Private testicular pain and lumps clinic in London, same-day men's health.

Checking yourself

Once a month, after a warm bath or shower when the scrotum is relaxed. It takes a minute.

1. Hold the scrotum in your palms and get a sense of the usual size and weight. One testicle being slightly larger or hanging lower is entirely normal.
2. Roll each testicle between thumb and fingers, gently. The surface should feel smooth and firm, like a hard-boiled egg without the shell.
3. Find the epididymis — the soft, slightly lumpy tube at the back and top. This is normal anatomy and is the structure most often mistaken for a lump.
4. You are looking for change: a hard painless lump, a change in size or firmness, or a heavy dragging feeling. Knowing your own normal is the entire point.

What lumps usually turn out to be

• Epididymal cyst — smooth, fluid-filled, separate from the testicle itself. Harmless.
• Hydrocele — fluid around the testicle, giving a soft painless swelling. Common and benign.
• Varicocele — enlarged veins, often described as a bag of worms, usually on the left, sometimes with a dull ache. Occasionally relevant to fertility.
• Epididymo-orchitis — infection causing gradual pain, swelling and often fever. Needs antibiotics, and sometimes sexual health testing.
• Testicular cancer — usually a painless, hard, irregular lump on the testicle itself. Painless is the point: waiting for it to hurt is what causes delay.

Aching without a lump

A dull ache in one or both testicles, worse at the end of the day or after standing, is common and often has no serious cause. Contributors include a varicocele, a small hernia, referred pain from the back or hip, previous infection, or nerve irritation after surgery. It still deserves an examination, particularly if it persists beyond a couple of weeks.

Protecting yourself

• Wear a properly fitted box or guard for contact and racquet sports, cricket and martial arts.
• Practise safer sex; chlamydia and gonorrhoea are common causes of epididymitis in younger men.
• Check monthly, and see someone about any change rather than deciding to watch it.
• If you had an undescended testicle as a child, your risk of testicular cancer is higher — checking matters more, not less.