Approximately 2,400 men are diagnosed with testicular cancer in the UK each year, with the highest incidence in men aged 30–34.[1] Ultrasound is the first-line investigation for any scrotal lump, swelling, or pain — it can distinguish between benign conditions (epididymal cysts, hydroceles, varicoceles) and potentially malignant lesions with high accuracy.[3]
When to Have a Testicular Ultrasound
See a doctor promptly if you notice:
- A painless lump or swelling in either testicle
- A change in size, shape, or texture of a testicle
- A dull ache or heaviness in the scrotum
- Sudden testicular pain or swelling
- A feeling of fluid collection around the testicle
What the Scan Detects
| Condition | Ultrasound Appearance | Clinical Significance |
|---|---|---|
| Testicular tumour | Solid hypoechoic intratesticular mass | Urgent referral — 95%+ cure rate if caught early |
| Epididymal cyst | Anechoic (fluid-filled) cyst in epididymis | Benign — monitoring only unless symptomatic |
| Hydrocele | Fluid surrounding the testicle | Usually benign — investigate if new onset in adults |
| Varicocele | Dilated veins (>3 mm), increased on Valsalva | May affect fertility — referral if symptomatic or infertility |
| Epididymitis/orchitis | Enlarged, hyperaemic epididymis/testis | Infection — antibiotics and follow-up scan |
| Testicular torsion | Absent blood flow on Doppler | Surgical emergency — immediate referral |
What to Expect During the Scan
The scan is performed in a private room. You will be asked to lower your clothing and lie on the examination couch. A warm gel is applied to the scrotum and a small ultrasound probe is moved gently across the area. The scan takes approximately 15–20 minutes and is painless. Both testicles are examined, along with the epididymis and blood flow (Doppler). Results are discussed immediately afterwards.[4]
From Our Practice
"I understand that scrotal symptoms can cause significant anxiety. Many men delay seeking help because of embarrassment. At Victoria Medical, the scan is performed discreetly and professionally, and in the majority of cases I can provide reassurance immediately — most scrotal lumps are benign."
— Dr George Xynopoulos, Consultant Physician
Frequently Asked Questions
Is a testicular ultrasound painful?
No. The scan is painless. If you have acute pain or swelling, the sonographer will be gentle and can adjust pressure as needed.
Do I need a referral?
No. You can book directly at Victoria Medical without a GP referral. NICE guidelines recommend urgent ultrasound for any unexplained testicular lump.
How quickly will I get results?
Results are discussed immediately after the scan. A written report is available within 24 hours.
What if something abnormal is found?
If a suspicious lesion is identified, I arrange urgent specialist referral (usually within 48 hours) to a urological cancer team. The vast majority of testicular cancers are curable.
At what age should I be concerned?
Testicular cancer is most common between ages 15 and 49. Any new lump, swelling, or change in a testicle at any age warrants investigation.
Can the scan detect infertility causes?
Yes. Ultrasound can identify varicoceles (a common treatable cause of male infertility), testicular atrophy, and epididymal obstruction.
Related Guides
Well-Man Health Check
Comprehensive men's screening
Abdominal Ultrasound
What it shows and when you need one
Private GP Services
Same-day consultations
Ultrasound Scans
All scanning services
References
- [1] Cancer Research UK. Testicular cancer statistics. 2024. View source
- [2] NICE NG12. Suspected cancer: recognition and referral. 2015 (updated 2023). View source
- [3] Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. Radiology. 2003;227(1):18–36. View source
- [4] Aganovic L, Cassidy F. Scrotal ultrasound: pearls and pitfalls. Br J Radiol. 2012;85(1014):e294–e305. View source
- [5] Woodward PJ, et al. From the archives of the AFIP: tumors and tumorlike lesions of the testis. RadioGraphics. 2002;22(1):189–216. View source
- [6] EAU Guidelines on Testicular Cancer. 2024. View source
