What causes enlargement of one testicle?

Testicular enlargement on one side may be caused by orchitis, epididymitis, hydrocele, testicular torsion, or testicular tumors. Testicular enlargement is usually accompanied by symptoms such as pain, fever, and scrotal skin redness and swelling. It is recommended to seek medical treatment in time for a clear diagnosis.

1. Orchitis

Orchitis is mostly caused by bacterial or viral infection. Common pathogens include Escherichia coli, mumps virus, etc. Patients may experience unilateral testicular swelling with severe pain, and the scrotal skin may become red and hot, possibly accompanied by chills and high fever. Treatment requires the use of antibiotics such as levofloxacin tablets and cefixime dispersible tablets as directed by the doctor, combined with bed rest and scrotal elevation. Cold compresses can be used to relieve pain in the acute stage.

2. Epididymitis

Epididymitis is often secondary to urinary tract infection or sexually transmitted diseases, and pathogenic bacteria infect retrogradely through the vas deferens. It presents as a cord-like mass above the testicle with tenderness, which may be accompanied by burning pain during urination and urethral discharge. Treatment requires the use of azithromycin granules, doxycycline hydrochloride tablets and other drugs, and sexual intercourse must be avoided until the inflammation subsides. Chronic epididymitis may form induration.

3. Hydrocele

Hydrocele is an accumulation of fluid due to the failure of the sheath to close, which manifests as painless swelling of the scrotum and a positive light transmission test. It is mostly congenital in infants and young children, and may be secondary to trauma or inflammation in adults. A small amount of effusion can be observed, but a large amount of effusion requires a sheath inversion operation. You should avoid strenuous exercise and trauma every day, and wear loose underwear to reduce friction.

4. Testicular torsion

Testicular torsion is a urological emergency in which the blood supply is interrupted due to rotation of the spermatic cord. Sudden severe pain with elevated testicular position, possibly nausea and vomiting. It can be reduced manually within 6 hours of onset, and orchiectomy is required if it exceeds 24 hours. It is more common among teenagers after strenuous exercise. Parents should seek medical attention immediately if they find abnormalities. Delayed treatment can lead to testicular necrosis.

5. Testicular tumors

Testicular tumors are more common in men aged 15-35 and manifest as painless testicular enlargement with a feeling of heaviness. Seminomas are the most common, and tumor markers such as AFP and HCG may be elevated. The diagnosis relies on ultrasound and pathological examination, and the treatment is mainly radical orchiectomy, combined with radiotherapy and chemotherapy. Monthly self-examinations can help detect lumps early.

You should keep your perineum clean and dry every day, and avoid riding or sitting for long periods of time. Choose breathable cotton underwear to avoid localized heat in the scrotum. It is forbidden to apply heat or squeeze by yourself when testicles are swollen. For acute pain, you can temporarily wrap an ice pack in a towel and apply cold compresses. It is recommended to conduct a physical examination of the urinary system every year, and parents of adolescent patients need to guide their children to correctly observe changes in the genitals. All abnormally enlarged testicles require early medical attention. Delay in diagnosis and treatment may affect reproductive function and sex hormone secretion.