All You Need to Know about Testicular Health

Testicles are an important part of the male reproductive system. They are a paired sex gland that produces sex cells and hormones (spermatozoa and testosterone that performs a number of basic functions in the male body). Diseases of the testicles are not so common. They happen in approximately 20–25% of the male population and are accompanied by uncomfortable sensations.

Some diseases of the testicles are life-threatening. Therefore, it is necessary to contact the specialist as soon as possible and take appropriate measures.

The main symptoms indicative of problems with the male sex glands include:

• An increase in the size of the testicles
• Lumps in one or both testicles
• Swollen testicles or a scrotum
• Pain in the testes

Some men also complain of pain in the lower abdomen, nausea, and vomiting. If any of the symptoms mentioned above occur, you should immediately consult a doctor, as it may be the first symptom of such a dangerous disease as testicular cancer. All these symptoms also may indicate about other diseases of the testicles, such as varicocele, inflammation, or a hernia. Only a doctor can determine the exact cause of these symptoms and assign the most appropriate treatment.

Causes for Lumps and Swollen Testicles

Usually, men find the lumps in the testicles while examining their genitals. Experts recommend doing a regular self-examination of male reproductive organs at least once a month. The lump in the testicle can be a symptom of serious diseases of the male genitourinary system. Such a lump is often a spermatocele (epididymal cyst), but only a qualified urologist can determine such a syndrome.

A spermatocele is a cyst located in the testicle or its appendage and filled with a mixture of spermatozoa and spermatocytes. Such a disease can occur at any age and may have an innate origin. The cyst is formed from the ducts of the Mullerian glands and reaches no more than 2–2.5 cm in size. It is usually filled with a liquid of a light yellow hue that does not contain sperm.

Swollen testicles can also indicate about such diseases as testicular cancer, inguinal hernia, hematocele or hydrocele, lymphadenitis or varicocele, etc.

A lump in the testicle can also be a sign of oncological processes in the tissues of the testicles. These processes can be of a malignant or benign nature or caused due to hormone production. One such oncology process is testicular cancer.

Sometimes, there is a weakening of the muscular tissues of the peritoneum in men, which leads to hernial subsidence in the inguinal area. This may be due to traumatic factors, intense coughing, or increased physical exercises. The hernial processes can be manifested by a lump on the surface of the testicle. When pressing on the scrotum, the formed soft lump can completely disappear, especially when the patient is lying down.

The causes of a pineal cyst may be associated with a varicose enlargement of the testicular veins, resulting from a disruption in the functionality of the intravenous valves. Normally, these valves interfere with the return blood flow. However, with their dysfunction, blood begins to overflow the blood vessels and they expand. As a result, varicocele develops in the testicles.

This pathology is accompanied by the appearance of lumps on the testicles, scrotal pain, an increase in the affected testicle, changes in the sperm test parameters, testosterone deficiency, external changes in the genitals, etc. Patients usually cannot detect varicocele because pronounced manifestations of the disease occur only in advanced stages.

The appearance of a lump can also be a sign of hydrocele, dropsy of the testicles. This pathology is most typical in men after 40 years old. It begins with the appearance of a small lump that quickly grows into a large one. The lump is a bloody cluster formed as a result of a trauma. Over time, it decreases and thickens.

Inflammatory lesions of lymph nodes can also appear as lumps on the testicles. Lymphadenitis, affecting the tissues of lymph nodes and vessels, is initially characterized by the appearance of balls on testicles. In addition, this pathology can lead to the formation of all sorts of tumors inside the testicle.

Possible Reasons for Testicle Pain

Pain in the testicles can occur in boys, adolescents, and older men. This symptom is expressed by sensations of a different nature in the scrotum area.

Pain can occur in the right, left, or both testicles. The localization of pain in some cases helps diagnose the disease that led to this symptom.

The main causes of pain in the testicles include:

• Traumas and injuries of the testicles
• Tight underwear
• Abstinence from sexual intercourse
• Inflammatory processes in the scrotum
• Torsion of the testicle (left or right)
• Neoplasms in the testicles, epididymis, and vas deferens
• Pathogenic microorganisms (chlamydia, gonococci, as well as bacteria that cause urethritis in men)
• Orchitis (complication after mumps)

After a trauma of the lumbar spine and sacrum, pain can occur in the testicles. This happens because of the compression of the nerves that come out of the intervertebral discs and are innervated in the scrotum.

