Posts Tagged ‘testis tumor’

Protect The Nuts-Testicular Injuries

October 27, 2013

This title came from a program called Save The Nuts, www.protectthenuts.com, which is focused on men checking themselves for testicular cancer.  A man’s testicles are important for reasons, which include their concept of their manhood, their confidence, fertility, and potency.  Despite the vulnerable position of the testicles, testicular trauma is relatively uncommon. Mobility of the scrotum may be one reason severe injury is rare. The testicles are also prone to injury because they are not protected by muscle or bone. Given the importance of preserving fertility, traumatic injuries of the testicle deserve careful attention.  This blog will discuss the common conditions associated with trauma to those gems down there!             

The anatomy of testicles

Testicles are also known as testes (one is a testis) or ‘balls’. They are two small, oval-shaped male sex glands that produce sex hormones and sperm. Each testicle is housed in a fibrous outer covering called the tunica albuginea. Sperm production needs a temperature that is around 2 °C lower than the body, which is why the testicles are located outside the body in a sack of skin (the scrotum).

Testicular torsion

The spermatic cord attaches the testicle to the body. Testicular torsion occurs when the spermatic cord twists and cuts off the blood supply to the testicle. This condition can occur at any age, but tends to be more common between the onset of puberty and the mid-20s. It requires urgent medical attention.

Hard physical activity can cause this twisting of the cord. In most cases, however, it is caused by abnormalities in a male’s anatomy (body structure and organs) that make it easier for the testicle to twist or rotate around the cord.

Symptoms of testicular torsion include:

  • Severe pain
  • Scrotal swelling
  • Nausea and vomiting.

These symptoms can often be confused with an infection of the testicles. An infection should not be diagnosed until torsion has been ruled out.

Urgent medical attention is needed to save the testicle when torsion is diagnosed. Surgery must untwist the spermatic cord and restore blood flow to the testicle. A doctor uses physical examination and ultrasound scans to make the diagnosis. Sometimes, a doctor can only make a conclusive diagnosis at the time of surgical exploration.

The survival rate of the affected testicle is poor unless surgery is performed within four to six hours. Unnecessary investigations should not take place if torsion is suspected, as delays to surgery can affect the viability of the testis. If the blood supply has been disrupted for too long, the testis may not be viable or salvageable and may need to be removed.

In many cases, the surgeon will also secure the spermatic cord on the unaffected side, to prevent future torsion of the other testicle. If the torted testicle has to be removed, then a surgeon can put a prosthesis or silicone testis into the scrotum for cosmetic reasons.

Other conditions that can affect the testicles include:

  • Epididymitis – the epididymis is a collection of small tubes located at the back of each testicle. They collect and store sperm. Epididymitis is infection and inflammation of these tubes. Causes include urinary tract infections and sexually transmissible infections (STIs). Treatment includes antibiotics
  • Epididymo-orchitis – infection of the epididymis and testicle that causes inflammation and pain. Treatment includes antibiotics
  • Varicoceleor varicose veins – 10 to 15 per cent of men have a varicocele, where veins draw blood from the testicle. This blood has to rise against gravity when the man stands up. Valves in the veins help this process. If the valves don’t work, blood pools in the veins. This swells the veins and gives the appearance of ‘varicose veins’. Varicoceles usually don’t need treatment, unless the varicocele is severe enough to cause discomfort or impair fertility. The links between varicocele and infertility are complex and research is ongoing. Treatment includes surgery or radiological techniques that can block the testicular veins
  • Haematocele – a blood clot caused by trauma or injury to the testicles or scrotum. In some cases, the body is able to reabsorb the blood. If not, the person will need surgery to remove the clot
  • Hydrocele – abnormal build-up of fluid that causes the affected testicle to swell. In some cases, the body can reabsorb the fluid. Even though the condition is painless, the hydrocele may become so large that the person will need surgery to remove it
  • Spermatocele – an abnormal build-up of sperm-filled fluid next to the epididymis, which feels like a separate lump on the testicle. This is harmless, but can be removed surgically if it becomes large or bothersome. It is more common after a vasectomy
  • Undescended testicles – either one or both testicles are missing from the scrotum and are lodged inside the lower abdomen. Premature and low-weight newborn boys are most prone to undescended testicles. This condition is a known risk factor for testicular cancer and strongly related to infertility. Unless the testicle is brought down into the scrotum by 12 months of age, there is a high risk of damage to sperm production in later life
  • Testicular cancer – an abnormal growth or tumour that appears as a hard and usually painless lump in either testicle. In most cases, testicular cancer can be cured if the person seeks medical treatment early. Surgical removal of the affected testicle (orchidectomy) is usually the first treatment for all testicular cancer.

Suggestions on how to reduce the risk of testicular problems include:

  • Take all reasonable precautions to prevent accidents. For example, drive safely and always wear a seatbelt.
  • Protect yourself from sexually transmissible infections (STIs) by wearing a condom.
  • Always use protective equipment such as a jockstrap or hard cup while playing sports.
  • If you injure your testicles, always seek urgent medical advice.
  • Perform testicular self-examination (TSE) once every month. Regular TSE helps you become familiar with the look, feel and shape of your testicles so you will notice any abnormalities. See your doctor for further information on how to perform TSE.

Always see your doctor if you experience any scrotal or testicular pain or unusual symptoms, or if you find a lump or swelling.

 Bottom Line

Those gems between our legs are worthy of protecting.  If you feel any discomfort or lumps or bumps down there, see your doctor your potency and fertility are worth protecting.

 

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When There’s a Problem In the Jewel Sack-Scrotal Pain

September 1, 2012

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


Most men with scrotal swelling worry about testicular cancer, it is actually relatively uncommon with only 7000 new cases diagnosed each year. The disease usually affects young men between the ages of 15-40. The cause is not known but it is much more common in males who have a testicle that has not descended into the scrotum at the time of birth. The man with testicular cancer usually notices a hard lump on the scrotum. The lump is usually painless. The diagnosis is confirmed with a blood test looking for tumor markers, beta HCG and alpha feto-protein, and a scrotal ultrasound. The treatment is to remove the testicle and the cancer. Testicular cancer has a very high cure rate. All men should learn to do a testicle self exam at least once a month. Any suspicious lumps or bumps should be brought to the attention of a physician.

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


A hydrococele is a swelling that takes place slowly over time. Usually months or even years. A hydrococele is a collection of fluid around the testicle, which remains entirely normal. A doctor can easily make the diagnosis by simply transilluminating the scrotum with a bright flashlight held up against the scrotum. The diagnosis can be confirmed with an ultrasound examination.

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


Varicoceles consist of dilated network of veins in the spermatic cord. This problem is common and occurs in 15% of men and occurs most commonly on the left side. It usually causes minimal discomfort but can be associated with infertility. Treatment consists of surgically tying off the abnormal veins or using a coil placed by a radiologist to occlude the abnormal veins.

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.

Pain in the Pouch- Scrotal Pain May Be Coming From Somewhere Else

June 9, 2012

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).

Pudendal Nerve Damage

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.

Testicle Self Exam-Now You Can Perform The Exam To Michael Jackson’s “Man in the Mirror”

December 2, 2010

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