Asymmetrical Testicles: When to Seek Medical Advice

Testicular issues - asymmetrical testicular position?

Hello, doctor.
Thank you very much for your review.
I recently noticed that my left testicle is significantly lower than the right, measuring approximately 2 centimeters at its highest point.
The weather has been colder lately, causing my scrotum to contract, making this symptom particularly noticeable.
However, when the scrotum is relaxed, the right testicle also descends, and both sides return to a normal position.
About a month ago, I began experiencing discomfort and a dull ache in the left testicle, and I visited the doctor three times, where only physical examinations were performed, and the doctors concluded that there were no issues.
Recently, while showering and urinating, I noticed a significant abnormality, but there is no pain or discomfort.
I would like to ask you, doctor: 1.
Is this possibly just a natural phenomenon? (If it does not affect fertility, I wouldn’t mind the appearance.) 2.
Do you think I need to seek medical attention again? 3.
Could this be testicular torsion? Thank you for your review, doctor.
Additionally, during my previous visits, I was even advised by a doctor that I was making a big deal out of a minor issue and that I did not need to seek medical attention.
However, I understand that my actions may have been a waste of healthcare resources.
Therefore, I kindly ask you to carefully assess whether I need to seek medical attention again.
Also, aside from the height difference, there are times when there is a significant front-to-back disparity, but the height appears normal.
There has been no pain or discomfort, and it does not affect my daily life, except for the psychological concern.
Thank you again for your review, and I wish you well.

Ren, 10~19 year old female. Ask Date: 2021/12/21

Dr. Li Xinyi reply Urology

The younger you are, the more you should pay attention to your health care; it cannot be considered a waste of health insurance.
Especially whenever there are changes or if you feel something is wrong, you should not hesitate to return for a follow-up.
Although the two sides of the body may not be perfectly symmetrical, significant differences should still be taken seriously.
Generally speaking, the situation is likely benign; for example, there may be a varicocele on the left side, which requires a thorough physical examination or a scrotal ultrasound.

Reply Date: 2021/12/21

More Info

When it comes to asymmetrical testicles, it’s important to understand that variations in size and position can be quite common among men. However, certain symptoms and changes can warrant further medical evaluation. Based on your description, here are some insights and recommendations regarding your situation.

1. Natural Variation: It is indeed possible that the differences in the height of your testicles are a natural phenomenon. Many men experience asymmetry in their testicles, and it can be influenced by various factors such as temperature, body position, and muscle tone. The scrotum is designed to regulate the temperature of the testicles, which is crucial for sperm production. When it’s cold, the scrotum contracts, which can make one testicle appear lower than the other. Conversely, when warm, the scrotum relaxes, allowing both testicles to hang lower.
2. Symptoms of Discomfort: The discomfort and pressure you mentioned in your left testicle, especially if it has been persistent, should not be ignored. While it’s possible that the discomfort is related to the natural position of the testicle, it could also indicate other conditions such as epididymitis (inflammation of the epididymis), a hernia, or even testicular torsion, which is a medical emergency. Testicular torsion typically presents with sudden, severe pain and swelling, but it can sometimes manifest with less acute symptoms, especially if the torsion is intermittent.

3. Need for Medical Evaluation: Given that you have experienced discomfort and have noticed significant changes in the position of your testicles, it is advisable to seek further medical evaluation. While previous examinations may have concluded that there was no issue, your ongoing symptoms and the recent changes you’ve observed warrant a second opinion. A thorough examination, possibly including an ultrasound, can help rule out any underlying conditions that may require treatment.

4. Psychological Impact: It’s also important to consider the psychological aspect of your concerns. Even if the physical symptoms do not significantly impact your daily life, the anxiety and worry about your condition can affect your overall well-being. Discussing your concerns with a healthcare provider can provide reassurance and help you understand what is normal and what might need attention.

5. When to Seek Immediate Care: If you experience any sudden severe pain, swelling, or changes in color of the scrotum, or if you notice any lumps or masses, you should seek immediate medical attention. These could be signs of conditions that require urgent intervention.

In conclusion, while asymmetry in testicles can be a normal variation, the discomfort you are experiencing and the noticeable changes in position are reasons to consult a healthcare professional again. It’s better to err on the side of caution when it comes to your health. A urologist can provide a comprehensive evaluation and address any concerns you may have about fertility or other potential issues. Remember, your health and peace of mind are paramount, and seeking further evaluation is a responsible step.

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