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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Hi I noticed a lump on the bottom of my

Answered by
Dr.
Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10114 Questions

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Posted on Thu, 28 Feb 2019 in Urinary and Bladder Problems
Question: Hi

I noticed a lump on the bottom of my left testicle around 1½ year ago. At the same time I noticed I had some occasional pain in the testicle and sometimes especialyl after sitting a lot I would have a burning or pinching sensation in the perineum area/ballsack.

I went to my doctor who referred me to get an ultrasound of the lump. The result was that I had a varicocele and I think the lump was part of the varicocele but it wasn't anything bad and they sent me home with no more info.

The result from the ultrasound:

(beware I translate this from XXXXXXX and it may be translated incorrect)
Both testicles are morphological normal with kept Parenchym (not sure about this word) by Doppler both equal signals without tumors or other pathology.
Extra testicular seen on left side, filled plexus pampiniformis med wide veins equal to a varicocele. By scanning kidneys look normal in the left side.

The pain I experience comes from sitting and or when I squueze my legs tight and thereby squeezing my testicles and the ball-sack tighter. I notice this when I sit straight on my perineum and when I lay down on the stomach and the pressure is put on the genital area. This is not very painful, but a constant sensation that annoyws me. It keeps me from sitting and relaxing.

I work in office and sit all day and it makes it hard to get through a day. The pain while ongoing comes almost imediately as I sit down again. It also annoys me in the night when I lie on my stomach or when I lay on the side and my legs tightens around my ball-sack.

I have these questions to the above:

1) What does the above result mean?
2) On the back of my left testicle I feel a lot of lumps, and the biggest one is at the bottom slightly to the left of the back/bottom of my left testicle. Is this lump caused by the varicocele or is it a vein that is so low?
3) I sometime notice the lump at the bottom of my left testicle when showering and it looks sometimes bigger, is this normal and why is it often after a shower I notice this? It's visible when it's worst.
4) What is causing the pain I experience? What can I do about it?
5) Should I worry about the lump on the back and this pain in the perineum/ball-sack/testicles?
6) I also experience this slightly itchy sensation sometimes in the skin on my ball sack that is directly where the varicocele is and the lump is located.
7)I struggle to sit a whole day at work, but standing doesn't seem to help me either, what is the best way to do it?
8) I don't think my testicles themselves are swollen, but my genital area feels slightly swollen, could this be the varicocele veins that are swollen?

I appreciate the answer, especially in regards to the lump on the lower part of the testicle, since I can't find anything in regards to having lumps on the lower part being because of varicocele online.
doctor
Answered by Dr. P. T. Patil 49 minutes later
Brief Answer:
The lump that you have is grade 2-3 Varicocele on Left side

Detailed Answer:
Hello
Thanks for query .Based on the facts that you have posted the lump that you have at the bottom of left testicle is dilated engorged pampiniform plexus of testicular vein that caries impure blood from testis to left renal vein .
I would briefly explain about the patho physiology Varicocele .
There are non returning valves located in veins of lower extremities and testicles that carry impure blood from legs and testicles to heart .These valve prevent falling of blood column when the individual is in upright position .However in Varicocele these valves become incompitant resulting into falling of blood column causing dilatation and engorgement of the veins which we call it Varicocele in case of testicular veins and Varicose vein in legs

It is the result of mechanical defect from birth and can not termed as a disease hence can not be cured with medicine ..

I would answer your questions point to point

1) The report suggests a bunch tributaries of dilated veins carrying impure blood from left testis .

2)The lump is a bunch of dilated veins .and not any thing else (Mass).

3) As explained earlier one is in upright position while taking shower which causes entire column of blood to fall down causing lump to be visible large and prominent .It is normal .

4)The pain is caused by the nerve ending in the walls of the vein being stretched due to dilatation.I would suggest the remedy at the end of our discussion (Para 7) .

5)There is nothing to be worried about it as long as you can bear the pain however if it increases over a period of time best option is to under go surgery of Varicocelctomy where dilated veins are are ligated and excised .
6)The itchy sensation over scrotum is not related to Varicocele and can be treated with appropriate anti fungal cream like Mecanozole and proper personal hygiene .

7)The best remedy is to use scrotal support which prevents testicles from being hanging down and prevents stretching of veins .You can get this scrotal support in Pharmacy.However if pain persists or you notice lump to be increasing in size it would be better to undergo surgery which I have explained earlier.

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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