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Why do I have a painless swelling above the testes?

Q: I am a 16 years old man. For the past 8 months I am noticing a firm, painless swollen mass or lump above the right testes (not on or in the testes). Because of this, my right testicle has declined a little towards the left side. I am not having any sort of pain or difficulty in urinating or ejaculating. I am a shy person so have not told this to my parents or anybody. I don't know want to do. Is there something serious?

A:Swelling above and separate from the testis has to originate from structures from spermatic cord, with which the testis is attached to the body. Usual soft swellings in this area are varicocoele (swollen veins), spermatocoele (collected sperms), lipoma of the cord (fat), hydrocoele of the cord (collected water) or epididymal cysts (some swellings as birth defects filled with water). Some of these when tensely filled with water may feel firm, as you have described your swelling. Some chronic inflammatory swellings like tuberculosis may also be asymptomatic to start with. You need an examination followed by an ultrasound of the swelling to characterise the problem so that further decision may be taken.

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