Dear Mike,
There are several different conditions that can give you the impression that one testicle is larger than the other and give you a sensation of pressure. These conditions can be either benign conditions like a hydrocele or hernia, or malignant like a lymphoma or other testicular tumor. To determine which abnormality you are suffering from, you first need to undergo a thorough history and physical. This may be followed up by a scrotal ultrasound to help your physician finalize his diagnosis. Which diagnosis is most likely will depend upon your age.
One likely diagnosis is a hydrocele. A hydrocele is a fluid collection that is usually between the layers of the tunica vaginalis covering the testicle. Hydroceles in infants and children are usually due to a congenital anatomical defect. However, hydroceles in adults are more frequently due to infection, tumor or trauma. The most common symptoms associated with hydroceles are scrotal enlargement(either on one side or both), a sensation of heaviness, and occasionally discomfort radiating along the inguinal area to the midportion of the back. Once it is determined that the hydrocele is not caused by a malignant condition, the decision whether or not to operate is based on the level of patient discomfort. If the patient does opt for surgery, usually a simple outpatient surgery will be curative. Once again I would like to stress the importance of you undergoing a complete history and physical by a physician.
This information is provided for general medical educational 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).
Sincerely,
HFHS M.D.-BL