Differential Diagnosis for Watery Semen and Left Testicular Pain

• Single most likely diagnosis
  • Epididymitis: This condition, which is an inflammation of the epididymis (a tube at the back of the testicle that stores and carries sperm), can cause testicular pain and changes in semen consistency, including making it more watery. The pain is often localized to one testicle, which aligns with the left testicular pain described.
• Other Likely diagnoses
  • Orchitis: Inflammation of one or both testicles, usually caused by bacterial or viral infections, can lead to testicular pain and potentially affect semen quality, making it a plausible cause for watery semen.
  • Varicocele: A varicocele is a swelling of the veins that drain the testicle. It's a common cause of low sperm count and could potentially affect semen consistency, though it's more commonly associated with fertility issues than pain.
  • Prostatitis: Inflammation of the prostate gland can cause pain in the testicles, among other symptoms, and might affect semen quality, including its consistency.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular Torsion: Although this condition is characterized by sudden, severe pain and swelling of the testicle, it's a medical emergency that requires immediate attention. Delayed treatment can result in the loss of the testicle.
  • Testicular Cancer: While less common, testicular cancer can cause pain and changes in testicular size. It's crucial to rule out this potentially life-threatening condition.
• Rare diagnoses
  • Spermatocele: A spermatocele is a cyst that forms on the epididymis and can contain sperm. It might cause changes in semen but is less likely to cause significant pain.
  • Hydrocele: A hydrocele is a type of swelling in the scrotum that occurs when fluid builds up around a testicle. It can cause discomfort but is less commonly associated with changes in semen consistency or significant pain.