Why are the two sides of the scrotum different in size?

The difference in size between the two sides of the scrotum may be related to physiological factors, varicocele, hydrocele, orchitis, testicular tumors and other reasons. Scrotal asymmetry usually manifests as unilateral scrotal volume increase or abnormal position, and can be diagnosed clearly through physical examination, ultrasonography, etc.

1. Physiological factors

It is a common phenomenon that the development of the left and right sides of the scrotum is not completely symmetrical. Most men have mild scrotal asymmetry, which may be related to the difference in testicular position and cremaster muscle contraction frequency. There is usually no pain or discomfort and no special treatment is required. Just be careful not to sit for long periods of time or wear tight pants.

2. Varicocele

Varicocele may cause more obvious droop of the left scrotum, which is usually related to venous valve insufficiency and manifests as a swollen feeling in the scrotum, which is aggravated after standing for a long time. The diagnosis can be confirmed by scrotal ultrasound. Mild cases can be relieved by wearing special support pants, while severe cases require high ligation of the spermatic vein.

3. Hydrocele

Hydrocele will cause cystic enlargement of the scrotum on the affected side and a positive light transmission test, which may be related to the failure of the sheath to close or infection. A small amount of effusion can be absorbed by itself, but a large amount of effusion requires a sheath inversion operation. In the acute phase, anti-infective drugs such as cefixime dispersible tablets and levofloxacin tablets can be used as directed by the doctor.

4. Orchitis

Orchitis often causes unilateral scrotal redness, swelling, heat and pain, mostly caused by bacterial or viral infection, and may be accompanied by fever. Bed rest is required and the scrotum is elevated with a scrotum support. Amoxicillin and clavulanate potassium tablets, ibuprofen sustained-release capsules and other drugs are used as directed by the doctor. Ribavirin granules can be added for viral infections.

5. Testicular tumors

Testicular tumors appear as painless scrotal masses that are hard and may be accompanied by a feeling of heaviness in the testicles. The diagnosis needs to be confirmed through tumor marker detection and pathological biopsy, and radical orchiectomy or combined radiotherapy and chemotherapy is selected according to the stage. Indicators such as alpha-fetoprotein need to be reviewed regularly after surgery.

It is recommended to avoid pressing or applying heat to abnormal areas on your own, clean the perineum daily and observe changes. Sudden scrotal enlargement accompanied by severe pain requires immediate medical attention to rule out testicular torsion. Those who have long-term asymmetry and no discomfort can undergo scrotal ultrasound every 1-2 years. You should choose breathable cotton underwear for daily use to avoid prolonged sitting in high temperature environments.