It's obvious why the testicles are one big and one small.

The obviously larger and smaller testicles may be due to physiological differences, or may be related to factors such as hydrocele, orchitis, testicular torsion or testicular tumors. It is recommended to seek medical treatment promptly to investigate the cause.

1. Physiological differences

There is naturally a slight asymmetry between the left and right testicles, and generally the difference in volume does not exceed 20%, which is within the normal range. There is usually no obvious discomfort, no hardness or tenderness on palpation of the scrotum, and no special treatment is required.

2. Hydrocele

Abnormal accumulation of fluid within the testicular tunica cavity may result in an asymmetrical appearance. It may be related to reproductive system infection, trauma and other factors, and is often accompanied by a feeling of scrotal swelling. Ultrasound examination can confirm the diagnosis, and a small amount of effusion can be observed. Significant effusion requires puncture aspiration or sheath inversion surgery.

3. Orchitis

The inflammatory reaction caused by pathogenic infection will cause the affected testicle to become swollen and congested, often accompanied by severe pain and fever. May be related to mumps virus and E. coli infection. Anti-infective drugs such as ceftriaxone sodium for injection and levofloxacin tablets need to be used, and bed rest is required in the acute stage.

4. Testicular torsion

Rotation of the spermatic cord causes blood supply to be blocked, and the testicle on the affected side will rapidly swell and harden, which is a urological emergency. It is common to experience sudden scrotal swelling and pain after strenuous exercise, accompanied by nausea and vomiting. Emergency surgical reduction and fixation are required, and the golden rescue time is within 6 hours after onset.

5. Testicular tumors

Painless progressive enlargement requires vigilance for testicular cancer, which may be related to a history of cryptorchidism and family inheritance. A hard mass can be palpated during physical examination, and tumor marker examination and CT are helpful in diagnosis. Radical orchiectomy is the main treatment method, which needs to be combined with radiotherapy and chemotherapy.

In daily life, you should pay attention to avoid impact on the scrotum and choose loose and breathable underwear. You can perform testicular palpation examination on your own every month. Use a standing position to gently roll the testicles on both sides with your hands to compare changes in size and texture. If you find that the volume difference increases, pain or induration occurs in a short period of time, you must immediately seek treatment at a urology department. Annual reproductive ultrasound screening is recommended for adult men.