Streptococcus A (strep A)
of infections and poisoning

GAS infection commonly presents as a mild sore throat (‘strep throat’) and skin/soft tissue infections such as impetigo and cellulitis.

Phone 999 or go to A&E if: you or your child is having difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs) there are pauses when you or your child breathes you or your child’s skin, tongue or lips are blue you or your child is floppy and will not wake up or stay awake

Contact your GP if you or your child: is getting worse is feeding or eating much less than normal is showing signs of dehydration, like sunken eyes, drowsiness has not passed urine for 12 hours is under 3 months and has a temperature of 38°C is older than 3 months and has a temperature of 39°C or higher feels hotter than usual when you touch their back or chest, or feels sweaty is very tired or irritable If your GP is closed, phone the 111 service. If you feel that you or your child is seriously unwell, trust your own judgement and seek medical assistance.

Strep A tests are not available through the NHS in Scotland for self-testing at home. Should you or your child need to be tested for Strep A, your GP or other healthcare professional will advise you.


Phone 999 or go to A&E if: you or your child is having difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs) there are pauses when you or your child breathes you or your child’s skin, tongue or lips are blue you or your child is floppy and will not wake up or stay awake

Contact your GP if you or your child: is getting worse is feeding or eating much less than normal is showing signs of dehydration, like sunken eyes, drowsiness has not passed urine for 12 hours is under 3 months and has a temperature of 38°C is older than 3 months and has a temperature of 39°C or higher feels hotter than usual when you touch their back or chest, or feels sweaty is very tired or irritable If your GP is closed, phone the 111 service. If you feel that you or your child is seriously unwell, trust your own judgement and seek medical assistance.

Strep A tests are not available through the NHS in Scotland for self-testing at home. Should you or your child need to be tested for Strep A, your GP or other healthcare professional will advise you.

Treatments

Most GAS infections are relatively mild illnesses that clear up on their own without the need for antibiotics.

Often symptoms that look like GAS infections, like sore throats, are more commonly caused by viruses than GAS bacteria. If you or your child has a runny nose with their sore throat, it’s likely to be a virus infection. Sore throats caused by viruses do not need to be treated with antibiotics unless there are concerns about complications.

More about sore throat symptoms, self-care at home, and what to do if your condition worsens 

Your healthcare professional will consider antibiotics if they think:

you or your child need medication to get better or to ease symptoms you or your child are at risk of serious complications from a GAS infection you or your child has scarlet fever

If you or your child is prescribed antibiotics, they could be in liquid or pill form.

It’s not uncommon for someone to have GAS bacteria on their skin or in their throat without being unwell. These people often don’t know they have the bacteria and won’t need antibiotics.

Preventions

GAS are spread by close contact between individuals, through respiratory droplets (moisture in your breath) and direct skin contact.

To help reduce the risk of picking up or spreading infections:

Do wash your hands properly with soap for 20 secondsuse a disposable tissue to catch coughs and sneezes and wash your hands afterwardskeep away from others if you feel unwell

Don’t do not share contaminated food, utensils, cups and glasses, baths, bed linen or towels

GAS can be a secondary infection, developing in people who are already unwell with illnesses like the flu. You can help protect your child from this risk by making sure they get their free flu vaccine this winter.

New evidence also shows that the nasal spray flu vaccine offered to children may also protect them from GAS infection. 

Mental wellbeing
of

Sleeping safely
of early parenthood, going home

Suicide
of

Sunburn
of injuries, skin injuries

The skin will normally start to flake and peel after a few days and will usually fully heal within 7 days.

While sunburn is often short-lived and mild, it’s important to try to avoid it, because it can increase your chances of developing serious health problems, such as skin cancer, in later life.

It’s easy to underestimate your exposure to the sun when outside, as the redness doesn’t usually develop for several hours. Breezes and getting wet (such as going in and out of the sea) may cool your skin, so you don’t realise you’re getting burnt.

You should always be aware of the risk of sunburn if you’re outside in strong sun, and look out for your skin getting hot.


While sunburn is often short-lived and mild, it’s important to try to avoid it, because it can increase your chances of developing serious health problems, such as skin cancer, in later life.

It’s easy to underestimate your exposure to the sun when outside, as the redness doesn’t usually develop for several hours. Breezes and getting wet (such as going in and out of the sea) may cool your skin, so you don’t realise you’re getting burnt.

You should always be aware of the risk of sunburn if you’re outside in strong sun, and look out for your skin getting hot.


It’s easy to underestimate your exposure to the sun when outside, as the redness doesn’t usually develop for several hours. Breezes and getting wet (such as going in and out of the sea) may cool your skin, so you don’t realise you’re getting burnt.

You should always be aware of the risk of sunburn if you’re outside in strong sun, and look out for your skin getting hot.

Symptoms

Do cool the skin by sponging it with cold water or by having a cold bath or shower – applying a cold compress such as a cold flannel to the affected area may also helpdrink plenty of fluids to cool you down and prevent dehydrationtake pain relief such as ibuprofen or paracetamol to relieve any pain – aspirin should not be given to children under 16try to avoid all sunlight, including through windows, by covering up the affected areas of skin until your skin has fully healed

Get treatment advice from your local pharmacy

Your nearest pharmacist can advise you on the best treatment if you have sunburn.

Find your nearest pharmacy

Treatments

Contact your GP practice if: You have sunburn and feel unwell or have any concerns about your sunburn, particularly if you’re burnt over a large area or have any of the more severe symptoms such as: blistering or swelling of the skin (oedema) chills a high temperature (fever) of 38C (100.4F) or above, or 37.5C (99.5F) or above in children under five dizziness, headaches and feeling sick (symptoms of heat exhaustion) You should also see your GP if a young child or baby has sunburn, as their skin is particularly fragile. If your GP practice is closed, phone 111.

Your GP may recommend using hydrocortisone cream for a few days (this is also available over the counter at pharmacies) to reduce the inflammation of your skin.

Severe sunburn may require special burn cream and burn dressings from your GP or a nurse at your GP practice. Very occasionally, hospital treatment may be needed.

Who’s at risk of sunburn?

Everyone who is exposed to UV light is at risk of getting sunburn, although some people are more vulnerable than others.

You should take extra care when out in the sun if you:

have pale, white or light brown skin have freckles or red or fair hair tend to burn rather than tan have many moles have skin problems relating to a medical condition are only exposed to intense sun occasionally – for example, while on holiday are in a hot country where the sun is particularly intense have a family history of skin cancer

People who spend a lot of time in the sun, whether it’s for work or play, are at increased risk of skin cancer if they don’t take the right precautions.

Snow, sand, concrete and water can reflect the sun’s rays onto your skin, and the sun is more intense at high altitudes. 

Preventions

Skin should be protected from strong sunlight by covering up with suitable clothing, seeking shade and applying sunscreen.

In the UK, the risk of getting sunburnt is highest from March to October, particularly from 11am to 3pm, when the sun’s rays are strongest.

There is also a risk of getting sunburn in other weather conditions. For example, light reflecting off snow can also cause sunburn. You can also burn in cloudy and cool conditions.

Suitable clothing

Suitable clothing includes:

a wide-brimmed hat that shades the face, neck and ears a long-sleeved top trousers or long skirts in close-weave fabrics that do not allow sunlight through sunglasses with wraparound lenses or wide arms with the CE Mark and European Standard EN 1836:2005.

Sunscreen

When buying sunscreen, make sure it’s suitable for your skin and blocks both ultraviolet A (UVA) and ultraviolet B (UVB) radiation.

The sunscreen label should have:

the letters ‘UVA’ in a circle logo and at least 4-star UVA protection at least SPF30 sunscreen to protect against UVB

Most people do not apply enough sunscreen. The amount of sunscreen needed for the body of an average adult to achieve the stated sun protection factor (SPF) is around 35ml or 6 to 8 teaspoons of lotion. 

If sunscreen is applied too thinly, it provides less protection. If you’re worried you might not be applying enough SPF30, you could use a stronger SPF50 sunscreen.

