Your testicles are the glands hanging between your legs that produce your sperm. They hang ‘outside’ your body, in a sac called the scrotum, because your sperm matures better at lower temperatures. To make sure that you try to avoid damage to your ‘bits’, the testicles have a lot of nerves, so that you automatically try to protect them to avoid pain.

The most common symptoms with regard to testicles are pain and swelling. If you get severe or ongoing problems like these with your testicles, you almost always need to see your urologist for further assessment. Delaying for too long puts you at risk of becoming infertile, or worse, losing a testicle. In the case of testicular cancer, early treatment quite literally saves lives.

If you suffer from problems with your testicles, compare your symptoms with these descriptions of selected conditions to see whether you need to act quickly, starting with the more common ones:

• Epididymal cyst: Fluid-filled cysts in a tubular organ attached to your testicle are usually small painless lumps that grow slowly and that you can feel rather than see. These cysts are harmless, and nobody really knows for sure why they occur. By feeling the lump carefully, you may be able to make out whether it’s attached to or part of your testicle, or separate from it. Sometimes, you may notice more than one cyst at the same time, either on one or both sides.
• Hydrocele: Fluid may accumulate between the different layers of tissue covering your testicles, which is called hydrocele – a swelling in your enlarged scrotum that develops gradually and feels a bit like a balloon filled with water. This condition is common, harmless, not painful and becomes more common the older you get – but can appear at any age.
• Varicocele: Intermittent pain or a ‘heaviness’ in your testicle, particularly after prolonged standing or exercise, may be due to congested veins in your scrotum called varicocele, which may feel and look like a ‘bag of worms’.
• Orchitis and epdidymo-orchitis: Orchitis is an infection of the testicle, which becomes tender and swollen, and is commonly due to mumps. In epididymo-orchitis the infection spreads to the epididymis. Common causes are a sexually transmitted chlamydia infection in younger men or prostate enlargement if you’re older. See your urologist for diagnosis. If confirmed, you need treatment with antibiotics.
• Testicular torsion: Occasionally, a testicle may suddenly twist around itself inside your scrotum, which is called testicular torsion. This condition is more common in younger men and can happen at any time – even during sleep. Your testicle becomes exquisitely tender to touch, and the pain comes on fast, is usually severe and may spread into your groin and lower abdomen – which is why you may misdiagnose this problem as appendicitis. You may feel sick or vomit and you’re likely to feel faint as well.
• Testicular cancer: Most swellings in your scrotum aren’t due to testicular cancer, but any new lump has the potential to be. Testicular cancer is very treatable and has an excellent prognosis when caught early. For this reason, check your testicles regularly – say, once a month or so – under the shower and feel for any changes, particularly lumps.

Many other conditions can also affect your testicles, and as a rule getting things checked out by an experienced urologist promptly is the best idea, instead of waiting too long.