Hardness and Pain in the Testicle: Possible Causes - Urology

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The testicles feel firm to the touch?


Hello doctor, in the past few months, I have noticed intermittent dull pain in my left testicle.
Sometimes it feels very hard and lacks elasticity compared to the right side, but at times it returns to normal.
A few weeks ago, I felt some improvement, but recently the symptoms have started again.
Upon self-examination, there is no noticeable enlargement compared to the right side.
Could this be a testicular tumor or epididymitis?

Jack, 10~19 year old female. Ask Date: 2013/12/23

Dr. Xu Weikai reply Urology


Jack: Hello, it's difficult to make an accurate diagnosis online.
I recommend consulting a nearby urologist.
If necessary, a testicular ultrasound examination may also be required.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Online responses should only be used as a reference; if needed, it is essential to seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2013/12/23

More Info


The symptoms you are experiencing with your left testicle, including intermittent dull pain and hardness, can be concerning and warrant further evaluation. While I cannot provide a definitive diagnosis without a physical examination and appropriate imaging studies, I can outline some potential causes of your symptoms and recommend steps for further investigation.

1. Epididymitis: This is an inflammation of the epididymis, the tube that carries sperm from the testicle. It can cause pain and swelling in the affected testicle. Epididymitis is often caused by infections, which can be bacterial or viral. In sexually active individuals, sexually transmitted infections (STIs) like chlamydia or gonorrhea are common culprits.

2. Orchitis: This refers to inflammation of the testicle itself, which can occur due to viral infections (such as mumps) or bacterial infections. Orchitis can cause swelling, tenderness, and pain in the affected testicle.

3. Testicular Torsion: This is a medical emergency where the spermatic cord becomes twisted, cutting off blood supply to the testicle. Symptoms include sudden, severe pain and swelling. If you experience acute pain, nausea, or vomiting, seek immediate medical attention.

4. Hydrocele: This is a fluid-filled sac around the testicle that can cause swelling and discomfort. It is usually painless but can lead to a feeling of heaviness or fullness.

5. Varicocele: This is an enlargement of the veins within the scrotum, which can cause a dull ache and a feeling of heaviness. It is often described as feeling like a "bag of worms."
6. Testicular Tumors: While less common, testicular tumors can present with hardness or a lump in the testicle. They may or may not be painful. It is crucial to have any new or unusual masses evaluated by a healthcare professional.

7. Hernia: An inguinal hernia can cause discomfort in the groin and may present with a bulge. This can sometimes be mistaken for testicular issues.

Given that your symptoms have fluctuated, it is essential to consult a healthcare provider for a thorough examination. They may perform a physical examination, ultrasound imaging, and possibly blood tests to assess for infection or tumor markers.
In the meantime, monitor your symptoms closely. If you notice any sudden changes, such as increased pain, swelling, or the development of a lump, seek medical attention promptly. Avoid any activities that may exacerbate your symptoms, and consider discussing your concerns with a urologist, who specializes in male reproductive health.

In conclusion, while there are several potential causes for the symptoms you are experiencing, only a healthcare professional can provide a definitive diagnosis and appropriate treatment plan. Early evaluation and intervention are crucial for the best outcomes, especially if there is a concern for more serious conditions like testicular tumors or torsion.

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