Conditions — Men

Testicular cancer most often affects men between the ages of 15 and 39. It usually shows up as a painless lump in the testicle. The good news is that a simple monthly self-exam can help find trouble before it gets serious. When detected early, testicular cancer is almost 100% curable.

Doing Your TSE

Do TSE once a month, during or after a warm shower. Spend about 3-5 minutes feeling for any lump, firm area, or change. If you do find a problem, don’t panic. Call your doctor and make an appointment.

Check the Testicles

Hold your scrotum in the palm of your hand. Roll each testicle gently between the thumbs and fingers of both hands. Feel for changes in each testicle, one at a time.

Check the Epididymis

The epididymis is a raised rim-like structure responsible for sperm storage. It runs along the top and back of each testicle and often hurts when you press on it. Gently feel each epididymis for changes. A spermatocele, which represents a cyst, can present as a painless growth near the testicle. These are noncancerous.

Check the Vas

The vas deferens is a little tube that runs up from the top of each testicle. A normal vas feels like a firm piece of cooked spaghetti. Feel for changes in the vas about each testicle.

Professional Screening

If you feel any abnormalities, tell your doctor right away. Along with your own TSE, see your doctor for regular checkups.

Epididymitis is an inflammation of the epididymis. Inflammation is most often caused by bacteria in the urinary tract (a bladder infection) or by bacteria passed between partners during sex. When the inflammation spreads to a testicle, it is called orchitis.

The Testicle and the Epididymis

The 2 testicles are the male sex organs that produce sperm and male hormones. The testicles lie inside the scrotum. Behind each testicle is a coiled tube called the epididymis.

Normal Flow of Sperm and Urine

Sperm travel from the testicle through the epididymis into a tube called the vas deferens. During ejaculation, sperm pass out of the body through the urethra.During urination, urine flows from the bladder out through the urethra.

How Inflammation Starts

The urethra contains bacteria. Bacteria can travel from the urethra into the epididymis. This causes inflammation in the epididymis. The inflammation can also spread to the testicle. Rarely, infections, such as mumps, start elsewhere in the body and spread to the testicle, causing orchitis.

Acute inflammation comes on quickly. Symptoms may include:

• pain and swelling in the scrotum.
• a frequent urge to urinate.
• a discharge from the penis.
• pain during ejaculation.
• fever.

Chronic inflammation is most often the late phase of an acute infection. Symptoms may include:

• an ache or dull pain in the scrotum, which may spread to the groin.
• a heavy feeling in the scrotum.

Treatment includes medication to get rid of the bacteria and relieve discomfort. Resting, supporting the scrotum, and using ice packs can help relieve your symptoms. If you are sexually active, any partners need to see a doctor as well, since the infection can sometimes be spread between sex partners.

Possible Treatments

• Antibiotics: Acute epididymitis is most often treated with oral antibiotics. You may also be given an injection of antibiotics. Be sure to take all of your medication.
• Anti-inflammatories: Your doctor may prescribe medication to reduce swelling and tenderness.
• Rest: You will most likely need to rest for 3-4 days, or until the swelling and fever are gone. Lying down with a towel folded under the scrotum to raise it slightly can help relieve discomfort.
• Scrotalsupport: If your testicles are swollen, you may want to wear an athletic supporter (jockstrap) or spandex bicycle shorts. This can help to relieve your discomfort until the swelling goes down.
• Ice and heat: Put an ice pack on the scrotum at first to help decrease any swelling. Once swelling is gone, sit in a warm bath to increase blood flow to the affected area. This helps to bring more antibiotic to the area and speeds healing.

After Treatment

The inflammation will go away with treatment. But you may have an achy feeling in the testicles for several weeks or months. This does not mean the infection has come back. The testicles just take time to heal. If you feel a lump in a testicle after treatment, however, you need to see your doctor. Once the inflammation is gone, you should feel like being active again.

A varicocele is a swelling in the veins above the testicles. It is similar to having varicose veins in the legs. The swelling occurs when too much blood collects in the veins. A varicocele most often occurs around the left testicle.

Veins in the Scrotum

The scrotum is a sac of skin that covers the testicles-the male sex organs that produce sperm and the male hormones. Blood vessels in the scrotum carry blood to and from the testicles. The vessels that carry blood away from the testicles are called veins.

When There’s a Problem in the Veins

The veins that carry blood from the testicles extend up into the groin. That means the blood has to travel upward a long way. Valves in the veins act like gates to keep the blood from flowing back toward the testicles. In some men, these valves don’t close fully. Or the muscles in the walls of the veins may be weak. Then some blood flows back into the scrotum and collects in the veins above the testicles. This makes the veins enlarge.

What Are the Symptoms?

A varicocele often causes no symptoms at all. Or it may cause an achy or heavy feeling in the scrotum. The pain may be worse later in the day or after standing for a long time. You may also see swollen veins just under the skin in the scrotum.

