Testicular Concerns: Differentiating Epididymis and Other Issues

Q: Testicular Concerns: Differentiating Epididymis and Other Issues

Hello： The information provided here is for reference only and cannot replace a doctor's examination. <br>I have felt a soft mass at both the anterior and posterior aspects of my testicles; could this be the epididymis? -- There is a high possibility, but I noticed that the anter

Testicular issues?

Hello, doctor.
I have noticed a soft mass on both the anterior and posterior aspects of my testicles, which I believe might be the epididymis.
However, I have observed that the anterior part of my left testicle is thicker, while the posterior part is quite small and barely noticeable.
On the other hand, the right testicle has a less prominent anterior part, but the posterior part is larger and seems to extend slightly below the right testicle.
Could you please confirm if this is indeed the epididymis? If it is, is it normal for the epididymis of both testicles to appear different? If this is abnormal, could it be due to testicular torsion or other causes? If this is not the epididymis, what else could it be? Should I be concerned about the severity of this condition? Additionally, during my self-examination, I accidentally rotated my left testicle (the anterior became posterior and vice versa), but it immediately returned to its original position.
After that, I did not experience any severe pain or discomfort associated with testicular torsion.
Does this mean there is no cause for concern? Could there be any long-term effects, such as an increased risk of testicular torsion in the future? Lastly, I would like to ask if self-examination of the testicles is necessary, or if it is better to leave it alone.
Thank you, doctor.

Niming, 20~29 year old female. Ask Date: 2021/08/09

Dr. Du Shixi reply Urology

Hello: The information provided here is for reference only and cannot replace a doctor's examination.
I have felt a soft mass at both the anterior and posterior aspects of my testicles; could this be the epididymis? -- There is a high possibility, but I noticed that the anterior part of my left testicle is thicker, while the posterior part is quite small and barely noticeable.
In contrast, the anterior part of my right testicle is less prominent, while the posterior part is larger and seems to extend slightly below the right testicle.
Could this be the epididymis? -- There is a high possibility.
If it is the epididymis, is it normal for the epididymis of both testicles to be different? -- It is normal for the epididymis to vary between sides.
If there is something abnormal, could it be due to testicular torsion or other causes? -- Testicular torsion is unlikely (as it is an emergency).
If this is not the epididymis, what could it be? It shouldn't be serious, right? -- It could be related to blood vessels or tissue.
Additionally, during my self-examination, my left testicle accidentally rotated (anterior became posterior, posterior became anterior), but it immediately returned to its original position, and afterwards, I did not experience the severe pain or discomfort associated with testicular torsion.
Does this mean there is no cause for concern? Could there be any long-term effects (such as a higher likelihood of testicular torsion in the future)? I'm a bit worried.
-- There should be no issues.
If pain persists, you should seek medical attention.
Lastly, I would like to ask if self-examination of the testicles is necessary, or is it better to not worry about it? -- Seeking medical attention is much better than self-examination.
Wishing you good health.

Reply Date: 2021/08/09

More Info

Understanding testicular concerns can be quite complex, especially when differentiating between normal anatomical structures and potential pathological conditions. In your case, you are observing variations in the epididymis and testicular structures, which raises several important questions.

Firstly, the epididymis is a coiled tube located at the back of each testis, responsible for storing and maturing sperm. It is normal for the epididymis to feel soft and somewhat distinct from the testis itself. Variations in size and shape between the left and right epididymis can occur and may not necessarily indicate a problem. However, significant asymmetry, especially if accompanied by pain, swelling, or changes in the texture of the testis or epididymis, should be evaluated by a healthcare professional.

Regarding your observation that the left testis feels thicker at the front and smaller at the back, while the right testis has a less pronounced front and a larger back, this could simply be a normal anatomical variation. However, if you notice any discomfort, swelling, or changes in the consistency of the tissue, it is crucial to seek medical advice. Conditions such as epididymitis (inflammation of the epididymis), testicular torsion (twisting of the testis), or even tumors can present with similar symptoms and should be ruled out.

You mentioned that during self-examination, the left testis rotated slightly but returned to its normal position without causing severe pain. This is a reassuring sign, as testicular torsion typically presents with sudden, severe pain and requires immediate medical intervention. If there was no significant pain or discomfort following the rotation, it is unlikely that you have experienced torsion. However, it is essential to remain vigilant, as recurrent torsion can occur in some individuals, particularly if there is an anatomical predisposition.

As for the necessity of testicular self-examinations, they are indeed recommended as a proactive measure for detecting abnormalities early. Regular self-exams can help you become familiar with the normal feel and appearance of your testicles, making it easier to notice any changes. If you find any lumps, swelling, or other unusual changes, it is advisable to consult a healthcare provider promptly.

In summary, while variations in the size and shape of the epididymis and testis can be normal, any significant changes or discomfort should be evaluated by a medical professional. Regular self-examinations are beneficial for early detection of potential issues, and if you have any concerns, do not hesitate to reach out for a thorough evaluation. Your health and peace of mind are paramount, and addressing these concerns with a healthcare provider can help alleviate any anxiety you may have.

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