A Lump, But Not in my Throat

A Pea Amongst My Plums

On Saturday 13th December 2014, whilst in the shower, I found an abnormal lump in my scrotum. I had this confirmed by my wife, as I wasn’t sure what to expect.

As soon as Monday came around, I rang my doctor and booked an appointment for that evening. My work day was a bit of a blur, thinking about what it could be. I couldn’t wait to get to the surgery and have clarification on what I had felt.

When I pulled down my trousers in the doc’s office to get checked, my heart was in my throat. My GP found the offending pea-sized lump very quickly and was unsure of what it was. Because of this ambiguity, he referred me for an urgent ultrasound scan to identify whether it was of concern.

Although I was relieved to have action taken quickly, it scared me to think about the worse case scenario. To try and ease my mind, I Googled the different outcomes to what a lump could represent. The NHS website has a vast amount of information on defining the many varieties of lumps;

“There are many possible reasons why your testicles may become swollen or develop a lump.”

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.

It put my mind at ease seeing the different types of swellings or lumps, as the majority of news press highlights a lump as cancer. Although it was impossible for me to diagnose myself, from the feel of the lump, it seemed to be an epididymal cyst;

“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.”

Despite having this positive feeling in my heart of hearts, I still couldn’t get the thought of the C word out of my mind.

On New Years Eve, it was the day of the ultrasound. I dropped off Isaac with his grandparents and headed to the hospital, trying not to be nervous about the procedure ahead. I grabbed a coffee and a bit of breakfast en route and sat in the waiting room, anxiously sipping my caffeine fix through the plastic, takeaway spout and dreading the embarrassment of having to whip my boxers down.

My name was called and in I went. All jellied up, the ultrasound began and there was nothing left to do but get on with it. The scan was as thorough as I’d hoped and the lump was found quickly. The results would be with my GP in 10 days.

The Not-So-Great Unknown

The 12th of January soon came and sitting in the surgery waiting room was a relatively calm experience. I was called in and took a seat to hear my fate. In my head, I’d convinced myself that a cyst was the most likely outcome and positivity had kept me sane. My number was called and I entered my doctor’s office, my heart beating just a little faster. He pulled up my notes and read them aloud. As he explained them back to me, some key phrases stuck in my head, “the nature of the mass is uncertain” and “it has a blood flow” and this meant I was to be urgently referred again, this time to Urology.

He said normally a lump in the epididymis wouldn’t be an issue unless it affected fertility. However, since it’s unknown and has blood flow, it could potentially be living off that flow and so it needed checking.

Well, my positivity wained and I left that appointment more worried than when I’d gone in. So many questions ran through my head: why was it uncertain? Does having a blood flow mean it’s a tumour and I need to be concerned? Had my ‘best case’ option of a cyst now been thrown out of the window? Could I bear to wait another two weeks to get some answers?

Luckily the wait was short and I received a phone call inviting me to a clinic on the 20th January, just over a week from my GP appointment.

This came around much quicker than I thought and it wasn’t long before the 20th arrived and I was in the hospital, waiting for my name to appear on the plasma screen. When it did, I was ushered into a private examination room and my nerves started to bother me.

What would I do if it was bad news? How would I take it?
Had I been overreacting?
Or did I need to prepare myself for the worst?

Enter the urologist. A man I had Googled before the appointment to make myself feel better that I was in good hands. And I was, he was very knowledgeable. He examined the area and established that since it was independent from any part of my scrotum and was moveable, that it was not a tumor and was in fact a sebaceous cyst.

The words “not a tumor” didn’t hit me straight away, because I had almost begun to expect the worst and therefore this great news took a while to sink in. From here I had a couple of options;

1. Have the lump removed under a general anaesthetic.

2. Leave it be and then deal with it if it became uncomfortable or grew larger in size.

I opted to leave it for the moment and go to my GP to be referred for the operation if anything changed and it began to bother me.

Know Your Nuts

Ok, I realise that this time it wasn’t serious and was nothing to worry about. My final point here is despite the outcome, I wouldn’t have spotted this lump if I didn’t check myself regularly and if it was something worse, I could have easily missed it.

The moral of the blog post is this; there is no shame or embarrassment in checking yourself – because knowing your nuts, is knowing what’s normal for you. Like me, it will probably be nothing, but that knowledge could one day save your life.

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