Testicular Issues: Symptoms, Concerns, and Solutions - Urology

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When it comes to testicular issues, it's essential to approach the symptoms and concerns with a clear understanding of the anatomy and potential complications involved. Based on your description, you have two primary concerns: the positioning of your left testicle and the presence of an oval-shaped mass in the scrotum.


1. Left Testicle Positioning
The first issue you mentioned is the left testicle's tendency to adopt a horizontal position, particularly when the scrotum relaxes due to heat or other factors. This phenomenon can be concerning for a couple of reasons.
Testicular Torsion Risk: Testicular torsion occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle. While your description does not indicate that you have experienced acute pain or swelling, the abnormal positioning of the testicle could theoretically increase the risk of torsion, especially if the testicle is not anchored securely in the scrotum. However, torsion is more commonly associated with sudden onset pain and requires immediate medical attention.

Surgical Options: If the positioning of your testicle is causing you discomfort or concern, surgical intervention may be an option. A procedure called orchidopexy can be performed to secure the testicle in its proper position within the scrotum. This surgery can help prevent torsion and alleviate any associated discomfort. It is advisable to consult a urologist who can assess your specific situation and recommend the best course of action.


2. Oval-Shaped Mass in the Scrotum
The second issue you raised is the presence of an oval-shaped mass on the anterior side of the left testicle, which you describe as being about the size of two grains of rice. The fact that it is painless but causes discomfort upon touch is noteworthy.

Possible Causes: This mass could be a variety of things, including:
- Epididymal Cyst: A common benign condition where fluid-filled sacs develop in the epididymis, often asymptomatic unless they become large.

- Spermatocele: Similar to an epididymal cyst, but specifically involves sperm fluid.

- Varicocele: Enlarged veins within the scrotum that can sometimes present as a mass.

- Testicular Tumor: Although less common, any new mass in the scrotum warrants careful evaluation to rule out malignancy.

Diagnostic Imaging: Given that this mass has been present for seven years and is causing discomfort, it would be prudent to undergo an ultrasound examination. An ultrasound can provide valuable information regarding the nature of the mass, whether it is solid or cystic, and help determine if further intervention is necessary.


Conclusion
In summary, both of your concerns warrant further evaluation by a healthcare professional, ideally a urologist. They can perform a physical examination, order imaging studies, and discuss potential treatment options based on their findings.
It is crucial not to ignore these symptoms, especially since they have persisted for an extended period. Early intervention can help prevent complications and provide peace of mind. Remember, your health is paramount, and seeking professional advice is the best course of action.