If you plan to be out in the sun long enough to risk burning, sunscreen needs to be applied twice:

30 minutes before going out just before you go out

Sunscreen should be applied to all exposed skin, including the face, neck and ears (and head if you have thinning or no hair), but a wide-brimmed hat is better.

How long it takes for your skin to go red or burn varies from person to person. The Cancer Research UK website has a handy tool where you can find out your skin type, to see when you might be at risk of burning.

Water-resistant sunscreen is needed if sweating or contact with water is likely.

Sunscreen needs to be reapplied liberally, frequently and according to the manufacturer’s instructions. This includes straight after you’ve been in water (even if it is ‘water-resistant’) and after towel drying, sweating or when it may have rubbed off.

Swollen glands
of glands

Sometimes swollen lymph glands can have a more serious cause and may need to be seen by a doctor.

Phone 111 or ask for an urgent GP appointment if: You have swollen glands and you: are finding it very difficult to swallow have difficulty breathing

Speak to your GP practice if: You have swollen glands and: they’re getting bigger they’ve not gone down within 1 week they feel hard or do not move when you press them you’re having night sweats or have a very high temperature (you feel hot and shivery) you have no other signs of illness or infection you have swollen lymph glands just above or below your collar bone (the bone that runs from your breastbone to each of your shoulders)


Phone 111 or ask for an urgent GP appointment if: You have swollen glands and you: are finding it very difficult to swallow have difficulty breathing

Speak to your GP practice if: You have swollen glands and: they’re getting bigger they’ve not gone down within 1 week they feel hard or do not move when you press them you’re having night sweats or have a very high temperature (you feel hot and shivery) you have no other signs of illness or infection you have swollen lymph glands just above or below your collar bone (the bone that runs from your breastbone to each of your shoulders)

Symptoms

These infections usually clear up on their own and the swollen glands will soon go down.

Swollen lymph glands are rarely caused by anything more serious.


Do drink plenty of fluids rest use over-the-counter medicines like paracetamol or ibuprofen

Causes

Swollen glands are usually caused by a viral or bacterial infection like:

a cold tonsillitis glandular fever a throat infection an ear infection a dental abscess cellulitis (a skin infection)

The glands in the affected area will often become suddenly tender or painful. You may also have other symptoms like a sore throat, cough, or fever.

These infections usually clear up on their own and the swollen glands will soon go down.

Swollen lymph glands are rarely caused by anything more serious.

Syphilis
of sexual and reproductive

It can be serious if it’s left untreated or passed on to a baby during pregnancy or childbirth.

The number of people getting syphilis in Scotland has greatly increased over the last 5 years. You could be at higher risk if you:

are a man who has sex with men have had sex overseas have had multiple sexual partners


The number of people getting syphilis in Scotland has greatly increased over the last 5 years. You could be at higher risk if you:

are a man who has sex with men have had sex overseas have had multiple sexual partners


are a man who has sex with men have had sex overseas have had multiple sexual partners

Symptoms

Many people with syphilis will not notice any symptoms either at the time of infection or later.

Syphilis usually has 3 stages.

The first stage (primary syphilis)

Ten days to 3 months after infection, a small, painless sore or ulcer will appear on the part of your body where the infection was transmitted. This is typically on either the:

penis vagina anus rectum tongue lips

Most people only have one sore, but some people have more.

The sore will then disappear within 2 to 6 weeks. If the condition is not treated, syphilis will move into its second stage.

Swelling in your lymph glands (such as in the neck, groin or armpit) often happens with the ulcers.

The second stage (secondary syphilis)

The symptoms of secondary syphilis will begin a few weeks after the disappearance of the sore. At this stage, common symptoms include:

a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet tiredness headaches swollen lymph glands

Less common symptoms include:

fever weight loss patchy hair loss joint pains

These symptoms may disappear within a few weeks, or come and go over a period of months.

Syphilis will then move into a stage where you will experience no symptoms, even though you remain infected. This is called ‘latent syphilis’. You can still pass it on during the first year of this stage. However, after a couple of years, you can’t pass the infection to others, even though you remain infected.

The latent stage can continue for many years (even decades) after you first become infected. Without treatment, there is a risk that latent syphilis will move on to the most dangerous stage – tertiary syphilis.

The third stage (tertiary syphilis)

The symptoms of tertiary syphilis can begin years or even decades after the initial infection. Up to 1 in 3 (10 to 30%) people who are not treated for syphilis develop serious symptoms eventually.

The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing any of the following symptoms:

stroke dementia loss of co-ordination numbness paralysis blindness deafness heart disease skin rashes

At this stage, syphilis can be dangerous enough to cause death.

Diagnoses

If you think you may have syphilis, you should make an appointment with your GP or local sexual health services.

The only reliable way to tell if you have syphilis or not is to have a blood test. This is usually sent to the lab. However in some sexual health services a same day test can be done if you have symptoms.

In the very early stage of the infection, syphilis in an ulcer can be seen if a swab is taken from the ulcer and looked at under a microscope or sent to the laboratory for syphilis detection. These tests are only available in some sexual health services.

Treatments

Early syphilis infections can be easily treated with antibiotics (usually penicillin), even during pregnancy.

In late stage syphilis infections, treatment at any time can stop further illness and cure the infection itself, though it does not repair any damaged organs.

Treatment is usually given by injection and may involve one or more doses, depending on the stage of the infection. In some cases tablet treatment may be offered.

Once the treatment has finished, further blood tests are carried out to make sure the infection has gone. These tests may be required at intervals for up to a year.

Testicular cancer
of cancer, cancer types in adults

Cancer of the testicle is one of the less common cancers. It tends to mostly affect men and anyone with testicles between 15 and 49 years of age.

The most common symptom is a painless lump or swelling in one of the testicles. It can be the size of a pea or it may be much larger.

Other symptoms can include:

a dull ache in the scrotum a feeling of heaviness in the scrotum

It’s important to be aware of what feels normal for you. Get to know your body and speak to your GP if you notice any changes.

Read more about the symptoms of testicular cancer and diagnosing testicular cancer.

Symptoms

The most common symptom of testicular cancer is a lump or swelling in 1 of your testicles.

The lump or swelling can be about the size of a pea, but may be larger.

Most lumps or swellings in the scrotum aren’t in the testicle and aren’t a sign of cancer. But they should never be ignored. Visit your GP as soon as you notice a lump or swelling in your scrotum.


Testicular cancer can also cause other symptoms, including a:

dull ache or sharp pain in your testicles or scrotum, which may come and go feeling of heaviness in your scrotum change in the texture or increase in firmness of a testicle difference between one testicle and the other

Causes

The exact cause or causes of testicular cancer are unknown, but a number of factors have been identified that increase a man’s risk of developing it. The 3 main risk factors are described below.

Undescended testicles

Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer.

About 3 to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles don’t descend. 

In most cases, testicles that don’t descend by the time a boy is 1 year old descend at a later stage. If the testicles don’t descend naturally, an operation known as an orchidopexy can be carried out to move the testicles into the correct position inside the scrotum.

It’s important that undescended testicles move down into the scrotum during early childhood because boys with undescended testicles have a higher risk of developing testicular cancer than boys whose testicles descend normally. It’s also much easier to observe the testicles when they’re in the scrotum.

People with undescended testicles are about 3 times more likely to develop testicular cancer than those whose testicles descend at birth or shortly after.

Family history

Having a close relative with a history of testicular cancer or an undescended testicle increases your risk of also developing it.

For example, if your father had testicular cancer, you’re around 4 times more likely to develop it than someone with no family history of the condition. If your brother had testicular cancer, you’re about 8 times more likely to develop it.

A number of genes may be involved in the development of testicular cancer in families where more than 1 person has had the condition. This is an ongoing area of research in which patients and their families may be asked to take part.

Previous testicular cancer

People who’ve previously been diagnosed with testicular cancer are between 4 to 12 times more likely to develop it in the other testicle.

For this reason, if you’ve previously been diagnosed with testicular cancer, it’s very important that you keep a close eye on the other testicle.

If you’ve been diagnosed with testicular cancer, you also need to be observed for signs of recurrence for between 5 and 10 years, so it’s very important that you attend your follow-up appointments.

