Doctors' Answers to "Frequently Asked Questions" - Testicles

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Infection after Vasectomy [posted 1/14/99]
Question: Three weeks ago I had a vasectomy. The pain increased after the operation. One week later I saw a physician who prescribed Sulfatrim for 2 weeks. It helped somewhat. As soon as I stopped taking the drug the pain increased. I have now been prescribed Cipro 500 mg for 10 days. The assumption is that I have an infection. There is no swelling or redness visible. The physician on duty stated that I should see my Urologist because it is possible that there is an abscess. If the Cipro makes me feel better can I assume that there is no abscess? Is there anything else that could cause the pain. I feel lower abdominal pain and my testicles feel like they are swollen even though they show no signs of swelling.

Answer: If an antibiotic helps, I'd assume you have an infection. Whether it is an abscess or just a tissue infection remains to be seen.

Testicular Lump [posted 1/14/99]
Question: I have a friend that is 26 years old, he recently discovered a lump on one of his testicles. The medical clinic he went to gave him some antibiotics, and ibuprofen for the pain. He has taken all the medications and still the lump is there and the pain is severe in the lower abdominal areas. What should be done?

Answer: See a urologist.

Testicle Pain [posted 1/7/99]
Question: I am a 16 year old male and I have been having a pain in my right testicle. It is not that severe and sometimes is not there at all. Something else that I noticed is that they are uneven, but I have read that that is nothing to be worried about. I have checked for lumps and have not found any so I wondering what could be the cause?

Answer: Not cancer, but get it checked. Could be referred pain from your right kidney (stone etc.) or a low-grade infection in the spermatic collecting system (pretty common) or a partial rotation of the testicle (which would need fixing).

Testicle Size [posted 7/17/98]
Question: My Husband is 25 years old and he has one testicle that is bigger then the other. He has had it for quite a while. They don't feel too different. Should he see a doctor?

Answer: This is not usually a problem unless there is greater than 50% difference. If he had mumps as a child it may have affected his testicles. If not, this is a normal variation. As long as he has erectile function, no problem.

Enlarged testicles
Question: Is there anything to worry about when a man's testicles are getting bigger? I'm 39 and my testicles are getting bigger year by year. I don't have "elephant" balls, but they are bigger - much bigger - than when I was even 30.

Answer: These usually represent cysts or more commonly varicose veins in the testicles. These are very common and are more prevalent on the left side due to the different blood supply of the left testicle than the right. The solid part of the testicle will be the same. The cord will enlarge. Occasionally there will be a hydrocele present . Both situations can be surgically corrected but rarely are unless there is pain or a mechanical problem.

Lump on testicle
Question: I am a 19 year old male and I have a problem . For about 1-2 years now I have had a lump on my left testicle. I didn’t pay much attention to it because I thought that it would go away . Is this one of the first signs of cancer? Could this be serious? Should I get it checked out?

Answer: Lumps on the testicles need to be seen by a health professional. Cancer of the testes is the most common cause of cancer in men under forty and is very fixable if present. If the lump is tender it probably is not a problem. If the lump is on the cord that the testicle hangs on it is probably no problem. If light can be shined through the testicle it probably is no Problem. However, a persistent lump needs to be seen soon.

Testicular pain
Question: I am a 55 year old male. A few weeks ago, I began to experience a persistent dull ache in my testicles. It is not a sharp pain, but a cause of mild discomfort. Alarmed that it might be cancer, I consulted a doctor. He examined me physically and drew blood for tests. He said it was not cancer because there was no "palpable mass" and that early testicular cancer is painless. Physical examination, lab results, and the absence of accompanying symptoms caused him to rule out epididymitis, varicocele, and hernia. He said my prostate gland was slightly enlarged and is condition not uncommon for a man of my age. The PSA test gave a result of 2.7, so he said nothing further need be done. With nothing to treat, he left me with the impression (though he didn't say so) that it was some sort of psychosomatic reaction. However, the ache continues. Do you think there could be some cause he overlooked? Should I take new tests?

Answer: There are a couple of possibilities. 1) This is referred pain and not actually in your testicles. Irritation in the bladder or in the tube as it enters the bladder can be experience in the testicles and the tip of the penis. This is common with kidney stones as they pass but, can be due to other irritations. 2) This represents a low grade infection. It is usually effectively treated with cipro or equivalent for 7-10 days. If it is abolished, that was the cause no matter what your physician says.

Sensitive Testicles
Question:My testicles are a little bit sensitive during sexual relations. If somebody is playing with them, there is a very light pain. It has been persistent for two years now. What to do?

Answer: The testicles are encased in a very thin layer of muscle. These allow the testicles to be retracted towards the body if stimulated or in cold weather. During sexual excitement, these muscles are stimulated. Also, the body begins to produce sperm and direct them towards the spermatic cord. Prolonged stimulation without ejaculation will produce pain called by many teens and adults-"lovers balls". These can be quite painful. Chronic ongoing pain needs to be examined to ensure that a low grade infection of the collecting system and cord called epidimitis is not present.


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