Q. Cyst in my testicles are getting bigger while trying to pass stools. Please help.

Answered by
Dr. Prathish Kumar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 02, 2020

Hello doctor,

When I am trying to pass stools my testicles get really big, also there is a cyst in my right testicle. Besides this, I have pain in my lower back. What is your advice to get the cyst killed and get back to normal? If necessary, I can send photos. Please help.

Dr. Prathish Kumar

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

With the history you have told, it seems like a hydrocele or an inguinal hernia with extension into the scrotum. If possible do send the pictures for a better idea.

And also answer these questions. Do you suffer from constipation? Any abdominal pain? Any fever? Any issues while passing urine? Do you have diabetes? Awaiting your reply. Please update a clear picture.


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Thank you doctor,

Yes, I suffer from constipation for three years or more but the problem of my testicles started around August 2018 then I feel a cyst a year later around May 2019 my testicle becomes bigger and bigger.

I had a fever in the first periods a lot around 2018 and 2019. In 2020, I did not have any fever. While passing urine, I often go to the toilet. I do not have diabetes.

Dr. Prathish Kumar

General Medicine Internal Medicine
#

Hi,

Welcome back to icliniq.com.

I have gone through your answers and photos (attachment removed to protect patient identity). It seems to a long-standing issue since 2018. Have not you consulted any doctor for this issue?

With these replies, I would say that the possibilities of hernia or hydrocele as I have already mentioned is less. Your scrotum is not so big as I have imagined with your previous description. The complete picture resembles an infection in and above the testis, we call it epididymo-orchitis.

This condition needs direct clinical hands-on examination by a doctor. Anyways, let us try to find it out with some tests. Please do the advised investigations and get back to me.


Investigations to be done:

Urine routine. Urine culture and sensitivity. USG (ultrasound) abdomen, pelvis, and scrotum.

Probable diagnosis:

? Epididymo orchitis.


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Thank you doctor,

I consulted a doctor and no abnormal findings in urine. They made a photo in radiology and they say I have a cyst in the right testicle? But my question is, it is possible a cyst can cause such a swelling of the testicle. It becomes big when I put pressure on it.

Last week Friday, I went to the urologist and he did examine with his hand and say this is not hernia and he put his finger in my anus and said he could not find any thing abnormal. I have an appointment in June to do an echo because I thought it may be a possibility for a hernia.

Is it still possible to have epididymo-orchitis when the urine control shows no urinary infection? And yes, this problem started in August 2018 when I had anal sex with a sex worker in May 2018. Please help.

Dr. Prathish Kumar

General Medicine Internal Medicine
#

Hello,

Welcome back to icliniq.com.

I have gone through your reply. Let me come one by one.

You are having a history of sexual contact, epididymitis infection following sexual contact in young males is usually caused by a bacteria called Chlamydia. In the acute stage, it is usually associated with features of urinary tract infection. But when this goes unnoticed, untreated and stays for a long time, then the urine infection features get settled whereas this stays and leads to complication like cyst formation or abscess formation.

The other possibility is such long-standing cases is tuberculosis infection and cyst formation as its sequel. If not for chlamydia infection, as per your radiologist report as a cyst in the testicle, this may be a simple epididymal cyst or a spermatocele (also a type of cyst which contains sperms collected within it). Both these conditions are very benign which does not cause any problems and does not need any treatment.

Rare complication is the enlargement of the cyst where you need to surgically remove the cyst. Otherwise, need not worry at all. And yes, for your important concern, it is possible that when you put pressure the swelling may enlarge in size particularly when the connecting tunnel between the abdomen and scrotum is not completely sealed or it is weak or if there is any abnormal connection.

As far as your description, these are the possibilities which I have explained. Further differentiation and confirmation of an appropriate diagnosis will depend on investigations and direct clinical examination and discussion with a urologist. At your next consultation with urologist, you can discuss the above said points with him and decide whether to check urine for chlamydia and TB bacilli, the already advised investigations and also regarding further management.


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