Small, Hard, Pea Sized, Painful Lump on Testicle: Symptoms, Diagnosis, Treatments

The testicle is a small, egg-shaped reproductive organ in men. There are two testicles in healthy men, enclosed in a sac known as the scrotum. The scrotum hangs loosely below the penis, mostly to allow for cool temperatures. Cool temperatures are essential for sperm production, which along with male hormones production are the main functions of testicles.

Sometimes, a mass or lump can be noticed on the testicles. Such a lump can appear on either or both testicles. When that happens, most patients get concerned, and not without a good reason.

A number of causes may be responsible for the appearance of a lump on the testicle. Depending on its cause and severity, different treatment options are available.

Symptoms of lump on testicle

The following symptoms are common in cases of lumps in the testicles:

  • Swelling in the testicles
  • Roughness
  • The affected testicle feeling heavier
  • Pain
  • Tenderness
  • Warm sensation on scrotum
  • Changes in temperature, fever and general feeling of sickness
  • Frequent urination
  • Presence of blood or pus in urine

Painful lump on testicle due to injuries

It is common for injured parts of the body to swell and form lumps. In most cases, the lumps will be painful and may with time show signs of infection.

The location of the testicles keeps them from frequent injuries. Even so, accidents can be sustained in the same.

The testicles may twist in the scrotum due to some form of injury. This causes a painful condition which requires immediate medical attention. It can lead to infertility and extreme pain if not given the emergency attention it deserves.

It may also happen that the areas near testicle become injured or fill with blood. The former is a bit more serious and more painful. Again, medical help is required.

Causes of painless lump on testicles


A lump above testicles may be due to varicocele. This is a condition that causes blood veins to dilate and accumulate on a localized point in the testicles. The condition is common in young male adults. It is neither harmful nor painful.


Hydrocele develops when fluid accumulates in the testicle. It is mostly seen in babies, especially those born prematurely. It is also seen in men above 40 years of age. The condition is not harmful and needs no special treatment. Large hydrocele lumps can be removed surgically.


Hernia is caused by complications in the arrangement groin and bowel muscles. It forces the scrotum to enlarge as part of the bowel protrudes into the groin.

Epididymal cyst

Sperm from the testicles pass through a tube known as the epididymis. It is a highly coiled tube, estimated to be about 7 meters in adult males. Sometimes, the tube clogs and is unable to allow passage of fluid. This leads to a condition known as epididymal cyst. If the tube contains sperm, spermatocele occurs. Epididymal cyst can be felt as a small lump on testicle located on the top end. It is harmless and painless.

Testicular cancer

Testicular cancer is not common but a possible cause of hard lump on testicle. As it develops, the lump is likely going to become painful and manifest other signs of malignancy.

Causes of painful lump on testicle

If you notice a painful lump on the testicle, it may be due to any of the following:

Epididymitis and orchitis

Either epididymitis or orchitis will cause the epididymis to become inflamed. The former is commonly due to STDs while the latter can be caused by infections that aren’t sexually transmitted.

Testicular torsion

This is a condition used to describe accidental twisting of the testicle inside the scrotum. It is more common in boys. The condition is very painful and should be treated immediately in a hospital.


Haematocele describes accumulation of blood in the regions surrounding the testicle. It leads to the formation of a painful lump on the testicle.  Accidental injuries are the most common causes.

Kidney stones

Kidney stones will not cause lumps on the testicles but can on the scrotum. They are usually accompanied by severe pain in the belly or back and nausea.

Hard lump on testicle due to cancer

Testicular cancer is the most dangerous of all the mentioned conditions. It is therefore important that we go through the various ways through which a hard lump on testicle can be checked for the signs of malignancy.