Cancer Research UK has more information about testicular cancer risks and causes.


The causes of testicular cancer are not fully understood.

However, several things that increase your risk of developing the condition.

Diagnoses

Cancer of the testicle is one of the less common cancers. It tends to mostly affect men and anyone with testicles between 15 and 49 years of age.

The most common symptom is a painless lump or swelling in one of the testicles. It can be the size of a pea or it may be much larger.

Other symptoms can include:

a dull ache in the scrotum a feeling of heaviness in the scrotum

It’s important to be aware of what feels normal for you. Get to know your body and speak to your GP if you notice any changes.

Read more about the symptoms of testicular cancer and diagnosing testicular cancer.


The testicles are the 2 oval-shaped male sex organs that sit inside the scrotum on either side of the penis.

The testicles are an important part of the male reproductive system because they produce sperm and the hormone testosterone, which plays a major role in male sexual development.


The different types of testicular cancer are classified by the type of cells the cancer begins in.

The most common type of testicular cancer is ‘germ cell testicular cancer’, which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm.

There are 2 main subtypes of germ cell testicular cancer. They are:

seminomas – which have become more common in the last 20 years and now account for 50 to 55% of testicular cancers non-seminomas – which account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumours

Both types tend to respond well to chemotherapy.

Less common types of testicular cancer include:

Leydig cell tumours – which account for around 1 to 3% of cases Sertoli cell tumours – which account for around 1% of cases lymphoma – which accounts for around 4% of cases

This topic focuses on germ cell testicular cancer. You can contact the cancer support specialists at Macmillan for more information about Leydig cell tumour and Sertoli cell tumours. Their helpline number is 0808 808 00 00 and it’s open Monday to Friday, 9am to 8pm.

Read more about Hodgkin lymphoma and non-Hodgkin lymphoma.


Testicular cancer is a relatively rare type of cancer. 

Testicular cancer is unusual compared to other cancers because it tends to affect younger men and anyone with testicles. Although it’s relatively uncommon overall, testicular cancer is the most common type of cancer to affect men and anyone with testicles between the ages of 15 and 49.

For reasons that are unclear, white men and anyone with testicles have a higher risk of developing testicular cancer compared with other ethnic groups.

The number of cases of testicular cancer that are diagnosed each year in the UK has roughly doubled since the mid-1970s. Again, the reasons for this are unclear.


The exact cause or causes of testicular cancer are unknown, but a number of factors have been identified that increase a man’s risk of developing it. The 3 main risk factors are described below.

Undescended testicles

Undescended testicles (cryptorchidism) is the most significant risk factor for testicular cancer.

About 3 to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles don’t descend. 

In most cases, testicles that don’t descend by the time a boy is 1 year old descend at a later stage. If the testicles don’t descend naturally, an operation known as an orchidopexy can be carried out to move the testicles into the correct position inside the scrotum.

It’s important that undescended testicles move down into the scrotum during early childhood because boys with undescended testicles have a higher risk of developing testicular cancer than boys whose testicles descend normally. It’s also much easier to observe the testicles when they’re in the scrotum.

People with undescended testicles are about 3 times more likely to develop testicular cancer than those whose testicles descend at birth or shortly after.

Family history

Having a close relative with a history of testicular cancer or an undescended testicle increases your risk of also developing it.

For example, if your father had testicular cancer, you’re around 4 times more likely to develop it than someone with no family history of the condition. If your brother had testicular cancer, you’re about 8 times more likely to develop it.

A number of genes may be involved in the development of testicular cancer in families where more than 1 person has had the condition. This is an ongoing area of research in which patients and their families may be asked to take part.

Previous testicular cancer

People who’ve previously been diagnosed with testicular cancer are between 4 to 12 times more likely to develop it in the other testicle.

For this reason, if you’ve previously been diagnosed with testicular cancer, it’s very important that you keep a close eye on the other testicle.

If you’ve been diagnosed with testicular cancer, you also need to be observed for signs of recurrence for between 5 and 10 years, so it’s very important that you attend your follow-up appointments.

Cancer Research UK has more information about testicular cancer risks and causes.


The most common symptom of testicular cancer is a lump or swelling in 1 of your testicles.

The lump or swelling can be about the size of a pea, but may be larger.

Most lumps or swellings in the scrotum aren’t in the testicle and aren’t a sign of cancer. But they should never be ignored. Visit your GP as soon as you notice a lump or swelling in your scrotum.


Speak to your GP as soon as possible if you notice a lump or other abnormality in your scrotum that you think may be on one of your testicles.

Most scrotal lumps aren’t cancerous, but if you have a lump that you think may be in one of your testicles it’s important you have it checked as soon as possible. Treatment for testicular cancer is much more effective when started early.


If you have a non-painful lump, or a change in shape or texture of one of your testicles, and your GP thinks it may be cancerous, you’ll be referred for further testing within 2 weeks.

Scrotal ultrasound

A scrotal ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your testicle. It’s one of the main ways of finding out whether or not a lump is cancerous (malignant) or non-cancerous (benign).

During a scrotal ultrasound, your specialist will be able to determine the position and size of the abnormality in your testicle.

It will also give a clear indication of whether the lump is in the testicle or separate within the scrotum, and whether it’s solid or filled with fluid. A fluid-filled lump or collection around the testis is usually harmless. A more solid lump may be a sign the swelling is cancerous.

Blood tests

To help confirm a diagnosis, you may need a series of blood tests to detect certain hormones in your blood, known as ‘markers’.

Testicular cancer often produces these markers, so if they’re in your blood it may indicate you have the condition.

Markers in your blood that will be tested for include:

AFP (alpha feta protein) HCG (human chorionic gonadotrophin)

A third blood test is also often carried out as it may indicate how active a cancer is. It’s called LDH (lactate dehydrogenate), but it isn’t a specific marker for testicular cancer.

Not all people with testicular cancer produce markers. There may still be a chance you have testicular cancer even if your blood test results come back normal.

Histology

The only way to definitively confirm testicular cancer is to examine part of the lump under a microscope. These tests and reports are called histology.

Unlike many cancers where a small piece of the cancer can be removed (a biopsy), in most cases the only way to examine a testicular lump is by removing the affected testicle completely.

This is because the combination of the ultrasound and blood marker tests is usually sufficient to make a firm diagnosis. Also, a biopsy may injure the testicle and spread cancer into the scrotum which isn’t usually affected.

Your specialist will only recommend removing your testicle if they’re relatively certain the lump is cancerous. Losing a testicle won’t affect your sex life or ability to have children.

The removal of a testicle is called an orchidectomy. It’s the main type of treatment for testicular cancer, so if you have testicular cancer it’s likely you’ll need to have an orchidectomy.

Other tests

In almost all cases, you’ll need further tests to check whether testicular cancer has spread. When cancer of the testicle spreads, it most commonly affects the lymph nodes in the back of the abdomen or the lungs.

Therefore, you may require a chest X-ray to check for signs of a tumour. You’ll also need a scan of your entire body. This is usually a CT scan (computerised X-ray) to check for signs of the cancer spreading. In some cases, a different type of scan, known as a magnetic resonance imaging (MRI) scan may be used.


After all tests have been completed, it’s usually possible to determine the stage of your cancer.

There are 2 ways that testicular cancer can be staged. The first is known as the TNM staging system:

T – indicates the size of the tumour N – indicates whether the cancer has spread to nearby lymph nodes M – indicates whether the cancer has spread to other parts of the body (metastasis)

Testicular cancer is also staged numerically. The 4 main stages are:

stage 1 – the cancer is contained within your testicle and epididymis (the tube at the back of the testicle) stage 2 – the cancer has spread from the testicles into the lymph nodes (small glands that help fight infection) at the back of the abdomen stage 3 – the cancer has spread to the lymph nodes in the middle of the chest or in the neck  stage 4 – the cancer has spread to the lungs or, rarely, to other tissues or organs, such as the liver, bones or brain

Cancer Research UK has more information about testicular cancer stages.


Chemotherapy, radiotherapy and surgery are the 3 main treatments for testicular cancer.

