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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How to cure tightness,discomfort on the testicular region?

Hello thank you. My name is Joseph I am 23 years old male and I am 5'11". I am currently a student.
Location -Left testicular epididymal region
Onset -2 weeks previous
Duration -constant
Intensity -No pain, tight discomfort, feeling of painless fullness, sensation of larger feeling of testicular region on the left and penile region.
Character -tight, swollen feeling, uncomfortable, not painful, in penis and epididymal region.
Aggravating of symptoms -leaning in a forward position, so when blood flow increases to the testicular region. However, not increases with increase in intra-abdominal pressure, sneezing, straining, or coughing.
Relieving of symptoms -none known will not disappear once appears there, symptoms are progressing.
Associated symptoms -painless swelling and hardening of the corpus cavernosum.
Systems review -no pain or problems with urination, no problems or pain with erection, no problems or pain with ejaculation, no open sores, no previous sores, both testicles are normal in size and painless and the swelling is not associated with the testicle itself or that inferior most region.

Past medical history -one sexual partner ever for the past 6.5 years and when I met her she was a virgin. We have been using condoms for the last 9 months and we have intercourse approximately twice per month. There has been no unprotected sex in that last 9 months. Never been diagnosed with a medical condition. Never had trauma to the region. Never had an infection of the region. Did not recently have any type of infection or illness. Did not recently travel to a different country or area or farm.

Physical exam -Observation -reveals left epididymal region is larger in size in comparison to other side. Testicles themselves appear symmetrical bilaterally.

Palpation reveals enlargement of the left vesicular region of the epididymis and a feeling of fullness in vasculature present just above the testicles and expanding throughout the epididymal region. According to Bates Guide to Medical Physical Examination this seems to look very similar to varicocele... to the point that I was convinced that this is the most common thing it could be based on the presentation. However, an alarming symptom occurred today when I checked my testicular region, and suddenly after 2 weeks of noticing a varicocele type presentation in my left epididymus, I also noticed a hardening of my corpus spongiosum today (without erection) it felt hard and strange to me. This was a sensation I have never felt before. I became very worried now considering these two symptoms and how quickly things seem to be progressing.
Valsava maneuver (increasing intra-abdominal pressure) does not reproduce the symptoms of fullness or swelling. Palpation of the inguinal canal is non-painful and unobstructed. Ascultation of the left testicle did not reveal any abnormal abdominal digestive sounds to indicate herniation.

Please let me know what you think. Directing me to a specific condition and help with whether I should consult a hospital would be appreciated. I will go to the walk in clinic tomorrow anyways. Thanks.
Thu, 2 Jun 2016
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Urologist 's  Response
Hello Joseph,
As an Urologist,i can understand your anxiety.
You've given a detailed history,which's similar to that seen in Varicocele.
You'll need to do a scrotal doppler ultra-sound scan.
This should be able to give a good idea, of the cause of your symptoms.
The other possibility is of an epididymal cyst.
You can send the scan to me,as a direct question,for an expert opinion.
Dr.Matthew J.Mangat.
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