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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 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.
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.
Epididymal cyst is a harmless sac in the testicles filled with fluid. [2] The most frequent clinical presentation occurs when a routine physical examination yields an unexpected finding, which is then confirmed by scrotal ultrasonography . [ 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.
The cremasteric reflex (elevation of the testicle in response to stroking the upper inner thigh) remains normal. [1] This is a useful sign to distinguish it from testicular torsion. If there is pain relieved by elevation of the testicle, this is called Prehn's sign, which is, however, non-specific and is not useful for diagnosis. [13]
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]