Your recommended treatment plan will depend on:

the type of testicular cancer you have – whether it’s a seminoma or a non-seminoma the stage of your testicular cancer

The first treatment option for all cases of testicular cancer, whatever the stage, is to surgically remove the affected testicle (an orchidectomy).

For stage 1 seminomas, after the testicle has been removed, a single dose of chemotherapy may be given to help prevent the cancer returning. A short course of radiotherapy is also sometimes recommended.

However, in many cases, the chance of recurrence is low and your doctors may recommend that you’re very carefully monitored over the next few years. Further treatment is usually only needed for the small number of people who have a recurrence.

For stage 1 non-seminomas, close follow-up (called surveillance) may also be recommended, or a short course of chemotherapy using a combination of different medications.

For stage 2, 3 and 4 testicular cancers, 3 to 4 cycles of chemotherapy are given using a combination of different medications. Further surgery is sometimes needed after chemotherapy to remove any affected lymph nodes or deposits in the lungs or, rarely, in the liver.

Some people with stage 2 seminomas may be suitable for less intense treatment with radiotherapy, sometimes with the addition of a simpler form of chemotherapy.

In non-seminoma germ cell tumours, additional surgery may also be required after chemotherapy to remove tumours from other parts of the body, depending on the extent of the spread of the tumour.

Deciding what treatment is best for you can be difficult. Your cancer team will make recommendations, but the final decision will be yours.

Before discussing your treatment options with your specialist, you may find it useful to write a list of questions to ask them. For example, you may want to find out the advantages and disadvantages of particular treatments.


The causes of testicular cancer are not fully understood.

However, several things that increase your risk of developing the condition.


Undescended testicles is the most significant risk factor.

When male babies grow in the womb, their testicles develop inside their abdomen. The testicles then normally move down into the scrotum when the baby is born or during their first year of life.

However, for some children, the testicles fail to descend. The medical name for undescended testicles is cryptorchidism. 

Surgery is usually required to move the testicles down. If you have had surgery to move your testicles down into your scrotum, your risk of developing testicular cancer may be increased.

Of surgery is performed before the child is 13 years of age, their risk of later developing testicular cancer is approximately double that of the rest of the population. However, if the operation is carried out after the boy is 13 years of age, the risk of developing testicular cancer is 5 times greater than that of the rest of the population.


Men and anyone with testicles who has previously been diagnosed with testicular cancer are 12 times more likely to develop testicular cancer in the other testicle.

For this reason, it’s important to attend follow-up appointments if you have previously been diagnosed with testicular cancer.

Treatments

Speak to your GP as soon as you notice any lump or swelling on your testicle. They’ll examine your testicles to help determine whether or not the lump is cancerous.

Lumps within the scrotum can have many different causes and testicular cancer is rare. If your GP thinks the lump is in your testicle they may consider cancer as a possible cause.

Research has shown that less than 4% of scrotal lumps or swellings are cancerous. For example, varicoceles (swollen blood vessels) and epididymal cysts (cysts in the tubes around the testicle) are common causes of testicular lumps.

If you do have testicular cancer, the sooner treatment begins, the greater the likelihood that you’ll be completely cured.

If you don’t feel comfortable visiting your GP, you can go to your local sexual health clinic, where a healthcare professional will be able to examine you.


Chemotherapy, radiotherapy and surgery are the 3 main treatments for testicular cancer.

Your recommended treatment plan will depend on:

the type of testicular cancer you have – whether it’s a seminoma or a non-seminoma the stage of your testicular cancer

The first treatment option for all cases of testicular cancer, whatever the stage, is to surgically remove the affected testicle (an orchidectomy).

For stage 1 seminomas, after the testicle has been removed, a single dose of chemotherapy may be given to help prevent the cancer returning. A short course of radiotherapy is also sometimes recommended.

However, in many cases, the chance of recurrence is low and your doctors may recommend that you’re very carefully monitored over the next few years. Further treatment is usually only needed for the small number of people who have a recurrence.

For stage 1 non-seminomas, close follow-up (called surveillance) may also be recommended, or a short course of chemotherapy using a combination of different medications.

For stage 2, 3 and 4 testicular cancers, 3 to 4 cycles of chemotherapy are given using a combination of different medications. Further surgery is sometimes needed after chemotherapy to remove any affected lymph nodes or deposits in the lungs or, rarely, in the liver.

Some people with stage 2 seminomas may be suitable for less intense treatment with radiotherapy, sometimes with the addition of a simpler form of chemotherapy.

In non-seminoma germ cell tumours, additional surgery may also be required after chemotherapy to remove tumours from other parts of the body, depending on the extent of the spread of the tumour.

Deciding what treatment is best for you can be difficult. Your cancer team will make recommendations, but the final decision will be yours.

Before discussing your treatment options with your specialist, you may find it useful to write a list of questions to ask them. For example, you may want to find out the advantages and disadvantages of particular treatments.

Testicular cancer: Teenagers and young adults
of cancer, cancer types in teenagers and young adults

Diagnoses

It can be embarrassing to talk about your testicles and any changes to them that you’ve noticed. Understanding more about what they do might help.


Testicles are small and oval-shaped. They hang below your penis in a sac called the scrotum.

From puberty, your testicles produce a hormone called testosterone. This gives you a lower voice, hair on your face and body, and makes your muscles get bigger. You also need it for your sex drive and for getting an erection.

The testicles make sperm from puberty (around 13 to 14 years old) onwards. When sperm meets with a female egg during sex, this can cause pregnancy.

The testicles make millions of sperm a day, but if sperm are not ejaculated they are reabsorbed back into your body.

Sperm wait in the epididymis next to the testicle until they are ejaculated. At ejaculation, they travel up through the spermatic cord and mix with fluid from the prostate to make semen. They go out of the body through the urethra (this is the same tube you pass urine (pee) through).


You may have tests done by your GP or at the hospital. They will help your doctors see whether you have testicular cancer.


Treatment for testicular cancer can be very successful. Surgery and chemotherapy are the 2 main types of treatment. Often people have both treatments.

To make sure you have the right treatment, your specialist needs to know what stage the cancer is. The stage of a cancer describes the tumour and whether it has spread outside the testicle. You may need some more tests to confirm what stage you are at. Waiting to hear about the stage of the cancer can be worrying. But this information is important because it helps your doctors plan the right treatment.

Treatment for testicular cancer can be really successful. Most young men with testicular cancer are cured, even if the cancer has spread. If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse.


Being diagnosed with cancer can have a big impact on your life, even after you’ve finished treatment.

Treatments

Treatment for testicular cancer can be very successful. Surgery and chemotherapy are the 2 main types of treatment. Often people have both treatments.

To make sure you have the right treatment, your specialist needs to know what stage the cancer is. The stage of a cancer describes the tumour and whether it has spread outside the testicle. You may need some more tests to confirm what stage you are at. Waiting to hear about the stage of the cancer can be worrying. But this information is important because it helps your doctors plan the right treatment.

Treatment for testicular cancer can be really successful. Most young men with testicular cancer are cured, even if the cancer has spread. If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse.


Being diagnosed with cancer can have a big impact on your life, even after you’ve finished treatment.


Once you finish your treatment, you’ll have regular follow-up appointments at the hospital. You’ll have blood tests for tumour markers and sometimes other scans or X-rays. If the tumour markers go up, this can be a sign that the cancer has come back. This means you need more treatment, which can still cure the cancer.

How will I feel?

You might find it embarrassing to talk about your private parts and how the cancer or cancer treatment has affected them. It can feel awkward talking to doctors or your family about this.

Try not to let this put you off talking about things. It can be really helpful to let someone know how you’re feeling, so that you don’t bottle things up.

Sex and fertility

Fertility is the ability to have children. Some cancers and cancer treatments can affect a young man’s fertility, but your doctors will always think about this when planning your treatment. Your doctor will talk to you about sperm banking prior to treatment if this might happen.

If only 1 of your testicles has been removed, the one left should continue to make sperm and produce enough testosterone so that your fertility is not affected. You can still have sex.

