Having one testicle larger than the other is often normal. Many men have some difference in size or position. However, a new change should not be ignored.
A testicular cyst can also cause a lump or swelling in or around the testicle. Most scrotal lumps are not cancer, but you cannot tell the cause by touch alone. A doctor may need to examine you and arrange an ultrasound.
So, if you have noticed a new lump, swelling, pain, or change in your testicle, it is best to get it checked.
Is It Normal to Have One Testicle Lower Than the Other?
Yes. It is common for one testicle to hang lower than the other.
The difference may be present for many years. It can also look more noticeable at some times than others.
The scrotum changes with temperature and muscle movement. The testicles can move closer to the body when you are cold and hang lower when you are warm.
Therefore, a small difference in height does not usually mean that something is wrong.
What matters more is a new or clear change from your usual appearance.
Is One Testicle Being Bigger Than the Other Normal?
A small difference in size can be normal. Your testicles do not have to be exactly the same size. One may be slightly larger or sit in a different position.
However, you should pay attention if one testicle has become larger recently.
New swelling can have many causes. These include a cyst, fluid around the testicle, infection, enlarged veins, injury, or a testicular tumour.
Because these conditions can feel similar, an examination is often needed.
What Is a Testicular Cyst?
A testicular cyst is a fluid filled sac. However, many lumps that people call a “testicular cyst” are actually located in the epididymis or other tissues around the testicle.
The epididymis is a small tube that sits behind and above each testicle. It stores and carries sperm.
An epididymal cyst can feel like a smooth lump near the testicle. Another common type is a spermatocele, which is also a fluid filled sac that usually develops near the epididymis.
These cysts are often harmless. Still, you should not try to diagnose the lump yourself. An ultrasound can help show whether a lump is inside the testicle or outside it.
What Causes One Normal Testicle to Be Bigger Than the Other?
Several conditions can cause swelling or make one side of the scrotum look larger.
Epididymal Cyst or Spermatocele
A cyst near the epididymis may feel like a small, smooth lump.
It may cause no pain at all. Some cysts stay small, while others become large enough to cause discomfort.
Treatment is not always needed. If the cyst causes pain or other problems, a urologist can discuss treatment options with you.
Hydrocele
A hydrocele happens when fluid builds up around the testicle.
It can make one side of the scrotum look larger. A hydrocele is often painless, although a large one can feel heavy or uncomfortable.
An ultrasound may be used when the cause of swelling is not clear.
Varicocele
A varicocele is an enlargement of the veins around the testicle.
It is often found on the left side. Some men have no symptoms. Others may notice a dull ache, heaviness, or a change in the size of the testicle.
A varicocele can also be linked with fertility problems in some men.
Your doctor can decide whether it needs treatment.
Infection
An infection can cause pain and swelling in the testicle or epididymis.
You may also have fever, redness, pain while passing urine, or discharge from the penis.
In younger and sexually active men, some infections can be linked to sexually transmitted infections. Other infections can have different causes.
Treatment depends on the cause. Antibiotics may be used when a bacterial infection is confirmed or strongly suspected.
Injury
A hit to the groin can cause swelling or pain.
Even when the pain seems mild, a significant injury should be assessed if swelling continues or the testicle looks different.
Testicular Cancer
Testicular cancer can cause a painless lump or swelling. It can also cause a change in how the testicle feels, pain or discomfort, or a sudden build up of fluid in the scrotum.
This does not mean that every lump is cancer. In fact, several non cancerous conditions can cause similar symptoms. Still, a new lump inside the testicle should be checked without delay.
Testicular cancer is most often diagnosed in younger men. The National Cancer Institute states that it is the most commonly diagnosed cancer in men aged 20 to 34. It is also highly treatable, and most cases can be cured.
Can a Testicular Cyst Be Cancer?
Usually, a cyst is not cancer.
The important point is where the lump is located.
A lump that is clearly outside the testicle may have a different cause from a solid lump within the testicle. This difference cannot always be confirmed by touch.
That is why an ultrasound is useful.
If you have found a new lump, do not assume that it is only a cyst. Let a doctor identify it.
When Should You See a Doctor?
You should arrange a medical check if you notice:
- A new lump in or around a testicle
- New swelling
- A testicle becoming larger
- A change in the shape or feel of a testicle
- Ongoing pain or discomfort
- A heavy feeling in the scrotum
- Fluid or swelling around a testicle
- A testicle that feels harder than before
- Swelling that does not go away
The National Cancer Institute lists a painless lump, swelling, a change in how a testicle feels, pain, and a sudden build up of fluid as symptoms that should be checked.
When Is Testicle Pain an Emergency?
Sudden and severe testicle pain needs urgent medical care.
One important cause is testicular torsion. This happens when the spermatic cord twists and reduces blood flow to the testicle.
Symptoms can include sudden severe pain, swelling, nausea, vomiting, abdominal pain, or a testicle sitting higher than usual.
Testicular Torsion is an emergency.
The testicle can be damaged if blood flow is blocked for too long. Therefore, you should go to an emergency department if you develop sudden severe testicle pain.
Do not wait for the pain to disappear on its own.
Even sudden pain that goes away can need urgent assessment because the testicle may have twisted and then untwisted.
How Is a Testicular Lump Checked?
Your doctor will first ask about your symptoms and examine the scrotum.
An ultrasound is often used to look at the testicles and nearby tissues.
It can help show whether a lump is solid or filled with fluid. It can also help doctors see where the lump is located.
If testicular cancer is suspected, blood tests may also be done. These can include tumour markers such as AFP, beta hCG, and LDH. The National Cancer Institute lists ultrasound and blood tests among the tests used when testicular cancer is being assessed.
The exact tests you need depend on your symptoms and examination.
Should You Check Your Testicles Regularly?
The National Cancer Institute says there is no standard routine screening test for testicular cancer. It also states that studies have not shown that routine self examinations in men without symptoms reduce the risk of dying from the disease.
That does not mean you should ignore changes.
If you notice a new lump, swelling, pain, or change in how your testicle feels, seek medical advice.
Knowing what is normal for your body can help you notice a new change. But you do not need to repeatedly check your testicles in an attempt to diagnose cancer yourself.
Does One Larger Testicle Affect Fertility?
Not always. A small natural difference in testicle size does not automatically mean that you will have fertility problems.
However, some conditions that cause swelling can affect fertility.
For example, varicocele can be linked with reduced sperm production in some men. Infections and some other testicular conditions can also affect fertility.
If you are worried about fertility, speak with a doctor rather than judging fertility from testicle size alone.
A semen analysis can provide useful information when fertility is being assessed.
What Should You Do If You Find a Cyst?
Do not squeeze or press the lump.
Instead, arrange an appointment with a doctor or urologist.
Tell the doctor when you first noticed it and whether it has changed in size.
Also mention pain, fever, urinary symptoms, injury, or any other change.
An ultrasound may then be used to identify the cause.
Many cysts do not need treatment. If a cyst becomes painful, large, or bothersome, you should discuss treatment with your doctor.
If you are unsure about a change in your testicle, getting it checked is the safest choice. A simple examination and, when needed, an ultrasound can help find the cause.
Also Read: Ways to Manage Kidney Pain
