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Question
I am a 23 year old guy and I can sometimes feel a lump on my right testicle. The lump is about pea sized (maybe smaller) and sometimes feels sort of hard and sometimes feels sort of squishy, and it doesn't hurt.

The thing is, it appears and disappears at random and I have no idea what's going on. I am certain the lump is on the testicle itself and not floating freely around in the scrotum, but I can't figure out its pattern - why it vanishes and why it appears.

I thought that perhaps it only appeared during vasocongestion, when my testicles become engorged just after arousal, but that isn't the case all the time. I can sometimes feel the lump during vasocongestion and sometimes I can't; I can sometimes feel the lump when my testicles are normal and sometimes I can't.

When the lump is there, it's not hard to find at all - I can easily zero in on it - but when I can't feel it in its usual spot, I check around the entire testicle and it's nowhere to be found - it hasn't moved, it's just disappeared.

I went to the doctor two months ago (this was before I realized that the lump was only apparent some of the time) and was pretty embarrassed when he couldn't feel anything abnormal. (plus, the exam room was very cold so he had a hard time grasping the testicle...)

I was hoping that you might be able to tell me what this might be.

Answer
Lorenzo:

I suspect you may have a spermatocele or cyst on the epididymis.  This can often be difficult to find.  Most likely, it's there all the time but is angled away some of the time making it difficult to identify.  You didn't tell me what the physician recommended, but when we hear such a story we usually go ahead and get a testicular ultrasound which can usually find such things.  You may also want to consult with a urologist to be sure.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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