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Damaged testicle
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Damaged testicle

During an assault 4 months ago, I received a hard blow to the left testicle and was also injected in the left testicle with 'something'.

Since this incident:

1.My left testicle appears smaller than usual and has a 'mushy' outer surface.  Previously, left testicle was slightly bigger than right and hung lower.  Situation has now reversed (left testicle 4cm in length, right is 5cm approx.).

2.The epididymus is tender and soar and seems to generate uncomfortable pains up the left side of my body.  

3.The testicle itself is moderately painful but is getting better, I think.  

4.The variocele problem I already had appears worse.

5.I have experienced lower sex drive, reduced ejaculation volume and reduced physical performance when exercising.  Loss of energy / will.

6.Left testicle is much colder than right in morning.

7.Apparent change in volume of left testicle when going from standing to sitting.  May be hydrocele.

I had an ultrasound.  Results were:

1. 0.4cm left variocele.

2. 0.2cm epididymal cyst.

3. 3 small hyperchoic foci (<3mm) in left testicular parenchyma.  Consistent with microlithiasis.  Acoustic shadowing not seen.  

4. 1.3cm deep left hydrocele.

No other abnormalities.

(a)Could I have epididymitis?

(b)Is there any way of determining whether the left testicle works?

(c)What else could cause these symptoms.
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To answer your questions:
1) Possible, but less likely given the results of the ultrasound.  You can consider a urine test for infection as well as testing for STDs for further evaluation.

2) You can consider Doppler blood flow studies (which can be done during the ultrasound) to ensure there is no problems with the blood vessels.  

3) The results of the ultrasound may lead to the symptoms.  If there is concern, or if the symptoms are getting worse, you can consider surgical options to resolve the varicocele, cyst and hydrocele.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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