Testicular Issues: Hydrocele vs. Hernia Explained

The right testicle is larger than the left?

Hello, Dr.
Lin.
When I was a child, I had a right-sided undescended testicle.
It wasn't until I was in the ninth grade that I noticed it started to descend slowly.
By the time I was in the tenth grade, it had fully descended, but when I palpated it, it felt like there was air or fluid inside (it shrinks when I sleep).
During a health check in the tenth grade, the doctor mentioned that it seemed like there might be some kind of hernia or hydrocele, but I don't understand the difference between hydrocele and hernia.
I was afraid of being found out by my classmates, so I just brushed it off with that doctor.
However, I've been thinking about going for a consultation by myself, but I know a lot of people and I'm afraid of running into someone I know (I feel very insecure).
I also want to add that sometimes after urinating, the area between my testicles and anus hurts quite a bit (though it doesn't happen often), and it feels tight.
In the morning or when I need to shower, my testicles can be itchy, and I have to scratch them to relieve the itch.
Additionally, there are three very small bumps on the right side of the skin beneath the glans, which look like tiny flesh-colored nodules.
This is something I've been too afraid to disclose for many years.

JJ, 10~19 year old female. Ask Date: 2006/11/13

Dr. Lin Wenxu reply Urology

Based on your description, you may have a right inguinal hernia.
I recommend that you visit a urology clinic for a thorough examination to confirm whether a hernia is present.
Regarding your other concern, I apologize, but it is not possible to provide a diagnosis based solely on your description; a physician's examination is necessary to determine the exact issue.

Please note that hernias can only be definitively treated through surgery.
Additionally, you mentioned having undescended testicles in childhood, which did not descend into the scrotum until the ninth grade, which seems rather late.
I suggest that you seek detailed treatment at a urology clinic as soon as possible.

Reply Date: 2006/11/13

More Info

Understanding testicular issues, particularly hydrocele and hernia, is essential for anyone experiencing symptoms or concerns in this area. Both conditions can present with similar symptoms, but they have distinct causes and implications.

Hydrocele is a condition characterized by the accumulation of fluid in the sac surrounding the testicle. This can lead to swelling in the scrotum, which may feel like a soft, fluid-filled mass. Hydroceles are often painless and can fluctuate in size, sometimes becoming more pronounced when standing or during physical activity. They are common in newborns and usually resolve on their own, but in older children and adults, they may require surgical intervention if they cause discomfort or are associated with other issues.

On the other hand, a hernia, specifically an inguinal hernia, occurs when a portion of the intestine protrudes through a weak spot in the abdominal muscles, often into the inguinal canal in the groin. This can lead to a bulge that may be visible when standing or straining and can be accompanied by pain or discomfort, especially during physical activities or when lifting heavy objects. Hernias do not typically fluctuate in size like hydroceles and may require surgical repair to prevent complications such as incarceration or strangulation of the intestine.

In your case, the sensation of "air" or fluid when palpating the area, along with the swelling that changes size, suggests a hydrocele. However, the pain you experience in the area between the testicle and the anus, particularly after urination, could indicate other issues, such as epididymitis or even a hernia. The small "meatballs" you describe on the skin of the glans may also warrant further investigation, as they could be sebaceous cysts or other benign growths.

It's understandable to feel self-conscious about these issues, especially in a school environment. However, seeking medical advice is crucial for your health. Many healthcare providers are accustomed to dealing with sensitive issues and can provide a discreet and professional evaluation. You might consider visiting a urologist, who specializes in male reproductive health and can offer a thorough examination and appropriate treatment options.

In summary, while hydrocele and hernia can present with overlapping symptoms, they are distinct conditions requiring different management strategies. If you are experiencing discomfort, changes in urination, or any other concerning symptoms, it is advisable to consult a healthcare professional. Early diagnosis and treatment can lead to better outcomes and alleviate any anxiety you may have about your condition. Remember, your health is paramount, and addressing these concerns is a vital step towards ensuring your well-being.

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