Rock Hard swelling of Right Testicle

Be warned, this will be a lengthy post! Not only that, but there's a lot of little bits of info to keep in mind. So feel free to back away now...

Hi. I am 28 going on 29 and I have had problems with my right testicle since I was a teenager.

It started when I was in my early-to-mid teens when I began developing a Hydrocele on my Right Testicle. It developed so slowly I just figured I had asymmetrical testicles. I even called a health advice line when I was much younger and they advised me that a size difference was perfectly normal (which it is).

The testicle continued to increase in size until it was easily 2+ times the size of the left and when I was around 25 I finally decided to see a doctor about it. In retrospect I left it quite late, but even when it was diagnosed treatment was optional since it wasn't causing me any pain, only discomfort. It was a pretty textbook diagnosis and the locum GP I saw that day who happened to specialise in Urology assured me it was an easy fix. In no time at all I had the Hydrocele Repair and was back on my feet. And for the first time since I was a child I had two identically sized testicles! Amazing! (remember that fact-identically sized testicles…!)

About six months or so after the OP I began to experience some discomfort in that same, now fixed, Right Testicle. This discomfort began to increase over time to the point of actually causing me pain, which I hadn't experienced with the Hydrocele. And, it was pretty easy to see this pain was directly related to me attempting to do press-ups! I went to see a GP (living in a different town now) and they initially thought the Hydrocele was returning. After an exploratory Ultrasound I was diagnosed with a Varicocele. During these first Ultrasounds the Varicocele was at it's worst, and was clearly visible through the scrotum. Treatment wasn't offered at this point, and thinking back on it, I have no idea why. Since this initial diagnosis I have managed the pain the Varicocele has caused on my own, metering my physical activity and being careful not to carry any heavy loads.

Now, possibly the most interesting symptom I have been suffering over the last three years has been Swelling of the Right Testicle. This only began after the Hydrocele Repair and after I was Diagnosed with a Varicocele. Basically, if I have a period of relatively intense physical activity, lifting flight cases (I work in media production), moving boxes, even shopping bags (yes, I now count that as intense physical activity) the Right Testicle will begin to swell. I won't really notice this until the day after the exertion. At it's absolute worst (which can happen quite often) the testicle will be twice the size and ROCK HARD. I mean, it has absolutely no give whatsoever, and feels like it is practically ready to explode (I can feel the pressure). Feeling around the Right Testicle, it becomes completely hard top-to-bottom. You can clearly make out the shape of the entire testicle leading to the Spermatic Chord, which is still soft and flexible. During this phase, the testicle can also become pulled up towards the body. If I then go through a period of relative lethargy (I can spend days/weeks working in front of a computer) the testicle will shrink and become incredibly soft and spongy. If I was to go on my gut feeling here, it feels as though the testicle is pooling with blood when my body is put under exertion and this takes time to dissipate.

I have been to the GP on and off over the last three years to ask about treatment and although it was mentioned it was never really offered. I began to realise that unless you really ask for help nothing is going to happen.

I finally saw a Urology consultant around 6-8 months ago, and upon explaining my symptoms (the testicle swelling) he basically told me he hadn’t heard of that before and simply focused on the Varicocele which was at this time quite reduced. He explained in great detail the procedure of a Varicocele Embolization and explained that he did not think that would help me with my pain at all (I even have that in writing). This kind of put me on the back foot, as I am in no way prepared to go through surgery no matter how small if it is the wrong course of action to take. I don't want surgery, I simply want this to be sorted out. I very rarely seek professional medical help for anything. I am not a hypochondriac and I most certainly do not want to be an unnecessary burden on our medical infrastructure in anyway.

In the last couple of months the symptoms have been getting worse. I can now feel discomfort when driving the hour to work in the mornings. A couple of months ago now, during one of it's large swollen phases, the testicle even twisted around during the night, causing the most intense pain I have ever felt down there.

I have since been back to see my regular GP and she has been absolutely amazing! Upon hearing my symptoms she immediately booked me for another Consultation with a Urologist. After this booking, while waiting, I found a lump on the top of the Right Testicle. I went back to my GP who didn't think it was an infection at the time but booked me in for an emergency Ultrasound before the consultation.

During the waiting period before the Ultrasound, one evening, after moderate lifting that day (one pumpkin, and separately carrying three bottles of wine in one bag) I stood up and found myself feeling incredibly nauseous. My temperature shot through the roof, I began sweating and had a feeling similar to that of being kicked in the testicles. I didn't really know what was going on and tried to shake it off, even having a bath to help relieve the symptoms. When this didn't work we went to see the out of hours GP and the local hospital (it was around 21:30). The GP thought it could be Epididymitis and prescribed antibiotics. I have been taking them for almost two weeks now and there has been no change in the lump. I have been experiencing pain in my legs, abdomen, deep in my right buttock and perineum.

During the Ultrasound they could not see any evidence of a Hydrocele (as expected), no Varicocele (not quite as expected) but she could see a Hernia! This is the first I had heard of this. By this point I was in so much pain we ended up travelling around to two different hospitals close by to be examined. None of the Doctors or Surgeons we saw could find any sign of a hernia.

Three days after this, I saw a new Urology Consultant who upon hearing my symptoms (the fluctuating swollen testicle, by this time pain in my legs, and right buttock and perineum) told me outright that aside from the pain the testicle itself can not be swelling. So far that's two Urology consultants who have told me that this simply can't be the case. This feels slightly maddening, since apart from the pain this is the only symptom I can easily self identify. The testicle clearly swells. It is directly related to my level of physical activity and no personal moderation over the last three years has had any effect.

I am now booked in for a CT scan to see if I do have a hernia, but I am worried that this pulls the focus away from the swelling of the testicle (which is still happening, and doesn't appear to be going anywhere…). Could the swelling be caused by a hernia? And, if so, wouldn't that mean I have been suffering from a hernia for three years?

My question to any Doctors reading this is, have you seen swelling of the testicle in this way before?