Marijuana smokers are nearly twice as likely to develop testicular cancer as not users of marijuana. The study was published in an online journal, Cancer.
Bottom line: Be careful about smoking pot. If you do smoke marijuana, be sure to do a testicle self-exam at least once a month.
Every man has taken one in the jewel box that bends him over in excruciating pain and discomfort. Fortunately, most of the pain goes away in a few minutes. However, the scrotum and its contents are very vulnerable to injury and disease. This blog will describe the most common conditions affecting men “down there”.
The scrotum is located outside the rest of the body in order to keep the testicles a few degrees cooler than the rest of the body. This is intended to keep the testicles which contain the sperm factories just the right temperature for sperm production.
Normal Anatomy of the Scrotum
The testicles have two functions: 1) sperm production and 2) testosterone production. Testosterone is the male hormone responsible for developing male characteristics like a deep voice, a beard, and the all-important sex drive.
Evaluation of the painful scrotum
Your doctor will take a careful history and find out how long the pain or swelling has been present. The doctor will want to know if the pain is associated with trauma like a soccer ball or someone’s foot to the “vital parts.” The association of pain and swelling with a fever is a sign of infection and inflammation. A physical exam will be conducted and a light may be used to see if there is excess fluid in the scrotum. This is followed by a urine exam and an ultrasound of the scrotum. This makes use of high frequency sound waves that are sent from a transducer and then reflected back to the transducer to be processed by a computer and then projected onto a computer screen. This test will usually diagnose most of the conditions that cause pain and swelling the scrotum.
Torsion
torsion of the testicle
This occurs when the testicle twists and inside the scrotum and cuts off the blood supply to the testicle. Although torsion of the testicle can occur at any age, it is most common in young boys and young men between the ages of 12 and 18. The chief compliant is the sudden onset severe pain in one testicle. It usually begins after exercise but can occur when the boy is at rest or even awaken the boy from sleep. The physical exam reveals that the testicle is painful to touch and drawn up high in the scrotum. The diagnosis is confirmed by the ultrasound exam. Immediate surgery is required in order to save the testicle. If surgical treatment is delayed beyond 4 hours, it is less likely that the testicle can be saved. Although torsion only occurs in one testicle, the urologist will always repair the opposite testicle so that torsion cannot occur on the opposite side in the future.
Testicular cancer
Testis Tumor
Orchitis
Orchitis is an inflammation of the testicle that is associated with pain and fever and swelling. Mumps is the most common cause. It is not very common thanks to the use of vaccination in young boys. Mumps orchitis is caused by a virus and there is no treatment except bed rest, anti-inflammatory medication, and pain medication.
Epididymitis
This is a inflammatory condition involving the gland and ducts that are behind the testicle and are responsible for allowing sperm to mature until they are ready to enter the semen. It is usually a bacterial infection that starts in the urine or the prostate and then backs up and goes down the vas to cause an infection in the epididymis. The problem may be accompanied by burning on urination and a urethral discharge. Men may also have a fever.
The diagnosis is made with a physical examination, a urine test which may show evidence of infection. The treatment is bed rest, a scrotal support or tight jockey underwear to support the scrotum, antibiotics and anti-inflammatory medication.
Hydrococele
hydrococele
The treatment is usually surgical procedure which is brief operation, done on a one day stay basis and most men can return to all activities two weeks after the operation.
Spermatococele
Spermatococeles are fluid filled cysts in the epididymis. Spermatococeles are usually painless swellings that can also be diagnosed by tranillunination. Surgery is the treatment of choice if the spermatococele causes discomfort because of its size or if it is cosmetically unacceptable.
Varicocele
varicocele
Bottom Line: A lump or bump down there should get a man’s attention. Most scrotal conditions can be easily diagnosed in the doctor’s office or with a scrotal ultrasound. Most cases are not serious and prompt treatment will nearly always put a man back in action.
By far, most causes of pain in the pouch is from the testicles and the epididymis, the gland behind the testicle where sperm are nurtured and mature. But there are other causes of scrotal pain that must be considered and which have different treatments.
Testicular tumors do not usually cause pain, but it is possible. Since testicular cancer is common in young men (between the ages of 18 and 32) and is often cured if treated early, prompt medical attention to any lump is important. If you feel something down there that is new or is hard, see your doctor right away.
