Why Does the Testicle Vary in Hardness, Sometimes Feeling Firm and Other Times Soft?

The Importance and Variations of Testicle Firmness

The significance of testicles is self-evident, as semen is produced by them. If there are issues with this area, it can directly impact a male's fertility. Testicles are a private part, and it's challenging to detect abnormalities without symptoms. However, some men notice that their testicles can be firm at times and soft at others. Let's explore the reasons behind this phenomenon.

Why Do Testicles Sometimes Feel Hard and Sometimes Soft?

If there are no pain or other abnormal symptoms, it's normal for testicles to vary in firmness, which is related to testosterone secretion. Testicles are located within the scrotum, one on each side, with the left typically slightly lower than the right by about 1cm. They are slightly flattened ellipsoids with smooth surfaces, divided into inner and outer sides, anterior and posterior edges, and superior and inferior ends. The anterior edge is free, while the posterior edge contains blood vessels, nerves, and lymphatic vessels, connecting to the epididymis and testicular part of the vas deferens. The superior end and posterior edge are attached to the epididymal head, and the inferior end is free. The outer side is more prominent, while the inner side is flatter. Testicles grow rapidly with sexual maturity and shrink with the decline of sexual function in old age.

Common Diseases of Testicles

1. Epididymitis

The posterior edge of the testicle is the epididymis, where sperm are temporarily stored after production. Epididymitis is common in people around 30 years old, often caused by persistent urinary tract infections that lead to bacterial entry into the epididymis through the vas deferens. It can occur alongside urethritis, prostatitis, and seminal vesiculitis. It can affect one or both sides, with varying onset times. Symptoms include redness, swelling, heat, and pain in the entire scrotum, sensitivity to touch, and burning pain during urination. Pain may be relieved when lying down. Treatment involves antibiotics to alleviate acute pain, followed by cold compresses and elevation of the testicles using rolled socks or medical gauze. Wearing a supportive briefs can also help reduce discomfort in the spermatic cord. Prevention includes immediate medical attention for any burning sensation during urination, as men are less prone to urinary tract infections but the consequences can be severe.

2. Testitis

Testitis is often caused by the direct spread of epididymitis to the testicles, caused by bacteria. In children, acute testitis is usually caused by the mumps virus. Symptoms are similar to epididymitis but with less pronounced redness and heat in the testicles. Swelling and tenderness of one or both testicles, redness and swelling of the scrotal skin, and a warm sensation upon touch are noticeable. Severe testitis can lead to infertility, so doctors prescribe antibiotics and pain relievers along with cold compresses. Improper treatment during the acute phase can lead to abscess formation or chronic testitis. Prevention includes vaccination against mumps for children.

3. Varicocele

Varicocele affects 10% of men aged 30-40, mostly occurring on the left side due to blood stagnation in the spermatic veins, leading to dilation, tortuosity, and elongation of the venous plexus. It can also be caused by kidney tumors. Varicocele is concerning as it may cause testicular atrophy and sperm production disorders, leading to infertility. Symptoms may include dull pain or no symptoms at all. Standing may reveal visible or palpable varicose veins in the spermatic cord area, which worsen with increased abdominal pressure. Severe cases may cause scrotal heaviness, pain, and low back pain, relieved by lying down. Diagnosis involves special tests like ultrasound and infrared scrotal thermography. Treatment options include injecting medication to close the veins or surgical ligation, a minor procedure requiring anesthesia that takes about 30 minutes. Prevention is challenging as varicocele is a type of venous tumor, and new ones can emerge.

4. Spermatocele (Third Testicle)

A benign cyst that occurs in the testicles or epididymis, the swollen lump is often compared to a sugar cube and humorously referred to as a "third testicle," though this condition is rare. Symptoms include a painless, rounded mass above the testicle that can be felt separately. Under a flashlight in a dark room, the spermatocele glows.