Testicular Size Discrepancies in Infants: When to Seek Medical Advice

Q: Testicular Size Discrepancies in Infants: When to Seek Medical Advice

Hello! The causes of scrotal swelling include： 1. <br>Scrotal edema： 6% of full-term infants may experience scrotal edema, but most cases resolve within the first year, so it is advisable to wait until after one year to decide on surgery for neonatal scrotal edema. <br>2. <br>Her

Testicular size

Hello Doctor: My grandson is 50 days old, and I recently discovered that his testicles are different sizes, with the left measuring 5.5 cm and the right 3.5 cm.
Is this normal? It seems like they have been different sizes since birth.
Could this be a case of hydrocele? Does he need to see a doctor? Thank you.

cuu4655, 50~59 year old female. Ask Date: 2009/11/18

Dr. Pei Rensheng reply Pediatrics

Hello! The causes of scrotal swelling include: 1.
Scrotal edema: 6% of full-term infants may experience scrotal edema, but most cases resolve within the first year, so it is advisable to wait until after one year to decide on surgery for neonatal scrotal edema.
2.
Hernia: Intestines or omentum may enter the hernial sac, causing abdominal wall protrusion and potentially extending into the scrotum, which requires prompt surgical intervention.
3.
Acute epididymitis: Symptoms may include pyuria and fever.
4.
Testicular tumor: A mass may be palpable.
5.
Testicular torsion: This condition typically presents with severe pain and is more common during puberty; it is rare in newborns.
6.
Other rare causes.
Please consult a pediatrician or urologist for further differential diagnosis.
Wishing you health and happiness! Sincerely, Dr.
Pei Ren-Sheng, Chief of Pediatrics, Taoyuan Hospital, Department of Health.

Reply Date: 2009/11/18

More Info

When it comes to the development and health of infants, particularly regarding the size of the testicles, it is essential to understand what is considered normal and when to seek medical advice. In your case, you mentioned that your grandson, who is 50 days old, has a noticeable discrepancy in testicular size, with the left testicle measuring 5.5 cm and the right measuring 3.5 cm.
First, it's important to recognize that some degree of asymmetry in testicular size is common in infants and young children. Typically, the testicles may not be perfectly symmetrical, and variations in size can occur. However, a significant difference, such as the one you described, warrants further evaluation.
One possible explanation for the size discrepancy could be a condition known as "hydrocele," which is characterized by the accumulation of fluid around the testicle. Hydroceles are relatively common in newborns and usually resolve on their own within the first year of life. However, if the hydrocele is large or persists beyond the first year, it may require surgical intervention.

Another possibility is that the size difference could be related to a condition called "testicular torsion," where the spermatic cord becomes twisted, cutting off the blood supply to the testicle. This condition is a medical emergency and requires immediate attention. However, torsion is less common in infants and usually presents with acute pain and swelling.

In addition to hydrocele and torsion, other conditions such as hernias or testicular atrophy could also contribute to size discrepancies. Testicular atrophy can occur due to various reasons, including hormonal imbalances or trauma.

Given the significant difference in size that you have observed, it is advisable to consult a pediatrician or a pediatric urologist. They will perform a physical examination and may recommend an ultrasound to assess the testicular structure and rule out any underlying issues. Early evaluation is crucial, as some conditions may require timely intervention to prevent complications.

In summary, while some variation in testicular size is normal, a discrepancy as pronounced as the one you described should be evaluated by a healthcare professional. It is always better to err on the side of caution when it comes to the health of infants. Seeking medical advice will provide peace of mind and ensure that any potential issues are addressed promptly. Thank you for your inquiry, and I hope your grandson remains healthy and happy!

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