Testicular Lumps: When to Worry and What to Know - Urology

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When it comes to testicular lumps, it’s understandable to feel anxious, especially when you notice something unusual in your body. Testicular lumps can arise from various causes, and while many are benign, it’s important to understand when to seek further evaluation.

From your description, it seems you have noticed two lumps on the upper part of your left testicle that are sometimes palpable and sometimes not, depending on your position. This variability can be concerning, but it’s also not uncommon. Testicular anatomy includes various structures, such as the epididymis, which can sometimes feel like lumps, especially when the testicle is elevated or contracted.
The fact that two different doctors performed physical examinations and did not find any lumps is reassuring. They likely assessed for common causes of testicular lumps, such as epididymal cysts, spermatocele (a cyst that forms in the epididymis), or even varicoceles (enlarged veins in the scrotum). These conditions are typically benign and do not require treatment unless they cause discomfort or other issues.

Regarding your question about the likelihood of malignant tumors developing in the upper part of the testicle, it is generally true that most testicular cancers present as lumps in the lower part of the testicle. However, malignancies can occur anywhere in the testicular region, and while they are less common in the upper part, it is not impossible. Testicular cancer is most often found in younger men, typically between the ages of 15 and 35, and it usually presents as a painless lump.

The lumps you are feeling could be due to several benign conditions, including:
1. Epididymal Cyst: A fluid-filled sac that forms in the epididymis, often asymptomatic and usually requires no treatment.


2. Spermatocele: Similar to an epididymal cyst but specifically contains sperm. These are also typically benign and asymptomatic.

3. Varicocele: Enlarged veins within the scrotum that can sometimes be felt as lumps, especially when standing.

4. Lipoma: A benign fatty tumor that can occur in the scrotal area.

5. Testicular Torsion: A medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. This usually presents with severe pain and swelling, not just lumps.

Given that both doctors have advised you to monitor the situation, it suggests that they do not believe there is an immediate cause for concern. However, if you notice any changes—such as increased size, pain, or any other new symptoms—it’s crucial to follow up with your healthcare provider.

If your anxiety persists, consider requesting an ultrasound of the scrotum. This imaging test can provide a clearer picture of the structures within the scrotum and help differentiate between benign and potentially concerning conditions.
In summary, while it’s normal to feel worried about changes in your body, the advice from your doctors to observe the lumps is likely sound, especially if they did not find anything concerning during their examinations. However, trust your instincts—if you feel uneasy, don’t hesitate to seek further evaluation or a second opinion. Regular self-examinations and awareness of your body are important, and staying informed is key to your health.