Hydrocele
Hydrocele is a condition in which the testicle becomes extremely swollen, with more fluid than normal collecting between the membranes surrounding the testicle. Normally, there is 1-2 ml of fluid in this range to ensure lubrication of the testicle. In hydrocele, this amount of fluid is 200-300 ml and sometimes even more. Hydrocele often does not cause pain.
-It may be congenital. These two membranes are open at birth. Intra-abdominal fluid leaks between the membranes. Then, as the open mouth of the two membranes closes, it takes the shape of a pouch. It can often disappear in infancy. Therefore, it is waited until the age of 1 for young babies to collect fluid.
-Strokes: Occur after testicular strokes. Sometimes there is blood in this fluid.
-Occurs after testicular inflammation
- Conditions of unknown cause.
Symptoms:
-The bag remains swollen
-When touched, the fluid inside can be felt.
- There is usually no pain. Unloading is done from time to time. In case of small fluid collections, evacuation with a needle may be attempted. It recurs after 2-3 months after injection. There is a possibility of bleeding into the fluid and inflammation. Surgery: Surgery is performed in very large cases and large fluid collections. The liquid is drained. To prevent recurrence, the membranes are reversed and stitched.
Spermatocele
They are small, painless masses located on and behind the testicle. It is a cystic formation containing dead spermatozoa. A cystic structure occurs as a result of the accumulation of spermatozoa. The reason is unknown. It does not cause pain. The patient notices a hardness or swelling inside the scrotum, separate from the testicle, on the upper back side of the testicle. Diagnosis is made by examination and ultrasound. If it does not reach large volumes, there is no need for treatment. If it grows too much, it is removed surgically.
Orchitis
It is a testicular infection that develops as a result of different microorganisms reaching the testicle through the blood. E. Coli, staphylococcus, streptococcus, klebsiella and pseudomonas are the most common microorganisms. Special attention was required, especially due to the frequent occurrence of mumps orchitis. rir. It is extremely rare before puberty. Mumps orchitis is seen in 20-35% of parotitis cases. Sometimes orchitis can occur without parotitis. It usually starts 3-4 days after parotitis, and the scrotum is erythematous and edematous. Fever can reach 40 degrees. There are no characteristic urinary symptoms seen in epididymitis. In 30% of cases with mumps orchitis, spermatogenesis is irreversibly damaged. Atrophy is observed in the affected testicle. In orchitis, the testicles become enlarged and sensitive. The scrotum skin is red and thickened. The patient's fever may rise to 40 degrees.
Antibiotics, analgesics and antipyretics, anesthesia around the spermatic cord, bed rest and local cold-heat application are useful in the treatment. Hanging the testicle up relieves the patient.
Epididymitis
It is an epididymal infection that develops as a result of various microorganisms reaching the epididymis. Microorganisms such as Pseudomonas, enterobacter, N. Gonorhoea and C. Trachomatis are causative agents. It is seen as acute or chronic inflammation.
The chronic condition occurs either in testicular tuberculosis or testicular syphilis. In acute inflammation, microbes come from the urinary opening or another focus of the body via blood. Sexually transmitted diseases are more common in young people. It occurs in the elderly after catheters are inserted into the urinary tract to urinate, etc. The scrotum is enlarged and its skin is red. The epididymis is sensitive. While the epididymis is initially distinguished from the scrotum, it is palpated as a single mass in the scrotum in the later hours. The mass is hard at first and then partially softens.
Treatment; Antibiotics, bed rest, cold compression, and anesthesia around the spermatic cord may be applied. Sexual and physical activity is restricted. Epididymitis heals without complications if treated well. If proper treatment is not given, it becomes chronic, may cause infertility, or even scrotal fistula may develop.
Testicular Torsion
Testicular torsion is an important disease of the testicle. In this disease, the spermatic cord, which contains the vessels that carry blood to the testicles, twists around itself, the spermatic vessels cannot carry blood, and if this situation is not corrected early, testicular necrosis (gangrene) may occur. It is happening. The risk of torsion is highest during puberty. The risk is also high in undescended testicles that have not been operated on.
Treatment: The testicles and epididymis are examined with an emergency surgical intervention through the bags or through an incision in the groin. If they are alive, the testicles and epididymis are detorsioned and fixed into the bag. If they are gangrene, they are removed by surgery. Since the anomaly that causes torsion may be in the other testicle, the testicle on the opposite side is also fixed into the scrotum in the same session.
