Testicular Issues: Pain and Mass Below the Left Testicle

Below the testicles

The patient had a right-sided undescended testicle (cryptorchidism) and underwent surgery at the age of four or five to reposition and secure it in the scrotum.
An ultrasound was performed approximately two years ago, which showed that the right testicle was underdeveloped due to its late descent, but no other abnormalities were noted.
Recently, upon examination, the patient discovered a soft, lump-like structure connected to the lower part of the left testicle (not above it), which is slightly painful to touch.
The right testicle is difficult to palpate.
The patient is inquiring about the nature of this structure and whether another ultrasound examination is necessary.

Zhe, 30~39 year old female. Ask Date: 2014/08/15

Dr. Lin Hexing reply Urology

Based on your description, it seems more like a condition related to varicocele.
Whether to perform an ultrasound examination depends on the situation; generally, it is not necessary.
If prolonged standing is causing swelling and pain in the left testicle, and there are concerns about infertility, then an ultrasound examination may be considered.

Reply Date: 2014/08/15

More Info

When it comes to testicular issues, particularly pain and masses below the testicle, it is essential to approach the situation with caution and thoroughness. Based on your description, it sounds like you have noticed a soft, tubular mass below your left testicle that is somewhat painful to the touch. Given your medical history of right-sided undescended testicle (cryptorchidism) and the surgery you underwent to correct it, it is understandable that you may have concerns regarding any new developments in your testicular health.

The mass you are feeling could potentially be several things. One common possibility is an epididymal cyst or a spermatocele. The epididymis is a coiled tube located at the back of the testicle that stores and matures sperm. Cysts in this area can develop and may feel like a soft lump. They are usually benign and may not require treatment unless they cause discomfort or grow significantly.

Another possibility is a varicocele, which is an enlargement of the veins within the scrotum. Varicoceles can sometimes cause a feeling of heaviness or pain in the testicular area, particularly after prolonged standing or physical activity. They are more common on the left side due to the anatomical differences in venous drainage.

In some cases, the presence of a mass or pain could indicate a more serious condition, such as a testicular tumor or an infection (like epididymitis or orchitis). Testicular tumors can present as painless lumps, but they can also cause discomfort. Given your history of cryptorchidism, you may be at a slightly increased risk for testicular cancer, which makes it even more crucial to have any new masses evaluated.

Considering the symptoms you are experiencing, it is advisable to seek further evaluation from a healthcare professional. An ultrasound is a non-invasive imaging technique that can provide valuable information about the nature of the mass. It can help differentiate between a benign cyst, a varicocele, or other potential issues. Additionally, a physical examination by a urologist can provide further insights and help determine if any additional tests or treatments are necessary.

In summary, while the mass you are feeling could be benign, it is essential to have it evaluated to rule out any serious conditions. Early diagnosis and treatment are key to managing testicular issues effectively. If you have not done so already, I recommend scheduling an appointment with a urologist for a thorough examination and possibly an ultrasound to ensure your testicular health is properly assessed.

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