There are two major primary disorders affecting the male external reproductive organs. These include penile dysfunction and testicular disorders. Penile and testicular dysfunctions can affect male fertility and sexual function.
The testes are part of the male reproductive system. The testicles are two oval-shaped organs, the size of two larger olives. They are located inside the scrotum, the free sac of the skin that hangs behind the penis.
The testes secrete male hormones, including testosterone, and produce sperm, the male reproductive cells. Testicular disorders can cause severe disorders, including hormonal imbalances, impaired sex life, and infertility.
Testicular trauma, testicular torsion, testicular cancer, epididymitis, and hypogonadism are among the most common testicular disorders.
Testicular trauma
Because the testes are located at the scrotum, which hangs on the outside of the body, they have no muscle and bone protection. This makes them more likely to hit, kick or crush, which occurs more frequently during contact sports. Men can protect their testicles by wearing athletic cup-shaped devices during sports.
Testicular trauma can cause severe pain, bruising and / or swelling. In most cases, the testicles – which are made of spongy material – can absorb the shock of trauma, without serious injury.
A rare form of testicular trauma, called testicular rupture, occurs when the testicle receives a direct hit or is crushed by the large bones of the pelvis. This type of trauma can cause bleeding in the scrotum. In severe cases, surgery is needed to repair the rupture, thus saving the testicle.
Testicular torsion
Inside the scrotum, the testicles are fixed at each end by a structure called spermatic cord. Sometimes, this cord twists around the testicle, thus disrupting the blood supply to the testicle. Symptoms of testicular torsion include sudden and severe pain, enlargement of the affected testicle and swelling.
This condition, which occurs mainly in men younger than 25 years, can occur due to a testicular or secondary impairment to an activity that requires a great deal of effort. It can also occur without an obvious cause.
Treatment
Testicular torsion requires emergency treatment. Usually, the treatment consists in correcting the condition through surgery. Testicular function can be saved if the disorder is diagnosed and treated immediately. If the blood supply to the testicle is interrupted for a long time, the testicle may be permanently damaged and may require surgical removal.
Testicular cancer
Testicular cancer occurs when the cells in the testis divide and grow uncontrolled. In some cases, certain benign (non-cancerous) tumors can progress and turn into cancer. Testicular cancer can develop in one or both testes in men or adolescents.
Symptoms
Symptoms of testicular cancer include:
– a swelling, an irregular area or enlargement at the level of each testicle;
– a sensation of traction or unusual weight at scrotal level;
– a pain that can be sustained at the groin or lower abdominal level;
– pain or discomfort (which may appear and disappear) at the testicular or scrotal level.
Etiology
The exact etiology of testicular cancer is unknown, but there are a number of risk factors for the disease. Risk factor is considered anything that increases a person’s chances of contracting a disease. The risk factors for testicular cancer are:
– age: testicular cancer can occur at any age, but most commonly it occurs in men between the ages of 15 and 40
– the unobstructed testicle: this is a condition in which the testicle does not descend from the abdomen, where it is located during the fetal development period, at the scrotum level, shortly before birth
– family history: a family history of testicular cancer increases the risk of cancer
– race and ethnicity: the risk of testicular cancer in white men is five times higher than in black men and twice as high as in Asian and American men.
Treatment
Testicular cancer is a rare form of cancer, with effective treatments being usually curable. Surgery is the most common form of testicular cancer treatment in Noida. Surgery involves the removal of one or both testicles by an incision (cut) at the groin level. In some cases, the urologist in Noida may also remove lymph nodes from the abdomen.
Radiation therapy, which uses high-energy rays to destroy cancer, and chemotherapy, which uses cancer cell-destroying drugs, are other therapeutic options.
The removal of a testicle does not lead to problems of conception or sexual activity. The remaining testicle will continue to secrete sperm and male sex hormones. In order to return to the normal appearance, a testicular prosthesis can be fitted, which is surgically implanted at the scrotal level, which looks and feels like a normal testicle.
Prognosis
The success of testicular cancer treatment in Noida depends on the stage of the disease at the time of diagnosis and treatment. If the cancer is detected and treated before spreading to the lymph nodes, the cure rate is very high, greater than 98%.
Even after testicular cancer has spread to the lymph nodes, the treatment is very effective, the cure rate is more than 90%.
