Testicular Ultrasound: Checking Lumps, Pain and Swelling
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer
A testicular ultrasound, also called a scrotal ultrasound, uses sound waves to create pictures of the testicles and nearby tissues. It's the main imaging test for lumps, swelling, pain or injury in the scrotum. It can find testicular cancer, cysts and testicular torsion, which needs emergency surgery. The test is painless and takes under 30 minutes.
What the research says
Microlithiasis matters only in some men: a review of 33 studies found tiny calcium spots called testicular microlithiasis carried no extra cancer risk in men without symptoms, but in men referred for scrotal problems they were linked to an 8.5-times higher risk of a germ cell tumor (Tan IB et al., Cancer, 2010) [2]
Ultrasound helps spot torsion: a review of 723 people found the ultrasound "whirlpool sign" of a twisted cord had 99% specificity for testicular torsion, with sensitivity of 73%, rising to 92% when newborns were excluded (McDowall J et al., Emergency Radiology, 2018) [3]
Key takeaways
A testicular ultrasound images the testicles with sound waves.
It's the first test for scrotal lumps, pain or swelling.
It can detect testicular torsion, an emergency.
It's painless, uses no radiation and takes under 30 minutes.
Results are often ready the same day.
What is a testicular ultrasound?
A small handheld device called a transducer sends sound waves into the scrotum. The echoes create real-time images of the testicles, epididymis and surrounding tissue. Doppler mode shows blood flow, which is key for spotting torsion. It's also called a scrotal ultrasound or sonogram. Sources: [1]
Why it's done
Ultrasound helps find the cause of scrotal symptoms.
A lump found during a testicular self-exam.
Testicular pain, swelling or injury.
Possible testicular cancer or cysts.
Varicoceles, hydroceles or an inguinal hernia.
Suspected testicular torsion.
Checking for an undescended testicle or blood flow problems. Sources: [1]
Testicular torsion is an emergency
Sudden, severe testicle pain, often with swelling, nausea or vomiting, can be torsion. The spermatic cord twists and cuts off blood flow, and the testicle can be lost within hours. Get emergency care right away; ultrasound may be done quickly, but surgery shouldn't be delayed if torsion is likely. Sources: [1, 3]
How to prepare
Wear loose clothing such as shorts or sweatpants.
Remove clothing and jewelry from the waist down; you may get a gown.
No shaving or other preparation is needed. Sources: [1]
What happens during the test
The test takes less than 30 minutes.
You lie on your back on an exam table; you may be asked to turn to one side.
Water-based gel is spread on the scrotum.
The technologist moves the transducer over the area and may ask you to stay still or hold your breath.
Doppler is used to check blood flow.
The gel is wiped off, and you can get dressed. Sources: [1]
Risks
Testicular ultrasound is safe, with no radiation and no harmful side effects. It isn't painful, though pressure may be uncomfortable if the area is already sore or swollen. There's no recovery time. Sources: [1]
Results
A radiologist explains the findings.
Finding | What it may mean |
Normal | Healthy testicles and blood flow |
Fluid-filled cyst | Usually benign |
Enlarged veins | Varicocele |
Fluid around the testicle | Hydrocele |
Solid mass | Possible testicular cancer; needs follow-up |
Reduced or no blood flow | Possible torsion; emergency |
Results are usually ready the same day. If a mass is found, blood tumor markers and other tests may follow. Ultrasound can't always locate an undescended testicle in the belly, so more imaging may be needed. Sources: [1, 2]
Conclusion
Testicular ultrasound is a fast, painless and safe way to find the cause of scrotal lumps, pain or swelling. It plays a key role in catching testicular cancer early and in recognizing emergencies like torsion.
Keep learning: read about the testicular self-exam and testicular cancer.
Frequently asked questions
What is a testicular ultrasound?
An imaging test that uses sound waves to view the testicles.
Why is it done?
To check lumps, pain, swelling or injury in the scrotum.
Does it hurt?
No, though pressure may be uncomfortable if the area is sore.
How long does it take?
Less than 30 minutes.
Does it use radiation?
No.
Can it detect testicular cancer?
It can find masses that may be cancer and need follow-up.
What is testicular torsion?
A twisted cord that cuts off blood flow; it's an emergency.
Do I need to shave?
No.
When will I get results?
Usually the same day.
What happens if a mass is found?
Blood tumor markers and other tests may follow.
Related Reading
Testicular Self-Exam: How to Check Your Testicles and What's Normal how to check your testicles at home.
Testicular Cancer: The Young Man's Cancer That's Highly Curable — Symptoms, Self-Exam Guidance, and Treatment Explained a main condition ultrasound helps find.
Retroperitoneal Lymph Node Dissection (RPLND): Surgery, Risks and Recovery surgery used in testicular cancer.
Doppler Ultrasound: How It Works, Types, Uses and Results the ultrasound method that shows blood flow.
Ultrasound: Types, How It Works, Preparation and Results an overview of ultrasound imaging.
References
Cleveland Clinic. Testicular Ultrasound: Purpose, Procedure, Risks & Results. Cleveland Clinic. Last updated June 13, 2024. https://my.clevelandclinic.org/health/diagnostics/testicular-ultrasound
Tan IB, Ang KK, Ching BC, et al. Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520-4532. PMID 20578177. https://doi.org/10.1002/cncr.25231
McDowall J, Adam A, Gerber L, et al. The ultrasonographic "whirlpool sign" in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis. Emergency Radiology. 2018;25(3):281-292. PMID 29335899. https://doi.org/10.1007/s10140-018-1579-x
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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