What are testicles?
Testicles are the male reproductive glands. They are the two oval-shaped organs found behind the penis, within the scrotum.
Functions of the testicles
Functions of the testicles
- Reproduction: They are the site of production and storage of sperm prior to ejaculation.
- Endocrine: They are the primary source of testosterone, which is responsible for the development of sex drive, maintenance of fertility, as well as typical male characteristics.
Common causes of testicular pain
These include:
- Epididymitis: Inflammation of the epididymis. Most often caused by a sexually transmitted infections (STIs)such as gonorrhea and chlamydia
- Testicular torsion: Which occurs when the testicles twist around the suspending spermatic cord. This is considered a surgical emergency and needs immediate intervention to restore blood flow to the affected area.
- Kidney stones: Hard salt and mineral deposits that form within the kidneys.
- Inguinal hernia: Protrusion of a section of the intestines through a weak spot in the muscles of the abdomen.
- Orchitis: Inflammation of the testicles often caused by bacterial or viral infections, usually STIs and mumps virus.
- Varicocele: Caused by the pooling of blood in the veins, resulting in vein enlargement within the scrotum which contains the testicles.
- Diabetic neuropathy: Which is nerve damage because of diabetes
- Hydrocele: Testicular swelling caused by the pooling of serous fluid within the tunica vaginalis layer of the testicle
- Prostatitis: Inflammation of the prostate often caused by infection
- Spermatocele: An abnormal cyst that forms within the testicles, specifically the epididymis which is responsible for the collection and transportation of sperm.
- Urinary tract infection (UTI): An infection that occurs in any section of the urinary system.
- Trauma
- Testicular cancer
Symptoms of testicular disorders
Symptoms are usually dependent on the cause, but there are signs that are common to most disorders. These include:
- Pain in the scrotum, lower abdomen and/or back.
- Bruising or swelling of the scrotum/testicle.
- Redness of the scrotum/testicle.
- Tenderness of the testicles/scrotum
- Nausea and/or vomiting.
- Fever
What is testicular cancer?
Testicular cancer is the most commonly diagnosed cancer in males aged 15 to 35. Approximately 80% of testicular tumors are seminomas which arise from sperm cells. It usually develops in one testicle, but in a small percentage of individuals, it is present in both testicles.
Risk factors for testicular cancer
There are many factors which can contribute to the likelihood of developing testicular cancer. These include:
- Cryptorchidism: More commonly known as an undescended testicle. During the development of a fetus, the testes are formed within the abdomen and usually descend into the scrotal sac prior to birth. In some men, the testicles remain in the abdominal area and are then relocated into the scrotal sac surgically post birth. These men have an increased risk of developing testicular cancer than men whose testicles descend naturally.
- Abnormal development of the testicles: This is often caused by conditions that affect pubertal development such as Klinefelter syndrome.
- Positive family history: Men who have family members who have been diagnosed with testicular cancer are at an increased risk of developing testicular cancer themselves.
- Age: Testicular cancer is a disease that most often affects young men, typically those between the ages of 15 and 35.
- Race: Men of Caucasian descent are about 3.6 times more likely to be diagnosed with testicular cancer than men of African and Caribbean descent, and 2.5 times more likely than men of Asian descent.
Symptoms of testicular cancer
The most common initial symptom of testicular cancer is the presence of a painless lump in the testicle. Other common symptoms include:
- Feelings of pain or discomfort in the testicles
- Dull feeling of heaviness and dragging in the scrotum
Less common symptoms of testicular cancer include :
- Dull ache in the lower abdomen, lower back or groin.
- Back and bone pain
- Swelling in the lower limbs and breasts
- Cough
Red flags for testicular disorders
It is important to see your doctor upon the development of any of the following testicular symptoms:
- Any scrotal swelling, tenderness, or lumps
- Fever and general malaise
- Any scrotal redness or warmth to the touch
- Any urinary symptoms such as blood in the urine, burning sensation upon urination and frequent urination
- Nausea and/or vomiting
- Long-standing dull or sharp pain in any part of the penis.
- Presence of a sharp, cramping pain that may radiate from the back to the groin
Prevention of testicular disorders
There is no proven method of preventing most testicular disorders such as cancers, varicoceles, hydroceles, or testicular torsion.
Trauma can be prevented by wearing appropriate protective gear whilst playing contact sports.
The risk of epididymitis and bacterial orchitis can be decreased by practicing safe sex andavoiding heavy lifting or straining with a full bladder.
Immunization from mumps can decrease the risks of viral orchitis.
Diagnosis of testicular disorders
The diagnosis of a testicular disorder by a medical care professional includes:
- Complete history and physical exam: To detect any physical signs such as lumps, redness, swelling and tenderness of the scrotum, pain, and other associated symptoms.
- Laboratory testing: To determine the cause of the signs and symptoms noted during history taking and physical examination. This may include blood tests, urinalysis, and urethral swabs.
- Ultrasonography: A painless, non-invasive method used to determine the cause of testicular pain. A testicular ultrasound can be used to evaluate blood flow to the testicles, as well as investigate the presence and nature of any lumps, tumors, collections of fluid, rupture, or herniation. It can distinguish a malignant from a more benign disorder and help to determine the best management strategy moving forward.
Importance of early detection of testicular disorders
The early detection and treatment of any condition is an important prognostic factor, and the same goes for testicular disorders.
An infection such as chlamydia left untreated, or a serious condition such as testicular torsion may result in permanent damage to your testicles and scrotum, resulting in long-term negative effects on fertility and reproduction.
Testicular torsion left untreated can also lead to gangrene, a life-threatening condition caused by the restriction of blood flow to the scrotum.
In cases where testicular cancer is detected prior to its spreading to other parts of the body, the recovery rates are as high as 99%.
One way to ensure early detection of a testicular disorder is to regularly self-examine the testicles after a warm bath or shower.