Prophylaxis
In order to prevent testicular cancer, men should be familiar with the size and sensation of the testes, in order to detect any type of change. Most doctors believe that early recognition of swelling is an important factor in the success of testicular cancer treatment and recommends monthly testicular self-examination, associated with a routine physical examination, in all men after puberty.
Epididymitis
Epididymitis is an inflammation of the epididymis. The epididymis is the groove wrapped around and around each testicle. It has the function of transport, storage and maturation of the sperm cells, which are produced at the testicular level. The epididymis provides a connection between the testes and the deferential channels (the channels that carry sperm).
Etiology
Epididymitis commonly occurs due to infections or infections with Chlamydia, a sexually transmitted disease. In men over 40, the most common cause is the bacteria that exist in the urinary tract.
Symptoms
The symptoms of epididymitis are scrotal pain and swelling. Penile secretion, pain in the urine and sexual contact or painful ejaculation may also be present. In severe cases, the infection can spread to the adjacent testicle, producing fever and abscesses (pus collections).
Treatment
Treatment of epididymitis include antibiotics (drugs that kill the bacterium that caused the infection), physical rest, application of ice bag to reduce swelling, use of a device to support the testicles and anti-inflammatory drugs. The partner should also be treated, if the epididymitis is secondary to a sexually transmitted infection, to prevent re-infection.
If left untreated, epididymitis can cause scar tissue damage, thus blocking normal sperm leakage at the testicular level. This can lead to fertility problems, especially if both testicles are involved or if the man has recurrent infections.
Prophylaxis
Condom use during sexual contact can prevent epididymitis secondary to chlamydia or gonococcal infection.
Hypogonadism
One of the testicular functions is the secretion of testosterone. This hormone plays an important role in developing and maintaining the majority of male physical characteristics. These include strength and muscle mass, fat distribution, bone mass, sperm production, and sexual behavior.
Hypogonadism in men is a condition that occurs when the testicles (gonads) do not produce enough testosterone. Primary hypogonadism occurs when there is a disorder or anomaly in the testis itself. Secondary hypogonadism occurs when there is a disorder in the pituitary gland of the brain, which transmits chemical impulses to the testicles to stimulate testosterone secretion.
Hypogonadism can occur during the fetal period, at puberty or during adulthood.
Signs and symptoms
If it occurs in adult men, hypogonadism can produce the following:
– erectile dysfunction (inability to obtain or maintain an erection);
– infertility ;
– decrease in sexual activity;
– reduction of hair or body hair;
– decrease in size or firmness of the testes;
– decreased muscle mass and increased fat deposition;
– decrease in bone mass (osteoporosis);
– enlargement of the male breast tissue (gynecomastia);
– emotional and mental symptomatology similar to that seen in menopausal women (profuse sweating, changes in mood, irritability, depression, fatigue ).
Etiology
There are various causes of hypogonadism:
– Klinefelter syndrome: This syndrome involves the presence of abnormal sex chromosomes. Men usually have an X chromosome and a Y chromosome. The Y chromosome contains the genetic material in coded form, which determines the male sex, as well as the development and specific male characteristics. Men with Klinefelter syndrome have an additional X chromosome, which results in abnormal testicular development.
– unobstructed testicles
– Hemochromatosis: this condition consists of excess iron in the blood, which can cause disorders of the testicular function or the pituitary gland.
– Testicular trauma: testicular trauma can affect testosterone production
– Anticancer treatments: chemotherapy or radiotherapy, treatments frequently applied in cancer, may interfere with testicular production of testosterone and sperm
– Normal aging process: older men have lower levels of testosterone, although the rate of decrease of this secretion varies greatly from man to man
– Disorders of the pituitary gland: disorders of the pituitary gland (a small organ located in the middle of the brain), including either trauma or a tumor, may interfere with the ability of the gland to send hormonal signals to the testes to stimulate testosterone synthesis.
– Medicines: certain drugs may affect the production of testosterone; these are some commonly used antipsychotic drugs.
Treatment
The treatment of hypogonadism is different depending on the etiology. For the treatment of testicular disorders, hormone replacement treatment (testosterone replacement therapy) is used.
If the etiology is a condition of the pituitary gland, pituitary hormones can be used to increase testosterone levels and sperm production.