Men’s health involving the scrotum and testes made news recently with the report of a man who developed a 100-pound scrotum and is seeking donations to cover restorative genital surgery. While hypertrophy of the scrotum and testes is rare event, men’s health does encompass genital conditions that typically fall under 5 common conditions that affect the scrotum and testes.
The mechanics of testicular torsion are due to a spermatic cord that attaches the testes to the scrotal sac. When a spermatic cord is twisted the blood supply to a testis is cut off leading to immediate pain followed by swelling and tenderness of the testis. The causes of testicular torsion are typically due to strenuous activity or trauma, but can also happen on its own for unknown reasons.
Surgery is the treatment required for rearranging the testis back to its normal state. If the testis does not resume normal blood flow within a few hours, the testicle can be lost requiring surgical removal.
Genital Condition #2: Testicular Trauma
Testicular trauma is any kind of blunt or sharp force injury to the scrotum and testes. Contact sports are the leading cause of “racking the balls” injuries and are preventable through the use of an athletic cup and supporter.
Most injuries to the testes through blunt force trauma require little else than an ice bag treatment with rest. Temporary pain, swelling and bruising are the typical symptoms and disappear relatively quickly. However, blunt and sharp force trauma such as from a kick to the scrotum can cause a testicle to rupture, which then leads to leaking within the scrotal sac and swelling. Surgery is then required to repair the damage to save the testicle.
A less serious (but more embarrassing) injury is getting the skin of the scrotum snagged within the jagged edges of a zipper. Regardless of the embarrassment, treatment should be performed at an emergency room to prevent further damage. The scrotum is vascular and can bleed profusely if not treated carefully and runs the risk of becoming infected.
Genital Condition #3: Epididymitis
Epididymitis is an inflammation of the epididymis—a coiled tube alongside the testes that is responsible for the maturation, storage and transport of sperm that were produced in the testes before release into the vas deferens prior to ejaculation.
Inflammation of the epididymis is due to infection that can result from non-sexually transmitted disease, but typically is associated with chlamydia. Symptoms include scrotal swelling and pain, fever and a pus-filled abscess within the scrotum. If untreated, the infection can cause permanent scarring that essentially blocks sperm transport and results in infertility.
Treatment for epididymitis involves antibiotics for the infection, ice for the swelling and aspirin for the pain.
Genital Condition #4: Hypogonadism
Hypogonadism is a condition when the testicles fail to produce enough testosterone for normal male hormonal balance. Testosterone is a hormone produced by the testes and plays an important role in male development and maintaining secondary sexual characteristics.
Hypogonadism can occur at any time in an individual’s life resulting in ambiguous genitalia in infants, delay of puberty in adolescents and a plethora of ills for an adult male including erectile dysfunction, infertility, loss of libido, gynecomastia, loss of muscle and gain of fat, symptoms of female menopause, lack of facial hair, reduced sized testes, depression and mood swings.
The causes of hypogonadism are several including genetic conditions, undescended testes, medications, too much iron in the blood, chemotherapy and radiation therapy, normal aging, testicular trauma and pituitary disorders. Treatment typically involves testosterone hormone or pituitary hormone replacement therapy.
Genital Condition #5: Testicular Cancer
Testicular cancer is the uncontrolled growth of cells within the testes. Symptoms of testicular cancer include a lump or any other palpable irregularity on a testicle; sensations of heaviness or dull ache in the scrotum; or lower abdomen pain with achiness that may come and go in the scrotum.
Risk factors for testicular cancer include a family history of a male relative having had testicular cancer; being between the ages of 15 and 40; being of a Caucasian ethnicity has a testicular cancer risk five times greater than that of an African-American ethnicity; and, having a medical history of possessing an undescended testicle as an infant.
Found early, testicular cancer is usually easily treatable with a high survival rate. Treatment includes radiation and chemotherapy with or without surgical removal of the affected testis. Testicular self-examination after a hot bath or shower by rolling each testis between the thumbs and fingers of both hands palpating for any irregularities is the best method for early detection and successful treatment.
