Male Reproductive Disorders

Common Male Reproductive Disorders

Male reproductive disorders include conditions that affect the sexual health of a man. Frequently, family doctors evaluate male patients who come into their offices complaining of testicular pain and lumps, or the doctor discovers a scrotal mass during a routine examination. Common male reproductive disorders include testicular torsion, hydrocele, and spermatocele. An accurate medical history, in combination with a thorough examination of the external genitalia, will provide an initial diagnosis and appropriate treatment. Benign scrotal masses, including hydroceles (fluid-filled sacks found in the scrotum) and spermatoceles (sperm-filled cysts in the epididymis), are typically diagnosed and readily treated by the primary care professional. Patients with testicular masses typically present with a painless lump or scrotal pain that ranges in severity from severe to a dull aching, which worsens upon exercising. A thorough examination of the genitalia will ascertain if a mass is located within the testicle or an adjacent structure.

Overview of Male Reproductive Disorders

Common male reproductive disorders include testicular torsion, hydrocele, spermatocele, and cancers of the reproductive organs and structures. Testicular torsion is a twisting of the spermatic cord, which results in decreased testicular blood supply. A hydrocele is a fluid-filled sac that forms on the scrotum. A spermatocele is a sperm-filled sac that affects the epididymis.

Male Reproductive DisordersSource: lookfordiagnosis.com

Testicular Torsion

Testicular torsion is twisting of the spermatic cord, and this cuts off the blood supply to the testicle and surrounding structures contained in the scrotum. This particular reproductive disorder tends to be more common in an infant's first year as well as during puberty. However, it can also occur in older males.

Causes

There may not be an obvious cause for testicular torsion. However, some men may be predisposed to it because of insufficient connective tissue within their scrotum. There are other risk factors, including trauma to the scrotum, especially if there is a significant amount of swelling involved and strenuous exercise. Signs and Symptoms

Signs and symptoms of testicular torsion include:

  • Sudden, severe pain within a testicle, with or without an accompanying cause.
  • Scrotal swelling and tenderness.
  • Nausea and/or vomiting.
  • Dizziness.
  • Mass in the testicle.
  • Blood found in semen.
  • Affected testicle is higher than the other one.

Diagnosis and Treatment

With testicular torsion, an ultrasound examination will indicate blood flow. With complete torsion, there will be no blood getting to the testicle. In the case of partial torsion, there will be partial circulation.

An immediate referral to an urologist or surgeon is required as soon as torsion symptoms develop. When surgery is performed within the first six hours, the testicle is more likely to be saved. After six hours of impaired blood circulation, chances of testicular removal increase significantly. However, a testicle can still lose its functioning capabilities withless than six hours of restricted circulation.

Atrophy (shrinkage) of the testicle, resulting from prolonged torsion, can develop several days to months after the disorder has been corrected. Severe testicular or scrotal infections can develop if blood flow is restricted for prolonged time periods.

Hydrocele

A hydrocele is a fluid-filled sack in the scrotum, and this condition is very common in newborn babies. During normal fetal development, both testicles descend through a tube within the abdominal cavity downwards into the scrotum. Hydroceles occur when this tube does not close properly. Fluid will drain from the abdomen through the open tube. This fluid builds up and becomes trapped, causing the scrotum to swell. Typically, these sacks disappear within a few months of birth, but they can be worrisome to new parents. The main symptom of a hydrocele is a painless, swollen testicle. Sufferers say it feels much like a balloon filled with water.

Causes

In older males, this disorder can be caused by:

  • An inguinal hernia.
  • Fluid accumulation aroundthe testicular area.
  • Injury or inflammation of the testicle and/or epididymis (organ found on the back of a testis which stores sperm).

Diagnosis and Treatment

Hydroceles can make it difficult for a doctor to perform a testicular exam, which is done for early detection of testicular cancer. Generally, hydroceles are not dangerous and are treated only if they cause discomfort or an infection.

If an inguinal hernia is the cause of the condition, surgery should be performed immediately. The surgical procedure is known as a hydrocelectomy. A relatively easy procedure, it generally has an excellent prognosis. At times, a small needle is used to aspirate fluid from the hydrocele, but it often returns.

Hydrocele surgical risks can include:

  • Formation of blood clots.
  • Infections.
  • Scrotal injury.

Spermatocele

A spermatocele is a sperm-filled cyst located in the epididymis, which is a coiled, elongated tube lying above or behind each testicle. A spermatocele feels like a firm, smooth lump within the scrotum. Often, the reason a spermatocele forms is unknown, but it may result from an obstruction of the epididymal ducts.

Signs and Symptoms

Many times, spermatoceles are asymptomatic. However, signs and symptoms can include:

  • An extra lump detected above the testicle.
  • Generalized scrotal enlargement.
  • Swelling, pain, and/or redness of the scrotum.
  • Sensation of pressure at the bottom of the penis.

Diagnosis and Treatment

Generally, a scrotal examination and ultrasound detects a spermatocele. The majority of the time, spermatoceles are not considered dangerous. Treatment is only performed when they result in pain, embarrassment, or decreased circulation to the penis, which rarely happens. The surgical procedure used to remove a spermatocele is referred to as a spermatocelectomy.

Resources

  • Medline Plus (2013). Hydrocele. Retrieved from:http://www.nlm.nih.gov/medlineplus/ency/article/000518.htm
  • Medline Plus (2013). Testicular Torsion. Retrieved from:http://www.nlm.nih.gov/medlineplus/ency/article/000517.htm
  • WebMD (2013). Epididymal Cyst. Retrieved from:http://men.webmd.com/tc/spermatocele-epididymal-cyst-topic-overview

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