Why Are My Testicles Becoming Larger, Harder, and Painful?

The enlargement, hardening, and pain in the testes may be caused by testicular tuberculosis, epididymitis, or varicose veins of the spermatic cord. Here are the causes and relevant information:

Causes of Testicular Pain and Hardening

1. Testicular Tuberculosis

Testicular tuberculosis is mostly caused by the mutual spread of tuberculosis in the prostate, seminal vesicles, vas deferens, and epididymis. The main clinical manifestations of testicular tuberculosis include testicular pain, dull pain, and a sense of falling. It is not easy to diagnose in the early stage, and a few cases may have acute onset, often accompanied by epididymal tuberculosis. The testes may be enlarged with hard and smooth masses, sometimes accompanied by thickening of the vas deferens. If not treated promptly, the consequences can be severe.

2. Epididymitis

Epididymitis is commonly caused by Escherichia coli and Staphylococcus and can be divided into acute and chronic types. Patients with epididymitis may experience testicular swelling, tenderness, and a sense of fluctuation with accumulated pus if the abscess ruptures. They may also have symptoms such as high fever and chills.

3. Varicose Veins of the Spermatic Cord

Varicose veins of the spermatic cord manifest as a sense of fullness or pain in the scrotum or testes, enlargement of the scrotum, dilated and tortuous veins visible on the surface of the scrotum, and hardening of the testes. Severe varicose veins of the spermatic cord can lead to insufficient blood supply to the testes, resulting in atrophy.

Common Male Testicular Diseases

1. Epididymitis

Epididymitis is the most common testicular disease. It can be caused by prolonged sitting, squeezing of the testes, unclean sexual intercourse, frequent social engagements, urine retention, urinary tract infections, etc. Mild cases of epididymitis can be resolved by adopting healthy lifestyle habits. However, severe cases require treatment at a formal hospital as they may affect sexual function and fertility.

2. Ectopic Testis

During the descent of the testis from the inguinal canal, it may not descend into the normal position within the scrotum, resulting in ectopic testis. Ectopic testis is rare, and its clinical significance and treatment principles are generally the same as those for cryptorchidism. Surgical treatment should generally be considered if the diagnosis is clear, as androgen therapy is generally ineffective. Early testicular fixation before puberty can usually restore normal testicular function.