AboutArthur Goldstein, M.D. Expertise Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations American Medical Association, American Urological Association, American College of Surgeons
Question Im a 19 year old and have noticed for awhile that my left testicle is harder and slightly smaller than my right. It also produces some discomfort (sharp few times). though not getting worse its to some degree reoccurring. Not frequent as in everyday but few times a month at most. I tend to worry a bunch and it worries me that it could be something really serious. I have not experienced any problems ejaculating (ejaculate about 4-5 times a week) or getting an erection. I believe its because I just over "work" it, but why wouldn't it be both? Should I be worried about anything more serious and if it is just over ejaculation, what should I do to improve upon the problem?
Answer Casey, in over 90% of men, the left testicle is lower than the right, higher on the right in about 5% and equal in the rest. As with all other parts of your body, some asymmetry between the right and left sides is always present. Likewise, the testicles are should be similar in size but not exactly the same. However, they both should be about the same size and of normal consistency, one not noticeably harder than the other. Increased hardness or unilateral enlargement can be a sign of tumor. Because of the increased firmness of your left testicle, I suggest consultation with a urologist. If he cannot be sure as to the normalcy of a testicle on physical examination, an ultrasound of the scrotum can usually define the problem. Most subtle changes in the testicle turn out to be normal but it is safest to get this checked by a specialist.
Although the anatomic difference between your testes is unrelated to your frequency of masturbation, the discomfort you experience may be referred pain from an inflamed prostate gland (prostatitis). Let me explain. During sexual arousal the prostate gland & seminal vesicles manufactures fluid that account for the majority of the semen. The seminal vesicles are paired structures located behind the prostate gland that are also sensitive to sexual excitement. Sperm from the testicles (which account for only 1-2 % of the semen) travel up a series of tubes (epididymis and vas deferens) on each side to join the seminal vesicles forming the paired ejaculatory ducts. These structures empty into the prostatic portion of the urethra. At the time of ejaculation, fluid is discharged from the prostate gland and ejaculatory ducts into the urethra (urinary canal) forming the semen. The average semen volume is 2-6 cc. With the inception of ejaculation, the bladder neck closes and the semen is forced forward out the urethra by contraction of the pelvic muscles.
Your frequency of ejaculation is normal for a man your age. However, like any other part of the body, one's prostate has a certain tolerance for use. This level is different for each individual. Just as some pitchers can do so daily, others require a 4-5 day period of rest, otherwise, their arm will get sore. Discomfort, pain or other symptoms such as frequent urination, inability to get erection, decreased semen volume, inability to climx, etc. is your body’s way of talking to you and you should listen. Ejaculation beyond the tolerance of the prostate to fill and empty may also cause the gland to become inflamed (prostatitis). The prostate once inflamed, is then more susceptible to infection. Likewise if one ejaculates too infrequently, fluid still builds up from thoughts, dreams, fantasies, etc. and has to be released periodically to decompress the gland and relieve the symptoms. For most men, ejaculation in moderation, perhaps 1-2 times a week, is reasonable. Although some men can ejaculate daily or several times a day without symptoms, most cannot abuse their prostate to this degree without becoming symptomatic. An individual's tolerance can only be determined by trial and error. Good luck.
