Common Disorders Of The Male Reproductive System

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Common Disorders Of The Male Reproductive System

• By Joan Meade
• October 2006

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Testicular Trauma

• Occurs when testicles are struck, hit, kicked or
  crushed
• Symptoms are severe pain, bruising, swelling

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Torsion of Testicles

• Testicular torsion is the twisting of the
  spermatic cord, which cuts off the blood supply
  to the testicle and surrounding structures within
  the scrotum

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Torsion of Testicles

• Some men may be predisposed to testicular torsion
  as a result of inadequate connective tissue
  within the scrotum. However, the condition can
  result from trauma to the scrotum, particularly
  if significant swelling occurs. It may also occur
  after strenuous exercise or may not have an
  obvious cause.

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Torsion of Testicles

• Symptoms   
• Sudden onset of severe pain in one testicle, with
  or without a previous predisposing event
• Swelling within one side of the scrotum
• Nausea or vomiting
• Light headedness
• Testicle lump
• Blood in Semen

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Torsion of Testicles

• Surgery is usually required and should be
  performed as soon as possible after symptoms
  begin. If surgery is performed within 6 hours,
  most testicles can be saved.
• During surgery, the testicle on the other
  (non-affected) side is usually also anchored as a
  preventive measure. This is because the
  non-affected testicle is at risk of testicular
  torsion in the future.

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Undescended Testicles

• Undescended testicle occurs when one or both
  testicles fail to move into the scrotum prior to
  birth.
• Surgery (orchiopexy) is the definitive therapy.
  The trend in literature favours earlier surgery
  to prevent irreversible damage to the testis,
  which may cause infertility.

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Orchitis

• Orchitis is an inflammation of one or both of the
  testicles, often caused by infection
• Caused by numerous bacterial and viral organisms.
  The most common viral cause is mumps.

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Orchitis

• Symptoms   
• Scrotal swelling
• Tender, swollen, heavy feeling in the testicle
• Tender, swollen groin area on affected side
• Fever
• Discharge from penis
• Pain with urination (dysuria)
• Pain with intercourse or ejaculation
• Groin pain
• Testicle pain aggravated by bowel movement or
  straining
• Blood in the semen

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Orchitis

• Treatment   
• Medications to treat infection are prescribed if
  the causative agent is bacterial.
• Pain medications and anti-inflammatory
  medications are also commonly prescribed. In the
  case of gonorrhea or chlamydia, sexual partners
  must also be treated.
• When orchitis is caused by viral agents, only
  analgesics (pain relievers) are prescribed. Bed
  rest, with elevation of the scrotum and ice packs
  applied to the area, is recommended.

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Hydrocoele

• A hydrocoele is a fluid-filled sack along the
  spermatic cord within the scrotum
• Hydrocoeles can be easily demonstrated by shining
  a flashlight through the enlarged portion of the
  scrotum. If the scrotum is full of clear fluid,
  as in a hydrocoele, the scrotum will light up
  (transillumination).

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Hydrocoele

• During normal development, the testicles descend
  down a tract (tube) from the abdomen into the
  scrotum. Hydrocoeles result when this tube fails
  to close.
• Hydrocoeles may also be caused by inflammation or
  trauma of the testicle or epididymis, or by fluid
  or blood obstruction within the spermatic cord.
  This type of hydrocoele is more common in older
  men.

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Hydrocoele

• Treatment
• Drainage
• Surgery

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Inguinal Hernia

• An inguinal hernia occurs in the groin area, when
  an organ, usually a part of the intestine,
  protrudes through the abdominal wall into the
  inguinal canal. The inguinal canal carries the
  spermatic cord in men.

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Inguinal Hernia

• Symptoms
• None until the doctor discovers it during a
  routine medical exam.
• Bulge created by the protruding intestine when
  you stand upright, especially if you cough or
  strain.
• Other signs and symptoms
• Pain or discomfort in your groin, especially when
  bending over, coughing or lifting
• A heavy or dragging sensation in your groin
• Pain and swelling in the scrotum around the
  testicles when the protruding intestine descends
  into the scrotum

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Phimosis

• Tightening of the foreskin which may cause it not
  to be able to retract and may interfere with
  urination
• Treatment is usually circumcision

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Paraphimosis

• Entrapment of the foreskin behind the head of the
  penis
• Can be congenital or acquired
• Acquired due to poor hygiene or forceful
  retraction of foreskin
• Vigorous sexual activity may also cause
  paraphimosis

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Paraphimosis

• Symptoms
• Pain and swelling
• Pain with erection
• Treatment
• Manual reduction of the foreskin
• Slitting the foreskin to free the constriction
• Circumcision

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Hypospadias Epispadias

• The urethral opening appears either on the
  underside or upper side of the penis but not at
  the tip
• Treatment reconstructive surgery

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Varicocoele

• Varicose vein in the spermatic cord
• Cause - the valve that regulates blood flow from
  the vein into the main circulatory system becomes
  damaged or defective. Inefficient blood flow
  causes enlargement (dilation) of the vein.

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Varicocoele

• Signs and Symptoms
• Most men who have a varicocoele have no symptoms.
  Signs and symptoms may include the following
• Ache in the testicle
• Feeling of heaviness in the testicle(s)
• Infertility
• Shrinkage (atrophy) of the testicle(s)
• Visible or palpable (able to be felt) enlarged
  vein

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Varicocoele

• Treatment
• If the patient is asymptomatic or the symptoms
  are mild and infertility is not an issue, the
  condition can be managed by wearing an athletic
  supporter or snug-fitting underwear to provide
  the scrotum with support.
• Surgery If the varicocoele causes pain or
  atrophy, if it damages the testicle(s), or if the
  condition is causing infertility, surgery may be
  recommended. Most varicoceles can be corrected
  through a surgical procedure called
  varicocoelectomy (i.e., surgically "tying off"
  the affected spermatic veins).

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Prostatitis

• Prostatitis - inflammation the prostate gland
• Cause - bacterial infection, but evidence of
  infection is not always found
• Symptoms - painful urination and ejaculation

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Prostatitis

• Diagnosis
• Digital rectal exam to determine if the prostate
  gland is tender or swollen
• Urinalysis determines the presence of white blood
  cells (leukocytes) in the urine
• Urine culture to identify bacteria
• Treatment is antibiotics and analgesics

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Prostate Cancer

• Prostate cancer commonly occurs in men over age
  50
• Twice as common in black men as it is in whites.
• The likelihood of developing prostate cancer
  doubles if there is a family history.

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Prostate Cancer

• Symptoms include hesitant, frequent or painful
  urination, blood in the urine, sexual
  dysfunction, swollen lymph nodes in the groin,
  and pain in the pelvis, hips, back, or ribs.
• Treatment may include surgery, radiation therapy,
  hormone therapy, chemotherapy, or a combination
  of two or more of these approaches.