Hello I would like to know since how long is he having this problem and whether it was associated with fever at any point, does he have any burning sensation while urinating? From the info you have given. this could be epididymoorchitis..infection of the testis. he needs to under go certain basic blood tests and ultrasound scan of the testes, is he a diabetic? why and on whose advice is he taking testosterone injections?? if it turns out to be infection this thing will settle with antibiotics depending on the level of infection. Are there any skin changes over his testicals. Its important for him to consult a urologist with the scan report and he would then treat him for the difficuly in ejaculation part too. take care