Testicular disease can present in many forms including some benign findings, although it can be very difficult to discern from life threatening disease states and needs to be carefully evaluated by a Physician.
The findings can present as either enlargement of the scrotum on one or both sides of the genitals versus areas of firm masses or tenderness that can slowly develop or maybe relatively acute in onset. It is important to see a Physician for any significant pain or changes in the testicles which should be examined routinely every month similar to women performing monthly breast exams. This can be embarrassing for many men to discuss this with their Physician, although delaying evaluation may pose significant risks to your health.
One of the most important findings to evaluate are testicular masses to be sure that this does not represent testicular cancer which is the most common cancer found in men between the ages of 18 and 35, although it can be found outside of that age group as well. The majority of these cases are curable although they need to be diagnosed quickly.
- EPIDIDYMITIS – There are also many benign diseases which can be distressing or cause pain including epididymitis which is inflammation within the tubule system next to the testicle which can cause significant redness, tenderness and even fever. It can progress relatively quickly and it needs to be evaluated and treated appropriately otherwise it can lead to damage to the testicle possibly requiring even removal of the testicle.
- TESTICULAR TORSION – Torsion presents itself very acutely typically with severe pain in the affected testicle where the testicle has twisted its blood supply resulting in the blood supply being compromised. This is usually a significant emergency and needs to be evaluated immediately in order to keep the testicle viable and it should be evaluated in the Emergency Room upon the first signs of acute testicular pain.
- HYDROCELE – A hydrocele is a fluid collection that develops around the testicle and this typically occurs relatively slowly, although it can be the result of an acute process as well and needs to be evaluated carefully to be sure that it is not the result of a testicular mass or tumor. This can be uncomfortable due to increasing size and requires a complete physical examination to be sure that there is no underlying pathology and it typically can be treated with surgical procedures.
- VARICOCELES – Varicoceles are dilated veins which return blood from the testicle back to the body. Typically varicoceles are seen just above the left testicle. If it is noted above the right testicle it certainly requires further evaluation by a Physician and possible imaging studies to be sure that there is no obstruction of the blood flow returning from that testicle. This can lead to issues with fertility and possible discomfort and need to be evaluated appropriately.
It is difficult to tell with many testicular abnormalities whether they represent significant disease such as testicular cancer versus other more benign findings. Any abnormality should be evaluated carefully by a Physician with physical examination and possible x-ray imaging.