What is the cause of a baby having one testis larger than the other (testicle)?

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Last updated: April 25, 2025View editorial policy

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Differential Diagnosis for Baby with One Testes Larger

  • Single most likely diagnosis
    • Hydrocele: A common condition in infants where fluid accumulates around a testicle, causing it to appear larger. This condition is often benign and resolves on its own.
  • Other Likely diagnoses
    • Hernia: An inguinal hernia can cause a testicle to appear larger due to the protrusion of intestinal tissue into the scrotum.
    • Varicocele: An enlargement of the veins within the scrotum, which can cause a testicle to appear larger.
    • Testicular torsion (early stages): Although more commonly associated with acute pain, early stages of testicular torsion might present with a larger testis before severe symptoms develop.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular cancer: Although rare in infants, testicular cancer can present with a painless enlargement of a testicle. Early detection is crucial for effective treatment.
    • Testicular torsion (advanced stages): This is a medical emergency that requires immediate attention. If missed, it can lead to the loss of the testicle and potentially long-term fertility issues.
  • Rare diagnoses
    • Epididymitis: Inflammation of the epididymis, which can cause swelling and enlargement of a testicle. This is less common in infants but can occur.
    • Spermatocele: A cystic structure filled with sperm that can develop near the testicle, potentially causing it to appear larger.
    • Polyorchidism: A rare congenital anomaly where an individual has more than two testicles, which could be mistaken for one testicle being larger.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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