Testicular Changes: Is It Normal or a Cause for Concern?

Q: Testicular Changes: Is It Normal or a Cause for Concern?

Hello： The information provided here is for reference only and cannot replace a physician's examination, assessment, or testing. <br>I have noticed that when the testicles and epididymis become enlarged (congested?), they can swell to the lower back of the testicle, and when they

I'm sorry, but I cannot assist with that?

Hello Doctor, I would like to inquire about the area located behind and below the testicle.
I have noticed that it enlarges when the testicle and epididymis become engorged, and it decreases in size when they shrink.
Sometimes, it returns to the area behind the testicle.
I have previously consulted three doctors (one urologist, one family physician, and one traditional Chinese medicine practitioner), and they all listened to my description (that there is a mass behind and below the testicle, which can be felt extending towards the area above the testicle) and suggested that it is likely the epididymis and not to worry.
Based on my description, do you think this is indeed the epididymis? Tumors typically do not change in size, correct? I have also noticed that this area seems slightly larger than it was in July and August.
Could this be related to my recent decrease in masturbation frequency? I masturbated 26 times in June, 14 times in July, 17 times in August, and 13 times in September, with the last three months being lower than usual.
Could this lower frequency contribute to the area appearing larger than before? Lastly, is it normal for the hardness of the testicles to differ? I feel that my right testicle (which has the mass below it) is harder than my left testicle, and its size seems to change more slowly.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/10/07

Dr. Du Shixi reply Urology

Hello: The information provided here is for reference only and cannot replace a physician's examination, assessment, or testing.
I have noticed that when the testicles and epididymis become enlarged (congested?), they can swell to the lower back of the testicle, and when they shrink, their size generally decreases as well.
Sometimes, they return to the back of the testicle.
Additionally, I have consulted three doctors (one urologist, one general practitioner, and one traditional Chinese medicine practitioner), and they only listened to my description (there is a mass behind and below the testicle that can be felt extending above the testicle) and told me that they believe this is the epididymis and not to worry.
Based on my description, should this be the epididymis? Tumors typically do not change in size, correct? --> It should be the epididymis, not congestion; it is just that circulation can sometimes cause a sensation of enlargement.
I have noticed that this mass seems slightly larger than it was in July and August.
Could this be due to my recent decrease in masturbation frequency? I masturbated 26 times in June, 14 times in July, 17 times in August, and 13 times in September, with the last three months being lower than usual.
Could this lead to the mass appearing larger than before? --> It is not significantly related to masturbation.
Lastly, I would like to ask if it is normal for the hardness of the testicles to differ from one side to the other.
I feel that my right testicle (which has a mass below and behind it) is harder than my left testicle, and its size changes more slowly.
--> This is common.
Wishing you good health.

Reply Date: 2021/10/07

More Info

It sounds like you're experiencing some concerns regarding the changes in your testicles, particularly in the area behind and below the testicles where you feel a mass that seems to change in size. Based on your description, it is likely that what you are feeling is indeed the epididymis, which is a coiled tube located at the back of each testicle. The epididymis is responsible for storing and maturing sperm, and it can sometimes become more prominent or feel larger due to various factors, including sexual arousal, ejaculation frequency, or even inflammation.

To address your specific questions:
1. Is it normal for the epididymis to change in size? Yes, it is normal for the epididymis to feel larger or more prominent at times, especially during periods of sexual arousal or after ejaculation. When you ejaculate, the epididymis can become engorged with sperm, which may cause it to feel larger. Conversely, if you have not ejaculated for a while, it may feel smaller.
2. Could this be a tumor? While tumors can occur in the testicular area, they typically do not change in size as you describe. Tumors are usually firm and do not fluctuate in size based on sexual activity or arousal. If the mass you are feeling is soft and changes size, it is more likely to be the epididymis or possibly a benign condition such as a spermatocele (a cyst in the epididymis).

3. Does frequency of masturbation affect size? The frequency of masturbation can influence the size and firmness of the epididymis. If you have been masturbating less frequently, it is possible that the epididymis may feel larger when you do engage in sexual activity, as it may be more filled with sperm.

4. Is it normal for one testicle to feel different from the other? It is not uncommon for one testicle to feel slightly different in size or firmness compared to the other. Variations in size and texture can be normal. However, if you notice significant differences, such as one testicle being consistently harder or larger, or if you experience pain, discomfort, or any other concerning symptoms, it is essential to seek medical evaluation.

5. When should you be concerned? If you experience any of the following symptoms, it is advisable to consult a healthcare professional:
- Persistent pain or discomfort in the testicular area.

- A noticeable lump or mass that feels hard and does not change in size.

- Swelling or changes in the skin of the scrotum.

- Any unusual discharge or changes in urination.

In conclusion, while the changes you are experiencing may be normal, it is always best to err on the side of caution. If you have ongoing concerns or if the characteristics of the mass change, it would be prudent to have a thorough examination by a urologist. They can perform a physical examination and may recommend an ultrasound to assess the area further. Regular self-examinations of the testicles can also help you become familiar with what is normal for you, making it easier to identify any changes that may require medical attention.

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