If you have chemotherapy, your ability to produce sperm might be affected. After chemotherapy you can have a sample checked to see if this has happened. You can still have sex, but when you are on chemotherapy (and for a few months afterwards) you should always wear a condom to protect your partner from the chemotherapy.

If you had an operation to remove both of your testicles or the lymph nodes at the back of your tummy (abdomen), your fertility and your ability to have sex may be affected. This is a really tough thing to cope with on top of everything else that you’re going through. Your specialist nurse will provide support and help you find more advice and support if you feel you need it. There are things which can be done to help so that you can still have sex.

If you’re looking for information for all ages about testicular cancer, read our general testicular cancer section.

Testicular lumps and swellings
of sexual and reproductive

Lumps and swellings in the testicles are a relatively common symptom in boys, men and anyone with testicles and can have a number of different causes.

The vast majority of testicular lumps and swellings are caused by benign (non-cancerous) conditions that may not need treatment, but it’s important to know what’s normal for you and to see your GP if you notice any changes in your testicles so they can try to identify the cause.

What causes testicular lumps and swellings?

There are many possible reasons why your testicles may become swollen or develop a lump. Some of the main causes are:

varicoceles – swellings caused by swollen and enlarged veins within the scrotum hydroceles – swellings caused by a build-up of fluid around the testicle  epididymal cysts – lumps caused by a collection of fluid in the epididymis (a coiled tube behind the testicles) epididymo-orchitis – inflammation of the epididymis and testicles inguinal hernias – where fatty tissue or a part of your bowel pokes through into your groin, which can cause the scrotum to become enlarged

A sudden and severely painful swelling in one of your testicles can be a sign of a condition called testicular torsion, which is where the blood supply to a testicle is interrupted.

In rare cases, testicular lumps can be a sign of testicular cancer. Cancer Research UK estimates that fewer than four in every 100 testicular lumps are cancerous.

Read more about the causes of testicular lumps and swellings

Seeing your GP

You should see your GP if you notice any lumps, swellings or changes in your testicles.

Your GP will ask you about your symptoms and examine your testicles to try to identify the cause of the problem.

In some cases you may be referred for further tests, such as an ultrasound scan of your scrotum, to confirm a diagnosis.

If you experience sudden or severe pain in your testicles, it’s important to contact your GP immediately or visit your nearest accident and emergency (A&E) department as soon as possible because urgent treatment may be required.

Read more about diagnosing testicular lumps and swellings

Where is my nearest GP?Find your local GP practice using Scotland’s Service Directory.GP practices



How testicular lumps and swellings are treated

Treatment for testicular lumps and swellings will depend on the underlying cause. Many conditions do not need to be treated if they are not causing any many problems and they are not cancer.

Some lumps and swellings will improve over time, and simple measures such as taking over-the-counter painkillers or wearing supportive underwear may be enough to relieve any pain or discomfort in the meantime.

Surgery may be recommended to drain away any fluid or remove any solid lumps, if the problem gets worse.

Testicular torsion will require urgent surgery to restore blood flow to the affected testicle because the testicle will start to die if not treated within a few hours of the problem developing.

Read more about treating testicular lumps and swellings

Causes

Most testicular lumps and swellings are caused by benign (non-cancerous) conditions, although occasionally they can be a symptom of testicular cancer.

It’s important to see your GP if you notice a lump or swelling in one of your testicles so they can try to identify the cause and arrange any further tests if necessary. Read more about diagnosing testicular lumps and swellings.

Some of the main types of testicular lumps and swellings are outlined below.

Benign testicular lumps and swellings

There are a number of different benign causes of testicular lumps and swellings.

Most of these conditions are largely harmless and may not require treatment, although you should seek immediate medical advice if you suspect you have testicular torsion (see below) because it needs to be treated quickly.

Varicoceles

Varicoceles are soft lumps that usually develop gradually above the testicle and mostly on the left side of the scrotum (the loose sac of skin that contains the testicles). They are sometimes described as feeling like a “bag of worms”.

The exact cause of varicoceles is not clear, but it is widely thought that they occur as the result of abnormalities in the veins in the testicles leading to a build-up of excess blood in the veins, which makes them swell.

The size of varicoceles can vary. Some may only be noticeable when you touch them. Others can be larger and seen easily. The side of the scrotum that contains the varicoceles may hang slightly lower than the other side.

Besides a lump, varicoceles do not usually cause any other symptoms, although some men and anyone with testicles who have them experience a heavy feeling or aching pain in their scrotum or groin.

In a few cases, varicoceles have been linked to infertility. However, there is no evidence that surgically removing them improves your chances of being able to have a baby.

Hydroceles

Hydroceles are swellings in the scrotum caused by a build-up of fluid.

They often affect newborn babies, usually only causing a painless swelling of one or both testicles, although they can sometimes affect older boys, men and anyone with testicles, who may feel some discomfort in the scrotum.

During pregnancy, a male baby’s testicles develop inside his abdomen (tummy) and they pass down into the scrotum through a passage once they are formed. This passage usually closes before birth, but in some cases it stays open. If the passage remains open, fluid can pass from the abdomen into the scrotum, causing the swelling associated with a hydrocele.

In most cases affecting babies, the fluid is absorbed into the surrounding tissue during the child’s first year or two of life, and the hydrocele disappears.

Hydroceles that develop in men, older boys and anyone with testicles may be caused by inflammation (swelling) of the scrotum resulting from problems such as an injury or infection.

Epididymal cysts

An epididymal cyst is a small, smooth fluid-filled swelling that slowly develops in the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm).

They are often painless, but the affected testicle may sometimes ache or feel heavy. You may also experience some pain and discomfort if the cyst puts pressure on other structures in or around your testicle.

It’s not clear what causes epididymal cysts, but they tend to be more common in middle-aged men and anyone with testicles.

Epididymo-orchitis

Epididymo-orchitis is the inflammation of the epididymis as well as the testicle, causing the affected testicle to become swollen, painful and tender over a matter of hours or days.

It’s not always clear what causes epididymo-orchitis, but the condition is often linked to an infection, including:

sexually transmitted infections (STIs), such as chlamydia and gonorrhoea urinary tract infections (UTIs) mumps

Epididymo-orchitis can sometimes lead to a reduced sperm count, although this is rarely significant enough to cause infertility.

Inguinal hernias

An inguinal hernia occurs when fatty tissue or a part of your bowel, such as the intestine, pokes through into your groin at the top of your inner thigh.

The hernia can appear as a swelling or lump in your groin, or as an enlarged scrotum. The lump is often painless, but it can become suddenly and severely painful if the blood supply to the section of organ or tissue trapped in the hernia has become cut off (strangulation).

If you think you have a hernia that has become strangulated, you should visit your nearest accident and emergency (A&E) department as soon as possible because urgent surgery may be required.

Inguinal hernias occur when the tissue or bowel pushes through a weak spot in the surrounding muscle wall (the abdominal wall) into the inguinal canal. The inguinal canal is a channel through which blood vessels to the testicles pass in men and through which the round ligament (the ligament surrounding the womb) passes in women.

Inguinal hernias occur mainly in men. Most are thought to be due to ageing. This is because as you get older, the muscles surrounding your abdomen can become weaker. They can also sometimes appear suddenly due to strain on the abdomen, such as straining on the toilet if you have constipation or carrying and pushing heavy loads.

Testicular torsion

Testicular torsion is a benign but serious condition caused by the spermatic cord (the cord that supplies the testicles with blood) becoming severely twisted.

Unlike the other types of benign testicular lumps and swellings, testicular torsion is a medical emergency. You should contact your GP immediately or visit your nearest accident and emergency (A&E) department as soon as possible if you suspect you have testicular torsion.

Signs and symptoms of testicular torsion include:

a sudden, severe pain in one of your testicles swelling of the scrotum nausea vomiting abdominal (tummy) pain

If the spermatic cord becomes severely twisted, the blood supply for the affected testicle can be interrupted. If this is not treated quickly with surgery, there is a risk of losing the affected testicle.

Testicular torsion can occur at any age, but is most common in boys aged 13 to 17 and is rare in men and anyone with testicles over 30. It can also affect newborn babies and even unborn babies in the womb.

