The testicles are bigger on one side and smaller on the other.

Testicles that are larger on one side and smaller on the other may be a normal physiological phenomenon, or may be related to hydrocele, orchitis, varicocele, testicular tumors and other diseases. It is recommended to seek medical treatment promptly to clarify the cause and avoid delaying treatment.

1. Physiological differences

Most men have slight asymmetry between their testicles, with the volume difference usually not exceeding 20%. This difference is related to the different testicular descent time during embryonic development. It is a normal anatomical variation and does not require special treatment. Just pay attention every day to observe whether it is accompanied by pain or sudden changes in volume.

2. Hydrocele

Abnormal accumulation of fluid in the testicular vaginal membrane can lead to significant unilateral scrotal enlargement, which may be related to unclosure of the vaginal process, infection, or trauma. Patients often present with a swollen feeling in the scrotum and a positive light transmittance test. Clinically, sheath inversion surgery or puncture and fluid extraction are commonly used. Anti-infective drugs such as cefixime dispersible tablets and levofloxacin tablets can be used.

3. Orchitis

Testicular inflammation caused by viral or bacterial infection can cause unilateral swelling and pain. Common pathogens include mumps virus, Escherichia coli, etc. When accompanied by symptoms such as fever and difficulty urinating, acyclovir tablets as an antiviral tablet or ceftriaxone sodium for injection as an anti-infection is required. In the acute stage, bed rest and scrotal support are required.

4. Varicocele

When the left spermatic vein backflow is blocked, the testicle on the affected side may shrink in size due to congestion. The pain in the scrotum is obvious after standing for a long time, and vermiform varicose veins can be palpable on physical examination. Mild cases can be relieved by wearing a scrotal band, while severe cases require laparoscopic high spermatic vein ligation.

5. Testicular tumors

Painless testicular enlargement should alert you to germ cell tumors, which should be as hard as a stone when palpated. The detection of alpha-fetoprotein and chorionic gonadotropin is helpful for diagnosis. Radical orchiectomy is the main treatment method, followed by chemotherapy such as cisplatin injection according to the pathological type after surgery.

It is recommended to avoid wearing tight pants to reduce local compression, perform testicular self-examination once a month, and use standing palpation to compare the size and texture of both sides. If you find an abnormal mass, persistent pain, or significant changes in size within a short period of time, you should immediately seek medical advice from a urology department. Keeping the perineum clean and dry every day and supplementing with appropriate amounts of zinc can help maintain testicular function.