  • Cancer lumps start as painless hard lumps that may be located inside or on the testicle
  • The lumps are firm and fixed on testicular tissue
  • The lumps will continue to become bigger
  • In some cases, testicular cancer lumps will become painful after sometime. Pain can also be felt on the scrotum or in the bowels.
  • If the lump is inside the testicle, the affected testicle will increasingly gain mass. Note that testicles are not always symmetrically sized and aligned.
  • It has been noted that men with testicular cancer show a tendency to produce more sex hormones. This may lead to enlargement of breasts or early onset of puberty in boys.

If left untreated, cancer cells usually spread to other body regions. This can cause pain in the lower back, chronic cough, bloody discharges, headaches and pain in the belly. It may come as a surprise, the fact that even men can develop breast cancer. While it is rare, it is still possible. Ignoring signs of malignancy in testicles may in one way or another encourage a breast cancer lump.

Other causes of on testicle

A lump on the scrotum can be confused with one on the testicle. This is especially when the lump is painful and not allowing for thorough examination.

Sebaceous cysts may for example develop deep into scrotal sac to an extent of feeling like on the testicles. The cysts occur when hair follicles become clogged with sebum and bacteria. Cysts are mostly not painful. It is easy to confuse them with boils. Boils are common causes of lump under armpit painful symptoms.

Symptoms of STDs may also spread to the scrotum and cause small lumps on the skin. Syphilis is a good example. A lump due to syphilis soon becomes a sore and is initially painless.

Lipoma or fatty acids under skin may form on the scrotal sac. Lipoma is a common cause of a lump under the chin with no pain but can also be responsible for soft, tender and rubbery lumps on the scrotum.

Diagnosis for lump on testicle

It is not agreed on whether doing self-examination at home is of any benefits. However, it may succeed in warning you of early signs of a harmful lump in testicles. Here is how to do self-examination:

  • Closely study your testicles and check for any changes in size, color or shape
  • Using your thumb and fingers, feel the texture and the shape of the testicles. Generally, they should feel not roughly textured. Testicles are shaped like an egg.
  • Compare the physical features of both testicles.
  • Pay extra attention to any bumps, lumps or changes in consistency compared to the other testicle.

In a clinic, your doctor will do a physical examination and ask a couple of questions. The questions will mainly be on the symptoms you have been experiencing and when they did start.

A blood test can be performed to check for tumors and germs. If signs of STDs are present, screening will be performed. Injuries, tumors and abnormalities are checked with ultrasound devices or X-ray machines. For an infection occurring on the scrotum, it can be identified through a biopsy.

Treatment for lump on testicle

Varicocele and hydrocele do not call for medical treatment. This is unless they form large lump that is causing discomfort. A large lump near testicle is usually removed surgically.

Painful lumps due to infections are mostly treated with antibiotics. In case they are caused by STDs, treatments for the STDs will be necessary. Anti-inflammatory medications may also be helpful.

Even a pea sized lump on the testicle due to testicular cancer is best removed surgically. A single small hard lump left untreated will probably spread the malignant cells to body parts like the brain, liver, belly or breast. Cancer causes swollen lymph nodes which may appear as a hard lump behind the ear, in the armpit or on the groin.

Your doctor will discuss with you the best treatment alternatives. It is for this reason that patients are advised to report any signs or symptoms of lumps in the testicles. This includes if the lumps are not painful.

When to see a doctor

More than half of lumps in testicles are usually harmless and with no need for medical attention. Even so, some can lead to infertility and other complications.

See your doctor if the right testicle is increasingly becoming different compared to the left testicle or vice versa.

See your doctor if you notice signs of infection. Such include fever, chills, pus and blood discharge. They most commonly are signs of bacterial infections but can also be due to viruses.

See your doctor if you notice continuous mass gain in a lump in testicles. This applies to the bottom of the testicle, above or inside the same. It is not always that cancer lumps will form on the testicle. They too can form inside.

See your doctor if a lump on the testicle is accompanied by a painful lump in the throat, armpit, groin or behind the ears. These are parts of the body on which lymph nodes are located. Painful lumps indicate swelling. Swelling of the lymph nodes, on the other hand, indicate presence of disease germs in the body.