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Recently my pump has twisted, the deflate valve is lower than the pump an is behind it, to the right of my scrotum, the pump is arched high up and to the left of the scrotum. The deflate valve and pump are almost horizontal in my scrotum, twisted to the left (hope that makes sense).

Could this possibly be the cause of pain? Could this be the reason why my left cylinder inflates/deflates more? Is it possible for the tubing to have twisted causing issues with the cylinders?

J

Seems strange that it would have moved.
I think it could cause a kinked tube. Hopefully your doctor can get it re-positioned without more surgery.

My pump has finally mostly detached from my scrotum wall, however it's still on the left side and twisted along the vertical axis, so the wide dimension of the valve block is facing front to back.
This makes it protrude noticeably in front of my scrotum. Causing some discomfort and makes it very noticeable during sex.
Everything functions fine, and I have no trouble inflating or deflating, but I still plan to contact my surgeon to see if it can be re-positioned towards the center and rotated so the deflate button is in front.