Why are the testicles one big and one small?

One testicle is one big and one is small. It may be a normal physiological phenomenon, or it may be related to diseases such as varicocele, orchitis, testicular hydrocele, and testicular tumors. Physiological differences usually do not require treatment, while pathological differences require targeted treatment based on the cause.

1. Physiological differences

Most men have slight asymmetry in the testicles on both sides, and the difference in volume within 1 milliliter is within the normal range. This difference may be related to factors such as different testicular descent times and uneven local blood flow distribution during embryonic development. It usually does not affect reproductive function or sex hormone secretion. During daily observation, you should pay attention to whether the texture of the testicles on both sides is even and whether there is any pain, so as to avoid excessive anxiety.

2. Varicocele

The left testicle is more likely to be reduced in size due to varicocele. The disease may be related to factors such as venous valve insufficiency and increased intra-abdominal pressure. It manifests as symptoms such as a feeling of swelling in the scrotum on the affected side and venous mass-like protrusions. After diagnosis, intravenous active drugs such as Maizhiling Tablets and Diosmin Tablets can be used as directed by the doctor. In severe cases, laparoscopic high spermatic vein ligation is required.

3. Orchitis

Viral or bacterial infection may cause orchitis, causing acute unilateral testicular enlargement with tenderness. Mumps virus is a common pathogen, and patients may have symptoms such as fever and red scrotal skin. In the acute stage, bed rest is required, and drugs such as ceftriaxone sodium for injection and ibuprofen sustained-release capsules can be used as directed by the doctor. In the chronic stage, local hot compresses can be used to relieve symptoms.

4. Testicular hydrocele

Failure to close the sheath may result in fluid accumulation, resulting in a unilateral, painless enlargement of the scrotum. It is mostly congenital in infants and young children, and may be related to trauma and infection in adults. A small amount of effusion can be observed, but if the volume is large, testicular tunica inversion surgery is required. Strenuous exercise should be avoided after surgery to prevent recurrence.

5. Testicular tumors

Painless progressive enlargement of the testicles requires vigilance for germ cell tumors, which are common in men aged 15-35 years. The patient may feel a hard lump with a feeling of heaviness. The diagnosis requires ultrasound examination and tumor marker detection. The main treatment is radical orchiectomy, followed by radiotherapy and chemotherapy according to the pathological type.

It is recommended to perform a testicular self-examination once a month. After taking a warm water bath, hold the scrotum flat with your hands to observe the symmetry of both sides. If you find that the testicular volume difference exceeds 20% and is accompanied by induration or pain, you should seek immediate medical attention from a urology department. Avoid long-term wearing of tight pants, sitting for long periods of time, and other behaviors that may affect scrotal heat dissipation. Maintaining moderate exercise can help improve local blood circulation. Pay attention to supplementing zinc in your diet, and eat oysters, nuts and other foods in moderation.