Inguinal hernia—An inguinal hernia is part of the intestines which protrudes through the inguinal canal (passageway connected to the scrotum). Inguinal hernia is suspected if swelling or pain above the scrotum worsens with coughing, sneezing, movement, or lifting. This condition is fairly common, especially in young boys, and it occasionally causes pain in the scrotal area. Premature infant boys have the highest risk for inguinal hernia. This condition usually results from an abdominal wall weakness present at birth, but symptoms may not appear until adulthood. Hernias do not resolve without treatment and may cause serious complications if not treated. Hernia repair surgery is usually required to treat this condition. Often this surgery can be done through a laparoscope which consists of a several pencil sized openings in the lower abdomen. Most men can go home the same day of the surgery and resume all activities, including heavy lifting in 3-4 weeks after surgery.
Pudendal nerve damage (neuropathy), also called “bicycle seat neuropathy,” may cause numbness or pain. Pudendal nerve damage can result from the pressure of prolonged or excessive bicycle riding (e.g., competitive cycling), especially improper seat position or riding techniques are used. Special bicycle seats have been designed to decrease pressure on the area between the scrotum and the rectum, potentially preventing or resolving this problem. Pudendal neuralgia is the painful type of this nerve damage. Sometimes called “cyclist’s syndrome,” pudendal neuralgia is painful inflammation of the pudendal nerve. The pudendal nerve carries sensations to the genitals, urethra, anus, and perineum (area between the scrotum and anus), so the pain can be felt in any of these areas. Pain can be piercing and is more likely to be noticed while sitting. If untreated, nerve damage can lead to erectile dysfunction or problems with bowel movements or urination, such as involuntary loss of feces or urine (e.g., urinary incontinence).
Narrow bike seat can cause pudendal nerve injury
Surgery—Temporary testicular pain and swelling can be expected after surgical procedures in the pelvic area, such as hernia repair and vasectomy. Post-surgery pain that lasts longer than expected should be reported to a physician. Chronic or recurring pain may be the result of a surgical complication or an unrelated problem, and may need treatment.
Kidney stones—Stones usually cause abdominal pain, but the pain radiates into the testicular area in some cases. Intense, sudden, and severe pain in the scrotum that cannot be explained by a problem in the scrotum may be caused by kidney stones.
Swelling with mild discomfort—Conditions that cause swelling in the scrotal area also may occasionally result in mild discomfort. These conditions include varicocele, hydrocele, and spermatocele. Many cases are benign (mild and non-threatening), but swelling and discomfort in the scrotal area should be addressed by a doctor. If a hydrocele (an abnormal fluid-filled sac around the testicles) becomes infected, it can lead to epididymitis, which can cause severe pain.
Unrelieved erection—An erection that does not end in ejaculation sometimes can cause a dull ache in the testicles. This minor ache, commonly called “blue balls,” is harmless and usually goes away within a few hours or when ejaculation occurs.
Bottom Line: Scrotal pain is common condition that usually involves the structures in the scrotum. However, there are other conditions that can cause scrotal pain. If your doctor evaluates these other causes of scrotal pain, effective treatment can relieve the discomfort.
Getting the right screening test at the right time is one of the most important things a man can do for his health. Screenings find diseases early, before you have symptoms, when they’re easier to treat. Early colon cancer can be nipped in the bud. Finding diabetes early may help prevent complications such as vision loss and impotence. The tests you need are based on your age and your risk factors.
Prostate Cancer
Prostate cancer is the most common cancer found in American men after skin cancer. It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer. Screening tests can find the disease early, sometimes before symptoms develop, when treatments are most effective.
Screenings for healthy men may include both a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test. The American Cancer Society advises men to talk with a doctor about the risks and limitations of PSA screening as well as its possible benefits. Discussions should begin at:
• 50 for average-risk men
• 45 for men at high risk. This includes African-Americans.
• 40 for men with a strong family history of prostate cancer
The American Urological Association recommends a first-time PSA test at age 40, with follow-ups per doctor’s orders.
Testicular Cancer
This uncommon cancer develops in a man’s testicles, the reproductive glands that produce sperm. Most cases occur between ages 20 and 54. The American Cancer Society recommends that all men have a testicular exam when they see a doctor for a routine physical. Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. I suggest that most men learn how to do a self-examination. You can gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes. If you find an abnormality, contact your doctor. For more information on testis self-examination, please go to my website: http://www.neilbaum.com/testes-self-examination-tse.html
Colorectal Cancer
Colorectal cancer is the second most common cause of death from cancer. Men have a slightly higher risk of developing it than women. The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon. After cancer develops it can invade or spread to other parts of the body. The way to prevent colon cancer is to find and remove colon polyps before they turn cancerous.
Screening begins at age 50 in average-risk adults. A colonoscopy is a common test for detecting polyps and colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon. Some patients opt for a virtual colonoscopy — a CT scan — or double contrast barium enema — a special X-ray — although if polyps are detected, an actual colonoscopy is needed to remove them.
