enlarged left testicle and epididymis?

Posted by Chuck on May 29, 1999 at 12:36:45
Over the last 9 months, my left teticle appears to have become larger than the right testicle,and a marble size mass has appeared behind (posterior) to the left testicle.  I assume that the mass is the epididymis or attached duct.  Is this most likely inflammation of both structures, or something more serious? I will make an appointment to see a urologist, but that usually takes some time, so I am seeking advice in the interim.

Posted by HFHS M.D.-KR on June 02, 1999 at 08:45:28

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Dear Chuck,
       A scrotal ultrasound should be performed immediately to evaluate the testicle for a mass, if your physician is not comfortable with the findings on physical examination.. Other lumps and fluid collections in the scrotum include hydroceles,  and spermatoceles The lump that you describe at the top of testicle or epididymis could represent a torsed appendix testis. Other possibilities include a loculated hydrocele or small spermatocele or a testicular cancer.
Hydrocele is a collection of fluid around the testicle that may be caused by a number of things including  previous infection/inflammation of the testicle or a previous hernia. A spermatocele is  a collection sperm containing fluid which is usually located at the head of epididymis. Both of these can cause the finding of a fluid collection on ultrasound. Hydroceles can be associated with pain. If  a hydrocele is associated with inflammation ( like epididymitis), pain secondary to the infection of the epididymis or the hydrocele can occur.
Testicular cancer usually is first noticed as a lump on the testicle. It may be painful. However, most often it is painless. Associated hydroceles can occur.  This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
HFHS MD-KR
*keyword :testicular cancer

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