not mean harmless here — testicular cancer is usually painless. A firm lump on the body of the testicle should go to your GP this week, whether or not it hurts.
How do I know if it is torsion?
Sudden, severe pain, often with swelling, nausea or vomiting, and sometimes a testicle sitting higher than usual. If that describes you, stop reading and go to A&E — the testicle can usually be saved if surgery happens within a few hours.
What is a varicocele?
Dilated veins in the scrotum, often described as feeling like a bag of worms and more obvious when standing. Usually benign, though sometimes relevant to fertility. Ultrasound confirms it easily.
Should I check myself regularly?
Knowing what is normal for you is what matters — then you notice a change. A relaxed check in a warm shower every few weeks is enough; no rigid schedule is required.
Can you tell me if a lump is cancer?
The scan can say whether a lump is inside or outside the testicle and describe its features, which is often decisive information. A definitive diagnosis needs specialist assessment including blood markers and, where indicated, surgery — arranged through urology.
Will there be a chaperone?
If you would like one, yes — ask when you book or when you arrive. You are covered throughout and can stop the scan at any point.
Related

Where to go from here

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Hernia or something else — and when it is urgent.

Read the guide →LumpsArmpit Lump

Lymph node or cyst — and when to have it looked at.

Read the guide →ScansTesticular Scan

What the scan involves and what it assesses.

See the scan →

Answered this week, not next month

Both sides assessed with Doppler blood flow in a 30-minute appointment — whether the lump sits inside or outside the testicle, explained on screen as we scan, with the report usually within two hours for your GP or urologist.

From £159
Testicular ultrasound scan

Testicular scan

5a Lucerne Mews
Kensington, London W8 4ED
3 mins from Notting Hill Gate

This article is general information about testicular lumps and pain, not individual medical advice. Sudden severe testicular pain needs A&E or 999 immediately — imaging must never delay treatment for suspected torsion. Any new lump should be assessed by your GP — see NHS guidance on testicle lumps and swellings and testicular cancer. We do not offer blood tests, biopsy or surgery.

Written and clinically reviewed by the HCPC-registered sonographers who perform this scan at IUS London — a CQC-registered diagnostic ultrasound clinic (Provider ID 1-2775844974). Your own findings are explained to you at the scan and set out in your report.

Author: Yianni Kiromitis, Senior Sonographer, HCPC RA38415 — over 20 years’ experience in NHS and private ultrasound
Medically reviewed: 10 August 2026