Skin Cancer
The most dangerous form of skin cancer is melanoma (shown here). It begins in specialized cells called melanocytes that produce skin color. Older men are twice as likely to develop melanoma as women of the same age. Men are also 2-3 times more likely to get non-melanoma basal cell and squamous cell skin cancers than women are. Your risk increases as lifetime exposure to sun and/or tanning beds accumulates; sunburns accelerate risk.
The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine cancer checkup. Treatments for skin cancer are more effective and less disfiguring when it’s found early.
High Blood Pressure (Hypertension)
Your risk for high blood pressure increases with age. It’s also related to your weight and lifestyle. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm — dangerous ballooning of an artery. But it can be treated. When it is, you may reduce your risk for heart disease, stroke, and kidney failure. The bottom line: Know your blood pressure. If it’s high, work with your doctor to manage it.
Blood pressure readings give two numbers. The first (systolic) is the pressure in your arteries when the heart beats. The second (diastolic) is the pressure between beats. Normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher, and in between those two is prehypertension — a major milestone on the road to high blood pressure. How often blood pressure should be checked depends on how high it is and what other risk factors you have.
Cholesterol Levels
A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of your arteries (seen here in orange). This increases your risk of heart disease. Atherosclerosis — hardening and narrowing of the arteries — can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Lifestyle changes and medications can reduce this “bad” cholesterol and lower your risk of cardiovascular disease.
The fasting blood lipid panel is a blood test that tells you your levels of total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, and triglycerides (blood fat). The results tell you and your doctor a lot about what you need to do to reduce your risk of heart disease, stroke, and diabetes. Men 20 years and older should have a new panel done at least every five years. Starting at 35, men need regular cholesterol testing.
Type 2 Diabetes
One-third of Americans with diabetes don’t know they have it. Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), nerve damage, and impotence. This doesn’t have to happen. Especially when found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss, and medications.
A fasting plasma glucose test is most often used to screen for diabetes. More and more doctors are turning to the A1C test, which tells how well your body has controlled blood sugar over time. Healthy adults should have the test every three years starting at age 45. If you have a higher risk, including high cholesterol or blood pressure, you may start testing earlier and more frequently.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It’s in the blood and other body secretions of infected individuals, even when there are no symptoms. It spreads from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. Modern treatments can keep HIV infection from becoming AIDS, but these medications can have serious side effects.
HIV-infected individuals can remain symptom-free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It’s possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you were recently infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.
Most newly infected individuals test positive by two months after infection. But up to 5% are still negative after six months. Safe sex — abstinence or always using latex barriers such as a condom or a dental dam — is necessary to avoid getting HIV and other sexually transmitted infections. If you have HIV and are pregnant, talk with your doctor about what needs to be done to reduce the risk of HIV infection in your unborn child. Drug users should not share needles.
Glaucoma
This group of eye diseases gradually damages the optic nerve and may lead to blindness — and significant, irreversible vision loss can occur before people with glaucoma notice any symptoms. Screening tests look for abnormally high pressure within the eye, to catch and treat the condition before damage to the optic nerve.
Glaucoma Screening
Eye tests for glaucoma are based on age and personal risk:
• Under 40: Every 2-4 years
• 40-54: Every 1-3 years
• 55-64: Every 1-2 years
• 65 up: Every 6-12 months
Talk with a doctor about earlier, more frequent glaucoma screening, if you fall in a high-risk group: African-Americans, those with a family history of glaucoma, previous eye injury, or use of steroid medications.
Bottom Line: There’s a saying New Orleans that if ain’t broke, don’t fix it. Well that doesn’t apply to maintaining your car and it certainly doesn’t apply to your health and well-being. Men need to have screening tests in order to detect disease states early when they are treatable and curable.
Moustache Season is finally upon us and just in time for Mo Bros everywhere to get their annual health check up. Lets face the facts, most men are known to be more indifferent towards their health, and studies suggest that 24% of men are less likely to go to the doctor compared to women. Maintaining a good diet, smart lifestyle choices, and getting regular medical check-ups and screening tests can dramatically influence your health. Regardless of age or background, stay on top of your health by following these very important steps:
HAVE AN ANNUAL PHYSICAL
Find a doctor and make a yearly appointment each Movember for a general health check. Getting annual checkups, preventative screening tests, and immunizations are among the most important things you can do to stay healthy. By regularly visiting your doctor, you can greatly minimize your risk level for a number of conditions, from high blood pressure to diabetes to cancer. What better way could there be to celebrate Movember than calling your doctor to schedule a check-up?
KNOW YOUR FAMILY HEALTH HISTORY
Start a discussion with your relatives about health issues that have affected your family. Men with a family history of prostate cancer are twice as likely to be diagnosed with prostate cancer, so know your family history.
DON’T SMOKE!