Most cases happen for no apparent reason, although the problem can occur in boys who are born with an unusually loose spermatic cord and it can develop after an injury to the testicles.

You may also be at a higher risk of developing testicular torsion if you have a history of undescended testicles (where a boy is born without both testicles in their scrotum).

Testicular cancer

Although the vast majority of testicular lumps and swellings are benign, a lump in one of the testicles can sometimes be a sign of testicular cancer.

Cancer Research UK estimates that fewer than four in every 100 testicular lumps are caused by cancer.

Lumps associated with testicular cancer tend to develop slowly on the testicle itself (as opposed to the scrotum) are usually:

painless (although some people do experience pain or discomfort) solid and firm not tender to touch

Unlike many other types of cancer, the risk of testicular cancer does not keep increasing as you get older. The condition is most often diagnosed in boys, men and anyone with testicles between the ages of 15 and 49. It’s uncommon in men and anyone with testicles older than this.

Read more about the symptoms of testicular cancer

Diagnoses

Lumps and swellings in the testicles are a relatively common symptom in boys, men and anyone with testicles and can have a number of different causes.

The vast majority of testicular lumps and swellings are caused by benign (non-cancerous) conditions that may not need treatment, but it’s important to know what’s normal for you and to see your GP if you notice any changes in your testicles so they can try to identify the cause.

What causes testicular lumps and swellings?

There are many possible reasons why your testicles may become swollen or develop a lump. Some of the main causes are:

varicoceles – swellings caused by swollen and enlarged veins within the scrotum hydroceles – swellings caused by a build-up of fluid around the testicle  epididymal cysts – lumps caused by a collection of fluid in the epididymis (a coiled tube behind the testicles) epididymo-orchitis – inflammation of the epididymis and testicles inguinal hernias – where fatty tissue or a part of your bowel pokes through into your groin, which can cause the scrotum to become enlarged

A sudden and severely painful swelling in one of your testicles can be a sign of a condition called testicular torsion, which is where the blood supply to a testicle is interrupted.

In rare cases, testicular lumps can be a sign of testicular cancer. Cancer Research UK estimates that fewer than four in every 100 testicular lumps are cancerous.

Read more about the causes of testicular lumps and swellings

Seeing your GP

You should see your GP if you notice any lumps, swellings or changes in your testicles.

Your GP will ask you about your symptoms and examine your testicles to try to identify the cause of the problem.

In some cases you may be referred for further tests, such as an ultrasound scan of your scrotum, to confirm a diagnosis.

If you experience sudden or severe pain in your testicles, it’s important to contact your GP immediately or visit your nearest accident and emergency (A&E) department as soon as possible because urgent treatment may be required.

Read more about diagnosing testicular lumps and swellings

Where is my nearest GP?Find your local GP practice using Scotland’s Service Directory.GP practices



How testicular lumps and swellings are treated

Treatment for testicular lumps and swellings will depend on the underlying cause. Many conditions do not need to be treated if they are not causing any many problems and they are not cancer.

Some lumps and swellings will improve over time, and simple measures such as taking over-the-counter painkillers or wearing supportive underwear may be enough to relieve any pain or discomfort in the meantime.

Surgery may be recommended to drain away any fluid or remove any solid lumps, if the problem gets worse.

Testicular torsion will require urgent surgery to restore blood flow to the affected testicle because the testicle will start to die if not treated within a few hours of the problem developing.

Read more about treating testicular lumps and swellings


Most testicular lumps and swellings are caused by benign (non-cancerous) conditions, although occasionally they can be a symptom of testicular cancer.

It’s important to see your GP if you notice a lump or swelling in one of your testicles so they can try to identify the cause and arrange any further tests if necessary. Read more about diagnosing testicular lumps and swellings.

Some of the main types of testicular lumps and swellings are outlined below.

Benign testicular lumps and swellings

There are a number of different benign causes of testicular lumps and swellings.

Most of these conditions are largely harmless and may not require treatment, although you should seek immediate medical advice if you suspect you have testicular torsion (see below) because it needs to be treated quickly.

Varicoceles

Varicoceles are soft lumps that usually develop gradually above the testicle and mostly on the left side of the scrotum (the loose sac of skin that contains the testicles). They are sometimes described as feeling like a “bag of worms”.

The exact cause of varicoceles is not clear, but it is widely thought that they occur as the result of abnormalities in the veins in the testicles leading to a build-up of excess blood in the veins, which makes them swell.

The size of varicoceles can vary. Some may only be noticeable when you touch them. Others can be larger and seen easily. The side of the scrotum that contains the varicoceles may hang slightly lower than the other side.

Besides a lump, varicoceles do not usually cause any other symptoms, although some men and anyone with testicles who have them experience a heavy feeling or aching pain in their scrotum or groin.

In a few cases, varicoceles have been linked to infertility. However, there is no evidence that surgically removing them improves your chances of being able to have a baby.

Hydroceles

Hydroceles are swellings in the scrotum caused by a build-up of fluid.

They often affect newborn babies, usually only causing a painless swelling of one or both testicles, although they can sometimes affect older boys, men and anyone with testicles, who may feel some discomfort in the scrotum.

During pregnancy, a male baby’s testicles develop inside his abdomen (tummy) and they pass down into the scrotum through a passage once they are formed. This passage usually closes before birth, but in some cases it stays open. If the passage remains open, fluid can pass from the abdomen into the scrotum, causing the swelling associated with a hydrocele.

In most cases affecting babies, the fluid is absorbed into the surrounding tissue during the child’s first year or two of life, and the hydrocele disappears.

Hydroceles that develop in men, older boys and anyone with testicles may be caused by inflammation (swelling) of the scrotum resulting from problems such as an injury or infection.

Epididymal cysts

An epididymal cyst is a small, smooth fluid-filled swelling that slowly develops in the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm).

They are often painless, but the affected testicle may sometimes ache or feel heavy. You may also experience some pain and discomfort if the cyst puts pressure on other structures in or around your testicle.

It’s not clear what causes epididymal cysts, but they tend to be more common in middle-aged men and anyone with testicles.

Epididymo-orchitis

Epididymo-orchitis is the inflammation of the epididymis as well as the testicle, causing the affected testicle to become swollen, painful and tender over a matter of hours or days.

It’s not always clear what causes epididymo-orchitis, but the condition is often linked to an infection, including:

sexually transmitted infections (STIs), such as chlamydia and gonorrhoea urinary tract infections (UTIs) mumps

Epididymo-orchitis can sometimes lead to a reduced sperm count, although this is rarely significant enough to cause infertility.

Inguinal hernias

An inguinal hernia occurs when fatty tissue or a part of your bowel, such as the intestine, pokes through into your groin at the top of your inner thigh.

The hernia can appear as a swelling or lump in your groin, or as an enlarged scrotum. The lump is often painless, but it can become suddenly and severely painful if the blood supply to the section of organ or tissue trapped in the hernia has become cut off (strangulation).

If you think you have a hernia that has become strangulated, you should visit your nearest accident and emergency (A&E) department as soon as possible because urgent surgery may be required.

Inguinal hernias occur when the tissue or bowel pushes through a weak spot in the surrounding muscle wall (the abdominal wall) into the inguinal canal. The inguinal canal is a channel through which blood vessels to the testicles pass in men and through which the round ligament (the ligament surrounding the womb) passes in women.

Inguinal hernias occur mainly in men. Most are thought to be due to ageing. This is because as you get older, the muscles surrounding your abdomen can become weaker. They can also sometimes appear suddenly due to strain on the abdomen, such as straining on the toilet if you have constipation or carrying and pushing heavy loads.

Testicular torsion

Testicular torsion is a benign but serious condition caused by the spermatic cord (the cord that supplies the testicles with blood) becoming severely twisted.

Unlike the other types of benign testicular lumps and swellings, testicular torsion is a medical emergency. You should contact your GP immediately or visit your nearest accident and emergency (A&E) department as soon as possible if you suspect you have testicular torsion.

