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Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. [5] Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. [5] Large varicoceles present as plexus of veins and may be described as a "bag of worms".
Testicular size starts to increase normally from 8 to 9 years of age in boys. However, in patients with macroorchidism, around this time is when the testicles become abnormally and noticeably enlarged. [11] Also, because macroorchidism is usually associated with intellectual disability, brainpower typically declines with age. [5]
A hydrocele testis feels like a small fluid-filled balloon inside the scrotum. It is smooth and is mainly in front of the testis. Hydrocele testes vary greatly in size and are typically painless and harmless. However, as the fluid continues to accumulate and the scrotum further enlarges, more discomfort can be expected.
Testicular torsion occurs most commonly at 12 to 18 years but can occur at any age. Torsion results in swelling and edema of the testis, and as the edema increases, testicular perfusion is further altered. The extent of testicular ischemia depends on the degree of torsion, which ranges from 180° to 720° or greater.
The exact cause of an epididymal cyst is unknown, but it is most likely a congenital anomaly associated with hormonal imbalances during embryonic life. [3] Previous research has shown a correlation between the development of epididymal cysts and maternal exposure to endocrine disrupting substances like diethylstilbestrol during male fetal development.
Typical findings are redness, warmth, and swelling of the scrotum, with tenderness behind the testicle, away from the middle (this is the normal position of the epididymis relative to the testicle). The cremasteric reflex (elevation of the testicle in response to stroking the upper inner thigh) remains normal. [ 1 ]
Spermatocele is a fluid-filled cyst that develops in the epididymis. [3] The fluid is usually a clear or milky white color and may contain sperm. [4] Spermatoceles are typically filled with spermatozoa [5] and they can vary in size from several millimeters to many centimeters.
While varicocele is the diagnostic term for swelling in the valveless venous distribution of the male pampiniform plexus, this embryological structure, common to males and females, is often incidentally noted to be swollen during laproscopic examinations in both symptomatic and asymptomatic females. [2]