If you do smoke, stop! Compared to non-smokers, men who smoke are about 23 times more likely to develop lung cancer. Smoking causes about 90% of lung cancer death in men.
BE PHYSICALLY ACTIVE
If you are not already doing some form of exercise, start small and work up to a minimum of 30 minutes of moderate physical activity most days of the week. If you’re already there, set your sights on 60-minute days.
EAT A HEART HEALTHY DIET
Fill up with fruits, vegetables, whole grains; include lean meats, poultry, fish, beans, eggs, and nuts; and eat foods low in saturated fats, trans-fats, cholesterol, salt (sodium), and added sugars.
STAY AT A HEALTHY WEIGHT
Balance calories from foods and beverages with calories you burn off by physical activities. Over two-thirds of U.S. adults are overweight or obese! The USDA and leading cancer researchers suggest that we all fill up on vegetables, fruit, and whole grains, and choose lean proteins like fish and legumes over fatty ones like red meat. Evidence suggests that about a third of the 571,950 cancer deaths expected to occur will be related to obesity, physical inactivity, poor nutrition and thus could be prevented.
MANAGE YOUR STRESS
Stress, particularly long-term stress, can be the factor in the onset or worsening of ill health. Managing your stress is essential to your health & well being should be practiced daily.
DRINK ALCOHOL IN MODERATION
Alcohol can be part of a healthy balanced diet, but only if it’s in moderation, which means no more than a few, drinks a day. A standard drink is one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits. Alcohol consumption is ok, but should be kept to no more than two drinks per day for men, and one for women.
Ready to be proactive about your health but not sure where to start? Download Movember’s health poster for a checklist by age of what to ask your doctor about.
Do you know the facts? Check out the Movember site for more information on men’s health.
http://us.movember.com/mens-health/resources/
During November each year, Movember is responsible for the sprouting of moustaches on thousands of men’s faces, in the US and around the world. With their Mo’s, these men raise vital funds and awareness for men’s health, specifically prostate cancer and testicular cancer.
On Movember 1st, guys register at Movember.com with a clean-shaven face. For the rest of the month, these selfless and generous men, known as Mo Bros, groom, trim and wax their way into the annals of fine moustachery. Movember is supported by the women in their lives, Mo Sistas,
Movember Mo Bros raise funds by seeking out sponsorship for their Mo-growing efforts. Mo Bros effectively become walking, talking billboards for the 30 days of November. Through their actions and words they raise awareness by prompting private and public conversation around the often-ignored issue of men’s health.
At the end of the month, Mo Bros and Mo Sistas celebrate their gallantry and valor by either throwing their own Movember party or attending one of the infamous Gala Partés held around the world.
The Movember Effect: Awareness & Education, Survivorship, Research
The funds raised in the US support prostate cancer and other cancers that affect men. The funds raised are directed to programs run directly by Movember and our men’s health partners, the Prostate Cancer Foundation and LIVESTRONG, the Lance Armstrong Foundation. Together, the three channels work together to ensure that Movember funds are supporting a broad range of innovative, world-class programs in line with our strategic goals in the areas of awareness and education, survivorship and research.
For more information on the programs we are funding please visit the following: Prostate Cancer Foundation LIVESTRONG, The Lance Armstrong Foundation Awareness & Education Global Action Plan
Movember – a global movement Since its humble beginnings in Melbourne Australia, Movember has grown to become a truly global movement inspiring more than 1.1 Million Mo Bros and Mo Sistas to participate with formal campaigns in Australia, New Zealand, the US, Canada, the UK, Finland, the Netherlands, Spain, South Africa and Ireland. In addition, Movember is aware of Mo Bros and Mo Sistas supporting the campaign and men’s health cause across the globe, from Russia to Dubai, Hong Kong to Antarctica, Rio de Janeiro to Mumbai, and everywhere in between. No matter the country or city, Movember will continue to work to change established habits and attitudes men have about their health, to educate men about the health risks they face, and to act on that knowledge, thereby increasing the chances of early detection, diagnosis and effective treatment. In 2010, over 64,500 US Mo Bros and Mo Sistas got on board, raising $7.5 million USD.
Bottom Line: If you are a man, consider putting a sprout on your upper lip for the month of November and celebrate men’s health. If you are a woman and care about your man, have him put a tickler under his nose to create awareness for men’s health.
Testis cancer is the most common malignancy in men between the ages of 20-40. A monthly exam can identify a tumor when it is confined to the testicle and is nearly 100% curable. Check out this very entertaining video and make it a point to perform a monthly testicle self exam.
http://www.kevinmd.com/blog/2010/11/testicular-exam-sung-michael-jackson.html
Dr. Neil Baum's Urology Blog 