Signs and symptoms of testicular torsion include:

a sudden, severe pain in one of your testicles swelling of the scrotum nausea vomiting abdominal (tummy) pain

If the spermatic cord becomes severely twisted, the blood supply for the affected testicle can be interrupted. If this is not treated quickly with surgery, there is a risk of losing the affected testicle.

Testicular torsion can occur at any age, but is most common in boys aged 13 to 17 and is rare in men and anyone with testicles over 30. It can also affect newborn babies and even unborn babies in the womb.

Most cases happen for no apparent reason, although the problem can occur in boys who are born with an unusually loose spermatic cord and it can develop after an injury to the testicles.

You may also be at a higher risk of developing testicular torsion if you have a history of undescended testicles (where a boy is born without both testicles in their scrotum).

Testicular cancer

Although the vast majority of testicular lumps and swellings are benign, a lump in one of the testicles can sometimes be a sign of testicular cancer.

Cancer Research UK estimates that fewer than four in every 100 testicular lumps are caused by cancer.

Lumps associated with testicular cancer tend to develop slowly on the testicle itself (as opposed to the scrotum) are usually:

painless (although some people do experience pain or discomfort) solid and firm not tender to touch

Unlike many other types of cancer, the risk of testicular cancer does not keep increasing as you get older. The condition is most often diagnosed in boys, men and anyone with testicles between the ages of 15 and 49. It’s uncommon in men and anyone with testicles older than this.

Read more about the symptoms of testicular cancer


Visit your GP if you notice any changes in your testicles.

Most testicular lumps are not caused by testicular cancer and many do not necessarily need any treatment, but it’s best to get them checked out.

Your GP will ask you whether you have:

felt any pain, and if so, where it was, how severe it was, how suddenly it developed and how long it has lasted  any other symptoms, such as pain when you urinate or any discharge from your penis, which could be a sign of an infection a history of trauma, such as a sports injury to your groin 

They will also want to examine your testicles to check:

the size of your testicles  the position of the lump or swelling  whether the lump causes any pain when it is touched  whether the lump is firm or soft

Your GP may hold a small light or torch against the lump in your testicle to see whether light passes through it. This can help differentiate between solid lumps and lumps caused by a build-up of fluid (such as hydroceles).

Further tests

Depending on what your GP thinks may be the cause of your symptoms, you may be referred to a specialist – such as a urologist (a doctor specialising in conditions affecting the urinary system) – for further assessment or your GP may arrange more tests.

If testicular torsion is suspected, you will usually be referred to hospital for an urgent assessment to see whether an immediate operation is necessary.

Testing for infections

Your GP may take a urine sample if they suspect your lump or swelling may be caused by an infection. They may also use a swab (small cotton bud) to collect a sample of cells and fluid from your urethra (the tube that carries urine out of the body). This sample can also be tested to see if you have an infection.

You may be referred to a genitourinary medicine (GUM) clinic if it is thought you may have a sexually transmitted infection (STI).

Ultrasound scan

An ultrasound scan is used if there is any uncertainty about the cause of your lump or swelling. This is a painless scan that uses high-frequency sound waves to create an image of the inside of your scrotum.

An ultrasound scan can help give a clearer indication of whether the lump is solid or filled with fluid and can help determine the likelihood of the lump being cancerous.


Treatment for your testicular lump or swelling will depend on the underlying cause. Some lumps may not need to be treated at all if they are not causing any problems.

Treating varicoceles

In most cases, varicoceles do not require treatment. They usually don’t cause other symptoms or long-term problems.

Although varicoceles are sometimes associated with infertility, mostly fertility is not affected. There is currently not enough evidence to suggest that treating varicoceles will help improve your chances of having a child.

If you have a varicocele that is causing pain or discomfort, taking simple painkillers such as paracetamol and wearing supportive underwear may help initially.

Your GP can refer you to a urologist (a doctor specialising in conditions affecting the urinary system) who can discuss the option of surgery with you if your varicocele is still causing your problems.

Surgery

In many cases, a technique called varicocele embolisation can be used to treat problematic varicoceles.

A tiny tube is inserted into a vein in your groin or neck and X-ray equipment is used to guide it to the affected veins in your testicles. Metal coils or a special liquid are then passed through the tube to block the affected veins. The blood will then bypass the blocked veins, reducing the swelling associated with the varicocele.

Most varicocele embolisation procedures are carried out on an outpatient basis, which means you will not have to stay in hospital overnight. It is usually carried out under local anaesthetic (you’ll be awake during the procedure but the affected area will be numbed). 

Varicocele embolisation is a safe and effective procedure, although you may experience some swelling or bruising where the tube was inserted for a few days afterwards. There is also a small risk of infection, which can be treated with antibiotics, and there is a possibility the varicocele could recur later on.

Some varicoceles need surgery to directly tie off or remove the affected veins. This is usually performed under general anaesthetic (where you’re asleep) and involves making incisions (cuts) in your groin or abdomen.

Treating hydroceles

Hydroceles in newborn babies usually disappear by the time the baby reaches two years of age. Treatment is usually only needed if they persist for longer than this, or cause pain or discomfort.

Treatment may also be recommended in boys or adults with a hydrocele that is particularly large or is causing any other symptoms. In such cases, you can be referred to a surgeon to discuss your options.

Surgery

A surgical procedure known as a hydrocelectomy is often recommended for hydroceles.  

In children, an incision is made in the groin before sealing the passage between the abdomen (tummy) and the scrotum that allows fluid to flow into the scrotum. In adults, the incision is made in the scrotum, the fluid is drained away and the incision is closed using dissolvable stitches.

Both procedures are usually carried out under general anaesthetic and most people will be able to return home soon after having the operation.

You may experience some discomfort, swelling, and fluid seepage from the wound after the procedure, but this should only last for a few days. Taking simple painkillers and wearing supportive underwear may help reduce any discomfort in the meantime.

As with a varicocele embolisation, there is a small risk of infection after a hydrocelectomy and there is a possibility the hydrocele could recur.

Treating epididymal cysts

Epididymal cysts don’t normally require treatment because they are usually harmless and don’t cause other symptoms. However, if you have a cyst that is getting bigger or is causing any pain or discomfort, you may be referred to a urologist to discuss the possibility of surgery.

Surgery

A procedure to remove an epididymal cyst is carried out under general anaesthetic and involves removing the cysts through a small incision in your scrotum that is sealed with dissolvable stitches.

In some cases, it may also be necessary to remove the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm) to prevent another cyst from forming.

As with other procedures, you may experience some discomfort, swelling, and fluid seepage from the wound for a few days after the procedure, but this should only last for a few days. Taking simple painkillers and wearing supportive underwear may help reduce any discomfort.

There is also a small risk of the wound becoming infected and there is a chance of cysts recurring if the epididymis is not removed.

Treating epididymo-orchitis

As epididymo-orchitis is often thought to be caused by bacterial infections, such as sexually transmitted infections (STIs) and urinary tract infections (UTIs), treatment will usually involve a 10-14 day course of antibiotic tablets.

If your GP suspects epididymo-orchitis has occurred as a complication of a mumps infection, antibiotics are not used because mumps is caused by a virus.

In these cases, the swelling and pain in the testicles will usually resolve within a week or two. Wearing supportive underwear, applying cold or warm compresses to your testicles and taking simple painkillers may help reduce discomfort in the meantime.

Treating inguinal hernias

You may be referred to a surgeon to discuss the option of having an operation to push the bulge back into place and strengthen the weakness in the abdominal wall.

This operation will be carried out urgently if there are signs that the blood supply to the tissue forming the lump has become interrupted (strangulated), because this can cause the affected tissue to die.

There are two ways that an inguinal hernia repair can be performed:

open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen keyhole (laparoscopic) surgery – a less invasive but more difficult technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

There are advantages and disadvantages to both methods. The type of surgery you have will depend on which method suits you and your surgeon’s experience. With both types of surgery, you should be able to go home the same day or the day after.

An inguinal hernia repair is a routine operation with very few risks. Although it is not uncommon for a hernia to recur at some point after surgery.

