Monday, January 11, 2010

The Care and Feeding of the Testicles, a guest post by Aek

So the lovely Biki asked me (as the “medical specialist” in this corner of the blogosphere) to do a post on the following topic, as well as suggest the rather apt title.  I will touch upon 2 topics today: testicular torsion and testicular cancer.
Testicular Torsion

What is testicular torsion?
Testicular torsion is when the spermatic cord (that contains the artery and vein to the testicles) twists on itself and cuts off blood supply to a testicle.  It’s very painful and must be ruled out whenever there’s pain in the scrotum.

How does it happen?
Normally, the testicles are “anchored” to the bottom of the scrotum by the ligament made by the gubernaculum (such a fun word to say, say it with me: gubernaculum).  During fetal development, the gubernaculum pulls the testicles from inside the abdomen down into the scrotum (though no one knows exactly how it does this).  If the ligament made by the gubernaculum weakens/breaks, the testicle “floats” more freely in the scrotum, allowing it to more easily twist around itself.  The most common causes of testicular torsion are trauma to the testicles or strenuous physical activity.

How is it diagnosed?
There are a lot of things that can cause pain in the scrotum, such as inflammation or infection.  A good patient history and physical exam are usually sufficient to diagnose testicular torsion.  Sometimes an ultrasound may be used, if available.

Can it be dangerous?
Aside from extreme pain that can cause nausea and dizziness, testicular torsion can indeed be dangerous. Because the blood supply to the testicle is cut off by the twisting, the testicle is in danger of dying and become gangrenous.  Prompt treatment within hours may be necessary to save the testicle . . . otherwise amputation of the testicle to prevent gangrene infection may be needed.

How is it treated?
Testicular torsion is often treated surgically.  Sometimes it may be manually untwisted or it may even untwist on its own.  Such treatment should be attempted by a trained doctor only.

Take home message:
If you’re experiencing extreme pain in your testicles, see the doctor ASAP.  No excuses.
Testicular Cancer

What is testicular cancer?
That’s rather self-explanatory, lol.  It’s actually really freaky and I won’t go into the weird details of testicular cancer.  o_O

Who gets testicular cancer?
Testicular cancer is odd in that it’s not an “old person’s disease” like most cancers.  It’s the most common cancer of men between the ages of 15 and 34, occurring most often in men between the ages of 20 and 39. Testicular cancer accounts for about 1% of all male cancers in the US.  In 2009, 8400 new cases of testicular cancer were diagnosed in the US and there were 380 deaths from it.  Fortunately, testicular cancer has over a 95% cure rate if detected early.

How is it diagnosed?  What’re the symptoms?
Taken from the National Cancer Institute (NCI), the following are common symptoms of testicular cancer:
- painless lump/swelling in a testicle
- pain/discomfort in a testicle or in the scrotum
- enlargement of a testicle or changes to how it feels
- dull ache in the abdomen, back, or groin
- sudden collection of fluid in the scrotum

How is testicular cancer treated?
The same as any other cancer, more or less: surgery, radiation therapy, and/or chemotherapy.  Fortunately, treatment for testicular cancer tends to be less aggressive than for many other cancers.

What about prevention?
As with many cancers, prevention = early detection.  To detect testicular cancer early, guys should do monthly testicular self-exams.  It’s very easy to do.  During/immediately after a shower, when the scrotum is relaxed, gently hold one testicle and feel for lumps or anything different (such as tenderness, increased firmness, or buildup of fluid).  Then repeat with the other testicle.  Compare the two testicles for any changes in size.  Since many will forget to do this (I’m just as guilty), it may be a better idea to pseudo-incorporate this into masturbation sessions once in a while.  Just a thought.  o_O

Now for something amusing/interesting.  Guys have a special reflex called the “cremaster reflex.”  There’s a muscle in the spermatic cord called the cremaster muscle, that pulls the testicles closer to the body.  The nerve that innervates the cremaster muscle (the genito-femoral nerve) splits in the abdomen and also goes to the inner thigh.  So if you stroke your inner thigh, you’ll cause your testicles to pull towards your body.  Nifty, eh?


Ryan said...

So informative and concise! I loved it of course! I learned a lot about testicular torsion as well so if and when that happens (OUCH!!) I should be good!

Lots of love to you both!

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Old Midhurstian said...

A really brilliant and informative post. Having had a suspected torsion (thankfully it turned out to be orchitis) I'm astonished that anybody in that much pain wouldn't run screaming to their doctor.

As a former nurse who's seen unnecessary deaths I can only add to your message that it all comes down to early detection and the best form of early detection is self examination