Testicular Tumor
Testicular tumors are the most common between the ages of 15-35. It is one of the types of cancer. It constitutes 1-2% of malignant tumors seen in men. In testicular tumors, which were previously described as difficult and dangerous to treat, with today's developments, if they are diagnosed early, very satisfactory results are obtained and the survival rate increases to 95%.
In approximately 95% of the cases, the tumor originates directly from the tissue that produces spermatozoa. The causes of testicular tumors are unknown, but those with undescended testicles as a risk factor are more likely to develop the disease. Even if the undescended testicle is later removed by surgical methods, this risk continues.
Symptoms such as a sometimes painful but often painless mass or growth in one of the testicles, a feeling of heaviness in the sac, hydrocele (accumulation of fluid in the sac) must be evaluated by a doctor.
With early diagnosis, the chance of treating the tumor may increase. All men should perform a testicular self-examination and in case of doubt, a doctor's check-up is required. In the evaluation, beta-HCG and alphafetoprotein tests, which are called tumor markers, may be requested. In some tumor types, these markers may not increase, and ultrasonography and chest radiography may be required.
There are different treatment methods depending on the type of tumor (seminoma, nonseminoma) and stage. In approximately 95% of the cases, the tumor originates directly from the tissues that produce spermatozoa.
Seminomas are the most common tumor with an incidence rate of 40%. Nonseminomas are teratocarcinoma, embryocarcinoma, etc. It consists of different types of tumors.
Treatment varies depending on the type of tumor and the degree of spread (stage).
Surgical Treatment (radical inguinal orchiectomy): All The testicle and surrounding tissue are surgically removed. It should be evaluated assuming that there may be a tumor in the other testicle in 2-5% of cases. Radiation Therapy: It can be applied to seminomas that are sensitive to radiotherapy, but nonseminomas are not sensitive to radiotherapy. After surgical treatment of tumors, chemotherapy is performed with drugs that have minimal side effects.
Some important issues:
-Most men think that by removing one testicle, they will become infertile or their sexual activity will disappear. However, this is wrong. It is unlikely if the opposite testicle is intact.
- A prosthetic testicle, placed in a bag and giving the appearance of a normal testicle, can be inserted instead of the testicle removed for visual purposes.
- Removal of lymph nodes in tumors that have spread to the back of the abdomen does not negatively affect penis erection or orgasm. However, it can cause infertility. This can sometimes be corrected with medications.
-Radiotherapy can also have a lethal effect on sperm. Improvement is usually seen after a few months of treatment, but freezing sperm in a sperm bank may still be recommended as a precaution before treatment.
Undescended testicle:
It comes from the word hidden testicle (cryptorchidism). During the intrauterine development of the child, the testicle is in the abdomen. As birth approaches, the testicle begins to descend towards the bag. It settles in the bag from the moment of birth. Preventing this descent process for any reason causes the testicle to remain elevated. Its incidence in newborns is 2-5%.
Causes:
Some hormonal and mechanical reasons are held responsible.
-The main reason for this is the lack of development of the scrotum.
-Another reason. The muscles that pull the testicle down do not develop or there is a reason such as a hernia that prevents the descent.
When the testicle is not in the bag, its development is disrupted and it cannot fulfill its functions.
Functions of the Testicle:
-Secreting the male hormone called testosterone
-To produce sperm cells that enable reproduction.
In testicles that are not in place, there are symptoms due to the lack of male hormones. Cancer occurs more frequently in testicles that are not in place.
Symptoms:
-The testicle is not palpable in the bag. .
-It can be felt in the groin.
-It does not cause symptoms in most cases. Sometimes it causes pain.
Usually, ann It may escape the father's attention.
Treatment:
If a testicle does not descend normally, testicular rotation and destruction will occur, so it should be treated early.
-Hormone Therapy: It should be tried before surgery. It is worth trying, especially since the cause of bilateral undescended testicles is hormonal. After such a hormone is tried, it is waited for 2-4 months and if it still does not decrease, surgery is performed. Today, the age of 3 has been deemed appropriate because in modern medicine, surgery can be performed under anesthesia on children without hesitation. If surgery is performed after this age, testicular functions are likely to be lost.
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