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Not every lump in the scrotum is testicular cancer – in fact other causes are more likely. However, any lumps, swellings or changes to the testicles should always be checked out by a doctor.
The veins that drain blood away from the testicles can become varicose, forming a varicocele that feels like a bag of worms at the top of the affected testicle.
Causes of a Hydrocele: The testicle is surrounded by two layers of membrane called the tunica vaginalis. Symptoms of a hydrocele can easily be distinguished from testicular cancer, as a hydrocele is soft and squidgy, where a testicular cancer feels rigid and rough. As the fluid in a hydrocele is clear, light shone through it may be visible from the other side, however, the accumulation of fluids can be formally diagnosed through ultrasound. Hydroceles in newborn babies often disappear on their own during the first year or two. If the hydrocele in older males is not surgically removed, it may continue to grow.
The injection of a solution following aspiration of the hydrocele fluid (called sclerotherapy), can increase success rates, but in many patients the hydrocele will recur. The general recommendation is that a hydrocele should be surgically removed, in a procedure called hydrocelectomy.

A hydrocele will not generally affect fertility, although it could be indicative of other significant factors.
These are the most common causes of a swelling in the scrotum, and can reach several centimetres in size.
Finding a painless, cystic accumulation above the testicle (sometimes described as a third testicle) is usually indicative of an epididymal cyst, but confirmation with an ultrasound is recommended. Large, uncomfortable cysts should be surgically removed. Somerset Urological Associates are a leading urology practice based in Taunton and covering the whole of the South West of England. Cancer Research UK estimates that less than four in every 100 testicular lumps are testicular cancer. The veins  may be tender to the touch, and the testicle may ache with a drawing, dragging sensation.
Smooth and varying greatly in size, hydroceles, are normally both painless and harmless, although larger hydroceles can be uncomfortable because of their size and weight.
The hydrocele fluid can be drawn off, which is a less invasive procedure than surgical removal, but the hydrocele may return.

There are two surgical techniques available, dependent on the size of the hydrocele and the thickness of the membrane wall.
An uncommon condition, affecting one in every 4,000 males every year, testicular torsion usually develops in boys aged 13-17, but can also occur in men in their 20s. In the short term, wearing supportive pants or a jock strap will help. In moderate to severe cases, an operation to remove the varicose veins is recommended. An accumulation of this clear fluid, which is caused by its poor absorption, is called a hydrocele.

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