My Husband Has A Buldge On His Testicles With Pain

My husband has a buldge on his testicles with pain (he says its like a third testicle) He is 32 yrs old, smokes, and his health is fair at best. Anyway sexual intercourse and a long day of manual labor does make the pain and swelling worse. He says it hurts for even his legs to touch his testicles, and they feel heavy like being weighed down. No problems urinating, no blood and no mumps. Might as well not suggest the ER he wont go and doesnt have any insurance. I need to know how serious or not this could be though.