Treating testicular torsion

If you have testicular torsion, you will need surgery as soon as possible to untwist the testicle. Permanent injury to the testicle can occur within hours of having testicular torsion, which may affect your fertility or result in the loss of your testicle.

Surgery for testicular torsion is carried out under general anaesthetic. The surgeon will make an incision in your scrotum before untwisting the spermatic cord (the cord that supplies the testicles with blood). The testicle (or testicles) will then be stitched to the inside of the scrotum to prevent the spermatic cord twisting again.

The longer you wait before having surgery, the higher the risk that your surgeon will not be able to save the trapped testicle. Research has found that when men have surgery within six hours of testicular torsion occurring, nine out of 10 twisted testicles will be saved. However, if the surgery is delayed for 24 hours, only one out of 10 twisted testicles will be saved.

If it is not possible to save the affected testicle, the surgeon will need to remove it and seal the spermatic cord. In these cases, another operation can be carried out at a later date to fit a replacement artificial (prosthetic) testicle.

Treating testicular cancer 

If you have been diagnosed with testicular cancer, you will be cared for by a team of clinicians, who will help decide the best treatment for you.

This will depend on factors such as the specific type of testicular cancer you have and how far it had spread before it was diagnosed.

Surgery to remove the affected testicle will be recommended in most cases and this may sometimes be followed by a course of chemotherapy or radiotherapy.

If you want, you can have a prosthetic testicle inserted into your scrotum so that the appearance of your testicles is not greatly affected.

In rare cases where it is necessary to remove both testicles, you will become infertile. However, you may be able to bank your sperm before the operation to allow you to father children in the future.

Read more about treating testicular cancer

Treatments

Treatment for your testicular lump or swelling will depend on the underlying cause. Some lumps may not need to be treated at all if they are not causing any problems.

Treating varicoceles

In most cases, varicoceles do not require treatment. They usually don’t cause other symptoms or long-term problems.

Although varicoceles are sometimes associated with infertility, mostly fertility is not affected. There is currently not enough evidence to suggest that treating varicoceles will help improve your chances of having a child.

If you have a varicocele that is causing pain or discomfort, taking simple painkillers such as paracetamol and wearing supportive underwear may help initially.

Your GP can refer you to a urologist (a doctor specialising in conditions affecting the urinary system) who can discuss the option of surgery with you if your varicocele is still causing your problems.

Surgery

In many cases, a technique called varicocele embolisation can be used to treat problematic varicoceles.

A tiny tube is inserted into a vein in your groin or neck and X-ray equipment is used to guide it to the affected veins in your testicles. Metal coils or a special liquid are then passed through the tube to block the affected veins. The blood will then bypass the blocked veins, reducing the swelling associated with the varicocele.

Most varicocele embolisation procedures are carried out on an outpatient basis, which means you will not have to stay in hospital overnight. It is usually carried out under local anaesthetic (you’ll be awake during the procedure but the affected area will be numbed). 

Varicocele embolisation is a safe and effective procedure, although you may experience some swelling or bruising where the tube was inserted for a few days afterwards. There is also a small risk of infection, which can be treated with antibiotics, and there is a possibility the varicocele could recur later on.

Some varicoceles need surgery to directly tie off or remove the affected veins. This is usually performed under general anaesthetic (where you’re asleep) and involves making incisions (cuts) in your groin or abdomen.

Treating hydroceles

Hydroceles in newborn babies usually disappear by the time the baby reaches two years of age. Treatment is usually only needed if they persist for longer than this, or cause pain or discomfort.

Treatment may also be recommended in boys or adults with a hydrocele that is particularly large or is causing any other symptoms. In such cases, you can be referred to a surgeon to discuss your options.

Surgery

A surgical procedure known as a hydrocelectomy is often recommended for hydroceles.  

In children, an incision is made in the groin before sealing the passage between the abdomen (tummy) and the scrotum that allows fluid to flow into the scrotum. In adults, the incision is made in the scrotum, the fluid is drained away and the incision is closed using dissolvable stitches.

Both procedures are usually carried out under general anaesthetic and most people will be able to return home soon after having the operation.

You may experience some discomfort, swelling, and fluid seepage from the wound after the procedure, but this should only last for a few days. Taking simple painkillers and wearing supportive underwear may help reduce any discomfort in the meantime.

As with a varicocele embolisation, there is a small risk of infection after a hydrocelectomy and there is a possibility the hydrocele could recur.

Treating epididymal cysts

Epididymal cysts don’t normally require treatment because they are usually harmless and don’t cause other symptoms. However, if you have a cyst that is getting bigger or is causing any pain or discomfort, you may be referred to a urologist to discuss the possibility of surgery.

Surgery

A procedure to remove an epididymal cyst is carried out under general anaesthetic and involves removing the cysts through a small incision in your scrotum that is sealed with dissolvable stitches.

In some cases, it may also be necessary to remove the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm) to prevent another cyst from forming.

As with other procedures, you may experience some discomfort, swelling, and fluid seepage from the wound for a few days after the procedure, but this should only last for a few days. Taking simple painkillers and wearing supportive underwear may help reduce any discomfort.

There is also a small risk of the wound becoming infected and there is a chance of cysts recurring if the epididymis is not removed.

Treating epididymo-orchitis

As epididymo-orchitis is often thought to be caused by bacterial infections, such as sexually transmitted infections (STIs) and urinary tract infections (UTIs), treatment will usually involve a 10-14 day course of antibiotic tablets.

If your GP suspects epididymo-orchitis has occurred as a complication of a mumps infection, antibiotics are not used because mumps is caused by a virus.

In these cases, the swelling and pain in the testicles will usually resolve within a week or two. Wearing supportive underwear, applying cold or warm compresses to your testicles and taking simple painkillers may help reduce discomfort in the meantime.

Treating inguinal hernias

You may be referred to a surgeon to discuss the option of having an operation to push the bulge back into place and strengthen the weakness in the abdominal wall.

This operation will be carried out urgently if there are signs that the blood supply to the tissue forming the lump has become interrupted (strangulated), because this can cause the affected tissue to die.

There are two ways that an inguinal hernia repair can be performed:

open surgery – where one cut is made to allow the surgeon to push the lump back into the abdomen keyhole (laparoscopic) surgery – a less invasive but more difficult technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia

There are advantages and disadvantages to both methods. The type of surgery you have will depend on which method suits you and your surgeon’s experience. With both types of surgery, you should be able to go home the same day or the day after.

An inguinal hernia repair is a routine operation with very few risks. Although it is not uncommon for a hernia to recur at some point after surgery.

Treating testicular torsion

If you have testicular torsion, you will need surgery as soon as possible to untwist the testicle. Permanent injury to the testicle can occur within hours of having testicular torsion, which may affect your fertility or result in the loss of your testicle.

Surgery for testicular torsion is carried out under general anaesthetic. The surgeon will make an incision in your scrotum before untwisting the spermatic cord (the cord that supplies the testicles with blood). The testicle (or testicles) will then be stitched to the inside of the scrotum to prevent the spermatic cord twisting again.

The longer you wait before having surgery, the higher the risk that your surgeon will not be able to save the trapped testicle. Research has found that when men have surgery within six hours of testicular torsion occurring, nine out of 10 twisted testicles will be saved. However, if the surgery is delayed for 24 hours, only one out of 10 twisted testicles will be saved.

If it is not possible to save the affected testicle, the surgeon will need to remove it and seal the spermatic cord. In these cases, another operation can be carried out at a later date to fit a replacement artificial (prosthetic) testicle.

Treating testicular cancer 

If you have been diagnosed with testicular cancer, you will be cared for by a team of clinicians, who will help decide the best treatment for you.

This will depend on factors such as the specific type of testicular cancer you have and how far it had spread before it was diagnosed.

Surgery to remove the affected testicle will be recommended in most cases and this may sometimes be followed by a course of chemotherapy or radiotherapy.

If you want, you can have a prosthetic testicle inserted into your scrotum so that the appearance of your testicles is not greatly affected.

In rare cases where it is necessary to remove both testicles, you will become infertile. However, you may be able to bank your sperm before the operation to allow you to father children in the future.

Read more about treating testicular cancer