During orchitis, an inflammatory lesion of one or both testicles is possible. Testicular torsion is more common in boys and adolescents, rather than in older men. The main symptom of the torsion is acute pain in one of the testicles. This pathology requires urgent medical help. If the blood flow is not resumed within 2 days, the testicle will die out.

Untimely treatment of a disease or pathological change, expressed by painful sensations in the testicles, can lead to the following complications:

• Infertility
• Ejaculatory dysfunction
• Decreased potency
• Development of benign and malignant tumors in the testicles
• Reduction in the level of the male hormone
• The appearance of purulent processes in the testicles with the possible removal of them

Undescended Testicle

Cryptorchidism (undescended testicle) is an innate pathology when one or both testicles are not descended into the scrotum. In this case, the testicle (or testicles) can linger in the abdominal cavity or inguinal canal.

The frequency of cryptorchidism in full-term newborn boys is 3%. The descent of the testicle does not always happen by the time of birth. When the newborn is underdeveloped, cryptorchidism is observed in 30% of cases.

The causes of cryptorchidism include:

• Hormonal failure during pregnancy
• Heredity
• Anatomical deviation

The complications are the following:

• The lag in the development of the child, since undescended testicle leads to its inadequate functioning, hence to insufficient production of hormones.
• Infertility. The undescended testicle, without timely treatment, can atrophy by the age of 6 years old, which leads to problems with childbearing. With bilateral cryptorchidism, infertility is observed in 90% of cases. The spermatogenic function is also disrupted due to the temperature difference with an incorrect testicular location.
• Cancer threat. The undescended testicle may be located in the abdominal cavity, where the temperature of the body is much higher than in the scrotum. Then, the undescended testicle is regenerated into a cancer tumor.
• Infringement of the testicle.

Treatment of undescended testicles:

• Therapeutic. With cryptorchidism, testosterone deficiency is observed, due to which the spontaneous descent of the testicle is possible in the first half of the year.
• Surgical intervention is recommended if the location of the testicle cannot be determined by palpation.

The consequences of not treating the undescended testicles are very dangerous. It is necessary to perform treatment after six months of age when spontaneous descent of the testicle into the scrotum did not occur.

Male Hormones and the Testicles

Male hormones are hormones that are produced in the male sex glands – the testicles. Male steroid sex hormones (androgens) are produced in the testicles by special cells of Leydig. Male sex hormones are synthesized from cholesterol by various chemical transformations using enzymes.

Male hormones include testosterone and dihydrotestosterone. Also, female sex hormones (estrogens) are synthesized in very small quantities in the testicles. The synthesis of male hormones is regulated by luteinizing and follicle-stimulating hormones of the pituitary gland. Under the influence of lutropin in the testicles, the synthesis and isolation of testosterone occur. Follitropin stimulates the formation of spermatozoa. The synthesis of pituitary hormones is under the control of the hypothalamus, which has a stimulating effect on the pituitary gland.

Male hormones are responsible for the formation of male sexual characteristics and the ability of men to conceive, namely:

• Formation and growth of the testicles, seminal vesicles, prostate gland, and the penis
• Manifestation of secondary sexual characteristics

Testicle Cancer Signs and Prevention

Testicular cancer is a malignant tumor that develops from the tissues of the testicles (male reproductive glands located in the scrotum). The risk group includes young people from 20 to 40 years old. The likelihood of the disease is higher in those men who, in childhood, suffered from cryptorchidism, the undescended testicles.

The first symptom of the testicular cancer is the appearance of a dense, sometimes painful, tumor in the scrotum. The main clinic is associated with the metastasis in the retroperitoneal lymph nodes, which causes severe back pain, and the lungs, which leads to hemoptysis and coughing. Sometimes, there is gynecomastia, an increase in the mammary glands.

It is necessary to urgently consult a doctor if the following signs appear:

• The testicles have increased in size
• Lumps in the testicles

Patients with testicular cancer in advanced stages can have the following symptoms:

• Weakness
• Loss of appetite
• Nausea

The prevention of malignant tumors of the testicles includes measures that decrease the development of cancer, especially cryptorchidism, traumas, and irradiation of the genitals.

Cryptorchidism and the cases of testicular cancer in the family are the main risk factors for the development of the disease. Many men with testicular cancer have no known risk factors. For this reason, there are no ways to prevent most cases of the disease. One of the prevention measures is self-examination of the testicles. If you note any changes in size, shape, or density of the testicles, seek medical help. Lumps first appear on the anterior or lateral surface of the testicles.

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