What's wrong with the newborn's testicles being one big and one small?

Newborn testicles that are one large and one small may be caused by physiological hydrocele or pathological cryptorchidism, testicular torsion and other reasons. Physiological factors usually do not require intervention, while pathological factors require prompt medical treatment.

1. Physiological hydrocele

When the neonatal testicular tunica vaginalis is not completely closed, peritoneal fluid will flow into the scrotum to form hydrocele, which manifests as unilateral scrotal enlargement. Most cases resolve spontaneously between 6 and 12 months after birth. Parents should avoid squeezing the scrotum and observe changes in swelling regularly. If it continues to increase or is accompanied by redness and swelling, seek medical attention.

2. Cryptorchidism

Failure of the testicles to descend into the scrotum may result in a size difference between the two sides, often accompanied by a lump in the groin area. It may be related to insufficient fetal hormones or anatomical abnormalities. The diagnosis needs to be confirmed by ultrasound examination. If the decline does not occur before 6 months of age, chorionic gonadotropin injection can be considered. Orchidopexy is required after 1 year of age.

3. Testicular torsion

Emergency symptoms include sudden enlargement of the affected testicle, violent crying, and refusal to eat, which are related to ischemia caused by rotation of the spermatic cord. Surgical reduction and fixation is required within 6 hours of onset, and testicular necrosis may occur if it exceeds 24 hours. Parents should seek emergency treatment immediately if they find abnormalities, and do not apply heat or massage.

4. Indirect inguinal hernia

The intestine enters the scrotum through the unclosed sheath, causing local enlargement. The mass increases when crying and may shrink when quiet. Incarceration is prone to occur and needs to be repaired as soon as possible. A hernia band can be used for temporary fixation, but laparoscopic high ligation of the hernia sac needs to be completed before 1 year old.

5. Testicular tumors

Infantile teratomas or yolk sac tumors may cause the testicles to become asymmetrically enlarged and hard-textured masses. Tumor marker detection and imaging evaluation are required. After diagnosis, radical orchiectomy is required, and postoperative chemotherapy is required according to the pathological type.

It is necessary to keep the perineum clean and dry every day and avoid using talcum powder to clog the pores. Wear a loose-fitting cotton diaper and wipe from front to back after each bowel movement. Breastfeeding mothers should avoid consuming hormone-containing foods, regularly measure the size of both testicles and record changes. If the size difference exceeds 2 cm or is accompanied by redness or heat on the skin, you need to see a pediatric surgeon immediately.