A Varicocele Can Lower Sperm Count

When blood collects in the veins above the testicles, changes occur that can reduce the number and the quality of the sperm. In many cases, sperm count improves after treatment.

In most cases, a varicocele is not serious. Your doctor may wait and watch the problem for a while. If needed, surgery or another procedure to close off the enlarged veins can be done. This may be suggested if you have pain, if the veins become unsightly, or if you and your partner are having trouble conceiving a baby.

Surgery: Open Varicocelectomy

Your doctor may recommend surgery to tie off the enlarged veins around the testicles.

• You are given anesthesia to keep you comfortable. You may or may not be asleep.
• An incision is made in the groin or in the lower abdomen.
• The veins are then cut and tied off.
• The incision is closed with sutures, staples, or surgical tape.

Surgery: Laparoscopic Varicocelectomy

Instead of open surgery, laparoscopic surgery may be recommended. This is surgery done through small incisions with an instrument called a laparoscope (a thin, telescope-like device).

• You are given general anesthesia to make you “sleep” during the procedure.
• Several small openings are made in the lower abdomen. The laparoscope is inserted through one opening. Surgical instruments are inserted through the other small openings.
• The laparoscope sends magnified pictures to a video monitor. Using these pictures, the surgeon identifies the veins that need treatment.
• The veins are clamped to seal them off.
• The instruments are removed. The incisions are closed with sutures, staples, or surgical tape.

Percutaneous Occlusion

In place of surgery, your doctor might recommend sealing off the enlarged veins using percutaneous occlusion. A radiologic procedure called a venogram is used to create a map of the veins. A tube is then placed in the large vein in the groin. Materials are injected through this tube into the enlarged veins to block them off.

After Your Varicocele Procedure

• You may feel some pain in your testicle for a few days.
• Mild swelling around the testicle is normal after the procedure. Put an ice pack (or bag of frozen peas or rice) wrapped in a thin towel on the area to help. Do this for no longer than 20 minutes at a time.
• Plan to rest for 2-3 days.

Risks of Varicocele Repair

Risks and possible complications of these procedures include:

• Hematoma (blood clot).
• Infection.
• Injury to scrotal tissue or structures.
• Injury to the artery that supplies the testicle.
• Risks of general anesthesia, if used.
• Damage to abdominal structures (laparoscopic surgery).

Call Your Doctor if You Have:

• Ongoing pain not relieved by pain medication.
• Black-and-blue around the incision, bleeding from the incision, or swelling in the scrotum.
• A fever above 100.2°F, chills, or greenish or foul-smelling drainage from the incision.

Urethritis occurs when the urethra is inflamed (red and swollen). This is the tube that runs from the bladder through the penis. The urethra can become swollen and cause burning pain when you urinate. You may also have pain with sex and masturbation. Read on to learn more about urethritis and how it can be treated.

What Causes Urethritis?

Urethritis can be caused by a bacterial or viral infection. Such an infection can lead to conditions such as a urinary tract infection (UTI) or sexually transmitted disease (STD). Urethritis can also be caused by injury or sensitivity or allergy to chemicals in lotions and other products. An inflamed urethra can cause pain during urination.

How Is Urethritis Diagnosed?

Your healthcare provider will examine you and ask about your symptoms and health history. You may also have one or more of the following tests:

• Urine test to take samples of urine and have them checked for problems.
• Blood test to take a sample of blood and have it checked for problems.
• Urethral discharge culture to take a sample of fluid  from inside the urethra. A cotton swab is inserted into the opening of the penis and into the urethra.
• Cystoscopy to allow the healthcare provider to look for problems in the urinary tract. The test uses a thin, flexible telescope called a cystoscope with a light and camera attached. The scope is inserted into the urethra.

How Is Urethritis Treated?

Treatment depends on the cause of urethritis. If it’s due to a bacterial infection, antibiotics (medications that fight infection) will be given. Your healthcare provider can tell you more about your treatment options. In the meantime, your symptoms can be treated. To relieve pain and swelling, anti-inflammatory medications, such as ibuprofen, may be given. Untreated, symptoms may get worse. Also, scar tissue can form in the urethra, causing it to narrow.

Call the healthcare provider right away if you have any of the following:

• Fever of 100.4°F or higher .
• Blood in the urine or semen.
• Burning pain with urination.
• Increased urge to urinate.
• Discharge from the penis.
• Itching, tenderness, or swelling in the penis or groin.
• Pain during sex or masturbation.

Preventing STDs

When it comes to sex, it’s important to take care and be safe. Any sexual contact with the penis, vagina, anus, or mouth can spread an STD. The only sure way to prevent STDs is abstinence (not having sex). But there are ways to make sex safer. Use a latex condom each time you have sex. And talk to your partner about STDs before you have sex.