Genital Condition #1: Testicular Torsion
Testicular torsion is just as bad as it sounds—it’s a twisting of a testis that leads to severe pain and potentially irreversible damage to the testis.
The mechanics of testicular torsion are due to a spermatic cord that attaches the testes to the scrotal sac. When a spermatic cord is twisted the blood supply to a testis is cut off leading to immediate pain followed by swelling and tenderness of the testis. The causes of testicular torsion are typically due to strenuous activity or trauma, but can also happen on its own for unknown reasons.
Surgery is the treatment required for rearranging the testis back to its normal state. If the testis does not resume normal blood flow within a few hours, the testicle can be lost requiring surgical removal.
Genital Condition #2: Testicular Trauma
Testicular trauma is any kind of blunt or sharp force injury to the scrotum and testes. Contact sports are the leading cause of “racking the balls” injuries and are preventable through the use of an athletic cup and supporter.
Most injuries to the testes through blunt force trauma require little else than an ice bag treatment with rest. Temporary pain, swelling and bruising are the typical symptoms and disappear relatively quickly. However, blunt and sharp force trauma such as from a kick to the scrotum can cause a testicle to rupture, which then leads to leaking within the scrotal sac and swelling. Surgery is then required to repair the damage to save the testicle.
A less serious (but more embarrassing) injury is getting the skin of the scrotum snagged within the jagged edges of a zipper. Regardless of the embarrassment, treatment should be performed at an emergency room to prevent further damage. The scrotum is vascular and can bleed profusely if not treated carefully and runs the risk of becoming infected.
Genital Condition #3: Epididymitis
Epididymitis is an inflammation of the epididymis—a coiled tube alongside the testes that is responsible for the maturation, storage and transport of sperm that were produced in the testes before release into the vas deferens prior to ejaculation.
Inflammation of the epididymis is due to infection that can result from non-sexually transmitted disease, but typically is associated with chlamydia. Symptoms include scrotal swelling and pain, fever and a pus-filled abscess within the scrotum. If untreated, the infection can cause permanent scarring that essentially blocks sperm transport and results in infertility.
Treatment for epididymitis involves antibiotics for the infection, ice for the swelling and aspirin for the pain.
Genital Condition #4: Hypogonadism
Hypogonadism is a condition when the testicles fail to produce enough testosterone for normal male hormonal balance. Testosterone is a hormone produced by the testes and plays an important role in male development and maintaining secondary sexual characteristics.
Hypogonadism can occur at any time in an individual’s life resulting in ambiguous genitalia in infants, delay of puberty in adolescents and a plethora of ills for an adult male including erectile dysfunction, infertility, loss of libido, gynecomastia, loss of muscle and gain of fat, symptoms of female menopause, lack of facial hair, reduced sized testes, depression and mood swings.
The causes of hypogonadism are several including genetic conditions, undescended testes, medications, too much iron in the blood, chemotherapy and radiation therapy, normal aging, testicular trauma and pituitary disorders. Treatment typically involves testosterone hormone or pituitary hormone replacement therapy.
Genital Condition #5: Testicular Cancer
Testicular cancer is the uncontrolled growth of cells within the testes. Symptoms of testicular cancer include a lump or any other palpable irregularity on a testicle; sensations of heaviness or dull ache in the scrotum; or lower abdomen pain with achiness that may come and go in the scrotum.
Risk factors for testicular cancer include a family history of a male relative having had testicular cancer; being between the ages of 15 and 40; being of a Caucasian ethnicity has a testicular cancer risk five times greater than that of an African-American ethnicity; and, having a medical history of possessing an undescended testicle as an infant.
Found early, testicular cancer is usually easily treatable with a high survival rate. Treatment includes radiation and chemotherapy with or without surgical removal of the affected testis. Testicular self-examination after a hot bath or shower by rolling each testis between the thumbs and fingers of both hands palpating for any irregularities is the best method for early detection and successful treatment.
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