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Men's Health

Testicular Problems

Prevention - Home Treatment - When to Call a Health Professional

The testicles produce sperm and male hormones. Males usually have 2 testicles, located behind the penis inside a sac of skin called the scrotum. It is normal for one testicle to be slightly larger than the other.

Each testicle is suspended at the end of a spermatic cord, a network of blood vessels that carry blood to and from the testicle. Sperm cells leave the testicle through the epididymis (a coiled tube located at the top of the testicle). Then they move through a tube called the vas deferens and are deposited in the seminal vesicles, which are near the prostate gland. Sperm mix with fluids produced by the seminal vesicles and the prostate to create semen, which exits the body through the penis during sexual activity.

The location of the testicles makes them prone to injury, especially during contact sports. Wearing a protective athletic "cup" can prevent injuries. Pain caused by a testicular injury usually goes away within an hour or so. However, if pain persists, or if a testicle becomes swollen or bruised, see a health professional.

Testicular torsion occurs when one of the testicles rotates, twisting the spermatic cord and cutting off blood flow to the testicle. Testicular torsion can occur at any age, but it is most common in young boys. It may occur after strenuous physical activity or after an injury, but it often has no specific cause and may occur while a boy is sleeping.

Symptoms of testicular torsion include sudden, severe pain in one testicle that may radiate to the lower abdomen; swelling high in the scrotum; nausea and vomiting; and fever.

Testicular torsion is a medical emergency. Surgery is often needed to restore blood flow to the testicle. If the procedure is not done within a few hours after the onset of symptoms, the testicle can be permanently damaged and may have to be removed.

Epididymitis is inflammation of the epididymis. It can be caused by a bacterial infection (including chlamydia, which is spread through

sexual contact, See Chlamydia is a bacterial infection that affects millions of men and women. It may be difficult to detect chlamydia; about 75 percent of women and 20 percent of men with the disease have no symptoms, but they can still infect their sex partners. If symptoms do show up, they occur 1 to 3 weeks after exposure to the bacteria. In women, symptoms may include vaginal discharge or irregular menstrual bleeding, pain when urinating, or lower abdominal pain. In men, there may be a discharge from the penis and pain when urinating.). Irritation resulting from a bladder infection or injury is another cause of epididymitis. Epididymitis causes pain and swelling in the scrotum that develops gradually, over hours or days, and can become severe. The scrotum may feel hot and be tender to the touch, and the person may have a fever. Bacterial epididymitis is usually treated with antibiotics.

Orchitis is inflammation of the testicle. It may be caused by a bacterial infection or by a virus such as the mumps virus. Orchitis can also occur with epididymitis or a prostate infection (prostatitis). Symptoms include scrotal pain; swelling (usually on one side of the scrotum); and a feeling of heaviness in the scrotum. If it is not treated, orchitis can cause infertility.

Testicular cancer is rare and most often affects males between the ages of 15 and 34. Those at highest risk include males whose testicles have not descended or did not descend until after age 6, and males with a family history of testicular cancer. Testicular cancer usually affects only one testicle and responds well to treatment if detected early. Symptoms of testicular cancer may include a painless lump or swelling or a feeling of heaviness in one testicle.

Prevention

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  • Prevent testicular injury by wearing a protective athletic "cup" when you play sports.

  • Prevent bacterial infections that are spread through sexual contact by following the safer sex guidelines on Prevention.

  • Make sure your child has completed the measles, mumps, and rubella (MMR) vaccination series. See Measles, Mumps, and Rubella (MMR).

  • Starting as teenagers, males should examine their testicles once a month. After taking a warm bath or shower:

    • Stand and place your right leg on an elevated surface such as the side of the bathtub or the toilet seat.

    • Examine the surface of your right testicle by gently rolling it between the thumb and fingers of both hands. Feel for any hard lumps or nodules. The testicle should feel round and smooth.

    • Feel for any enlargement of the testicle or a change in its consistency. It is normal for one testicle to be slightly larger than the other. Report any major size differences to a health professional.

    • Repeat the exam on your left testicle.

Home Treatment

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  • Elevating the scrotum with a pillow and applying ice may help relieve pain caused by an injury.

  • Wearing a jock strap daily may relieve scrotal pain.

    Gently feel each testicle for hard lumps or a change in size.

  • Take aspirin or acetaminophen to relieve pain caused by orchitis. Do not give aspirin to anyone younger than 20. Warm baths may also help relieve pain.

When to Call a Health Professional

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  • If you find a lump in a testicle.

  • If you notice any enlargement in a testicle or a change in its consistency.

  • If pain in a testicle or the scrotum comes on suddenly and is severe.

  • If pain and/or swelling in a testicle or the scrotum worsens over a period of several hours or days.

  • If pain and/or swelling in a testicle or the scrotum is accompanied by fever.

  • If pain and/or swelling in the scrotum develops after exposure to the mumps virus.

  • If pain resulting from an injury does not go away or if swelling does not lessen after a few days.

  • If you have a feeling of heaviness in one testicle.

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