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enlarged testicle with no pain

My son, age 10, has had one enlarged testicle for several years. The enlarged testicle varies in size from one and a half times to a little more than two times the size of the other testicle, depending upon how active my son is. When he plays in a baseball game for example, the enlarged testicle becomes twice the size of the other one, sometimes larger if the weather is hot. By the next morning it returns to the non-active size which is about one and a half times as big as the other one. He has never had any pain associated with the enlarged testicle. He says that it feels "gooshy" when he squeezes it. The color and outward appearance of the enlarged testicle is the same as the other one, just larger and somewhat less defined, like it has fat in it. My son is very afraid of pain, afraid of doctors, and very self-conscious about the testicle and he does not want to see a doctor about it. We are ready to make him see a doctor, but we would like to go into the experience with some information about what the problem might be, and what to expect. What do you think could be the matter, what should we expect the examination to be like, and should we bypass the family physician and go directly to a urologist or some other specialist? (We don't have health insurance, so if the physician is going to send us to a specialist anyway, we'd like to just go directly to the specialist ourselves.) Thank you very much for your help.
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233190 tn?1278553401
I would go directly to the specialist - likely a urologist.  Possibilities can include a hydrocele (a fluid collection within the scrotum), varicocele (a dilation of the spermatic veins, leading to scrotal enlargement), as well as a cyst.  

The next test to order would be a scrotal ultrasound, which can evaluate for each of these diseases.

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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