(1) Testicular and epididymal tuberculosis: Testicular and epididymal induration may occur, but there is a history of tuberculosis in urinary system or other parts of the body. Sclerosis often attach to scrotum, forming sinus tract, which will not heal for a long time, and the vas deferens will thicken and harden, showing beaded changes, which may be complicated with hydrocele of testis sheath. Mycobacterium tuberculosis can be found by secretion smear staining or culture of Mycobacterium tuberculosis, and the erythrocyte sedimentation rate will increase and the tuberculin test will be positive.
(2) Testicular syphilis Testicles: Sclerosis, shrinkage or spherical swelling, smooth surface or induration, insensitive to tenderness. He has a history of unclean sexual intercourse, with obvious symptoms in acute stage and testicular pain, ranging from mild discomfort to knife pain, accompanied by systemic symptoms such as aversion to cold, fever, nausea and vomiting, but not obvious in late stage. In addition to testicular induration, the examination is often accompanied by hydrocele of tunica vaginalis, swelling of epididymis, ulceration of scrotal skin, exudation on the surface and swelling of inguinal lymph nodes. Syphilis serum test is positive, and spirochete can be found by dark field examination of exudate.
(3) Chronic testicular epididymitis: There may be testicular induration, but it is mostly caused by acute testicular epididymitis, or it is a complication of chronic prostatitis and seminal vesiculitis, often accompanied by scrotal discomfort, and pain can radiate to the lower abdomen and thighs.