Left Testicular Pain and Swelling: Causes and Concerns

Occasional swelling and pain in the left testicle?

Hello, doctor.
Normally, there are no issues with my left testicle, but since puberty, if I experience sexual arousal or masturbate for an extended period (over an hour), the blood vessels above my left testicle (the spermatic cord?) become engorged, which is visibly noticeable as a bulge.
However, after resting or lying down for a while, it resolves.
In my daily life, there are no abnormalities.
Last night, during a self-examination of my testicles, I noticed a small lump about the size of a mung bean below my left testicle.
After touching it a few times, it seemed to disappear, but it appears to be more palpable when I'm aroused.
I've been more concerned about it lately, and my testicle feels a bit strange and sore...
What is the current situation, doctor? My left testicle seems smaller than the right one.
I read online that if I can encircle my testicle with my index finger and thumb, does that mean my testicle is too small?

Niming, 30~39 year old female. Ask Date: 2018/09/30

Dr. Li Xinyi reply Urology

It sounds like there is an issue with a left-sided varicocele.
If severe, it could affect testicular function, and surgery may be necessary for improvement.
There is a small mass, about the size of a mung bean, located beneath the left testicle, which could be an epididymal cyst or engorged veins.
It is advisable to see a urologist for an examination and to discuss with the physician.
To maintain health, it is important to improve pelvic blood circulation.
Prolonged sexual arousal or masturbation (over one hour) may also have an impact, so it is recommended to avoid sitting for long periods and to get up and walk around frequently.
Additionally, avoid wearing overly tight clothing.

Reply Date: 2018/09/30

More Info

Left testicular pain and swelling can be concerning, especially when accompanied by changes in size or the presence of lumps. Based on your description, it seems that you have experienced some discomfort in your left testicle, particularly after prolonged sexual arousal or masturbation, and you noticed a small lump that temporarily appeared and then disappeared.
There are several potential causes for left testicular pain and swelling, and it's essential to consider them carefully:
1. Varicocele: This is a common condition where the veins within the scrotum become enlarged. It often presents as a "bag of worms" feeling and can cause discomfort, especially after prolonged periods of sexual arousal or physical activity. Varicoceles are more common on the left side due to anatomical differences in venous drainage.

2. Epididymitis: This is an inflammation of the epididymis, which is the tube that stores and carries sperm. It can cause pain and swelling in the affected testicle. This condition can be caused by infections, sexually transmitted infections, or even trauma.

3. Testicular torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. It typically presents with sudden, severe pain and swelling. If you experience acute pain that comes on suddenly, this requires immediate medical attention.

4. Hernia: An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. This can cause swelling and discomfort in the groin or scrotal area.

5. Tumors: While less common, testicular tumors can present as lumps or swelling in the testicle. These can be benign or malignant, and any new lump should be evaluated by a healthcare professional.

Regarding your concern about the size of your left testicle, it's important to note that testicular size can vary between individuals and even between the two testicles of the same person. A slight difference in size is often normal. However, if you notice a significant change in size, shape, or if you feel any lumps, it is crucial to seek medical evaluation.

The lump you described that appeared and then disappeared could be related to a variety of factors, including temporary swelling from increased blood flow during arousal or a benign cyst. However, if it recurs or if you have persistent discomfort, it is advisable to consult a urologist for a thorough examination. They may perform a physical examination, and possibly an ultrasound, to assess the condition of your testicles and surrounding structures.

In conclusion, while some causes of left testicular pain and swelling may be benign, others can be serious and require prompt attention. It is always best to err on the side of caution and seek medical advice if you have any concerns about your reproductive health. Regular self-examinations and awareness of any changes in your testicles are essential for early detection of potential issues.

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