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Testicles are male reproductive organs responsible for the production of sperm and male sex hormones (mostly testosterone). It is said that the left and right testicle should be the same size, but they are actually never quite the same. A slight inequity can be perfectly normal, but if one testicle is significantly larger than the other one, a detailed examination is required.

Normal Variations

The right testicle usually develops more quickly than the left one during the embryonic and fetal period. Different studies investigated the development of the testicles and came up with different results, but all of them seem to agree that the left testicle usually hangs lower than the right, and that the right is slightly bigger than the left. This asymmetry is attributed to more developed muscles on the right side of the abdomen, which indirectly pull up the testicular cord, thus lifting the right testicle more than the left. That is also an explanation for an interesting fact that in left handers the asymmetry is the opposite (the right testicle hanging lower than the left).

Varicocele

An enlarged venous system of the scrotum is called varicocele. The most common cause of this condition is an inability of the venous valves to direct blood properly. That leads to increased pressure in testicular veins and consequently to stretched walls of the veins. This condition is usually painless, and it is presented as lump or swelling on one side of the scrotum. The diagnosis is usually made by physical examination, but your doctor may also order ultrasound imaging of scrotum to confirm the diagnosis.

Treatment is not necessary if the enlargement of the scrotum is small. If the patient has pain or other symptoms, surgical treatment or embolization of enlarged veins can be performed.

Hydrocele

A hydrocele of the testicle is a swelling of the scrotum caused by accumulation of fluid around the testicle. Many newborns have this condition, but the fluid is expected to resorb spontaneously by the end of the first year. A hydrocele can appear for no particular reason, but they can also be a sign of some other pathological process in the scrotum, such as infection or testicular tumor. A urological examination is necessary in order to determine the cause and decide if some form of treatment is needed.

Undescended Testicle

Asymmetry of testicles can also be caused by an undescended testicle (cryptorchidism), so the scrotal sac looks empty on one side. This is very common in prematurely born infants, as the testicles normally descend to the scrotum during the late fetal period. If the problem does not resolve spontaneously during the first year of life, surgical treatment is needed in order to avoid infertility.

Testicular Cancer

Testicular cancer is manifests as a lump or swelling that gradually increases, producing symptoms such as pain and discomfort. The diagnosis is made by physical examination, ultrasound imaging, and biopsy of the testis. Treatment includes chemotherapy, radiation therapy, and surgery. Testicular cancer is the most curable cancer with cure rate higher than 95 percent.

In conclusion, a slight testicular asymmetry can be normal. In any case of newly appeared asymmetry, especially if it increases and causes symptoms, you should visit your doctor for detailed examination.

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