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Testicle specialist: 10 Signs That Men Should See A Urologist


10 Signs That Men Should See A Urologist

If you’re a male with a possible urological issue, even if it seems minor, it’s important to visit a Urologist to get it checked out.

It’s a well-known fact that men avoid going to the doctor unless it’s an emergency. (As the old saying goes, “Women go to the doctor, men go to the emergency room.) Even then, they’d prefer to skip the entire experience if at all possible.

Jerry Weinberg, MD

However, as men get older, it becomes that much more important for them to pay attention to their health and heed warning signs along the way that something might be amiss. Particularly when it comes to urologic issues, minor annoyances can actually be warning signs of potentially life-threatening problems.

10 Signs That You Need to Visit a Urologist

There are many reasons for men to consult with a Urologist, and if you experience any of the following symptoms, you should too. A Urologist can correctly identify and diagnose the problem, determine the level of severity and provide treatment options. Remember: The sooner you catch a potential health issue, the better the chances of treating it before it develops into something major.

1. Erectile Dysfunction: This is an uncomfortable conversation to have, but it is an important one to share with a Urologist. Erectile Dysfunction (ED), the inability to achieve or maintain an erect penis, affects sexual performance and intimacy but can also reveal complications such as vascular disease, hypertension and renal failure. Even though many men find it embarrassing to talk about this issue, it’s important to evaluate and treat any underlying conditions as early as possible.

2. Blood in your urine: This is a sign to see a Urologist immediately, as it could be an early warning sign of bladder or kidney cancer. Even if you only experience blood in your urine intermittently, it signals a condition that needs immediate attention. A Urologist’s exam includes urine tests, an x-ray or CT scan and a cystoscopy (using a fiberoptic scope to see inside the bladder).

3. Testicular pain, lump or masses: When testicular pain is persistent and does not go away within two weeks, it is time to see a Urologist. Any masses, firmness or nodules on the testicles should be examined by a urologic specialist, due to the chance of testicular cancer. Fortunately, when caught early, cancer found in the testes is one of the most curable cancers.

4. Abnormal prostate exam: Men over the age of 40 are advised to get a yearly exam by the same doctor, if possible. This way, any changes can be monitored more closely and early detection of prostate cancer is more likely. If any firmness, small nodules or irregularities are detected, you should be referred to a Urologist to determine any potentially serious problems. Remember: If caught early, prostate cancer has a high cure rate.

5. Difficulty urinating: While not life-threatening, difficulty with urination can be uncomfortable. This is typically caused by an enlarged prostate and is a common symptom of getting older. Fortunately, this condition can be treated with medications to relieve the symptoms or even shrink the prostate to help with urination.

6. Painful urination: Infections can occur in any part of the urinary tract, most often caused by bacteria. A Urologist can determine the cause of such an infection and recommend targeted treatment.

7. Frequent urination or the urge to urinate often: It’s time to see your Urologist if incontinence (leaking urine) begins suddenly or if it interferes with your lifestyle. Urinary incontinence is fairly common and can usually be managed or treated successfully.

8. An elevated or change in Prostate Specific Antigen (PSA) level: The PSA test is often used as a way to detect early prostate cancer. Typically, a very low level of PSA is found in the bloodstream. When there is a change or a higher level of PSA in the blood, a Urologist can determine the cause.

9. Kidney abnormality: If your doctor detects anything unusual on X-ray, you should be referred to a Urologist.

10. Infertility: 25% of infertility issues can be directly related to a male problem. If you partner is being evaluated, you should get a concurrent evaluation by a Urologist.

Your Urologist is Your Healthcare Partner

As important as good nutrition and proper exercise, your urologist needs to be part of your overall healthcare maintenance system. Due to the sensitive nature of urologic problems, it’s absolutely crucial that you and your urologist feel comfortable with each other so that together, you can achieve the best possible level of health. Please call (914) 232-1919 to make an appointment with one of our Westchester Health urologists to come in and talk about any issues you may be having. Whenever, wherever you need us, we’re here for you.

By Jerry Weinberg, MD, a Urologist with Westchester Health, member of Westchester Health Physician Partners

Testicle Pain Specialist – Houston, TX & Nassau Bay, TX: Gulf Coast Urology: Urologist



This minimally invasive procedure involves inserting a scope through the urethra into the bladder. A cystoscopy can be used to help diagnose a problem with your urethra, bladder, or kidneys. Performing this procedure in an office setting is more convenient and less expensive for the patient than in an outpatient facility.


A urodynamic study is a series of tests that gives your doctor a detailed look at the function of your bladder and urethra. These tests can help your doctor evaluate any problems you may be having with storing urine or voiding (eliminating) urine from your body. Performing this procedure in an office setting is more convenient and less expensive for the patient than in an outpatient facility.

Prostate Biopsy

A prostate biopsy is done to help confirm whether or not you have prostate cancer. Ultrasound uses high-frequency sound waves to create an image of the prostate gland. This image helps guide the doctor as a biopsy (taking small tissues samples) is done. These samples of prostate tissue can then be checked for cancel cells.


A vasectomy is a simple, safe procedure that makes a man sterile (unable to father a child). It is the most effective birth control method for men. Most patients choose to have this simple, safe, and effective procedure done in the office for both convenience and economic reasons. Patients are given a mild sedative for the brief procedure, and recovery time is minimal.

Percutaneous Tibial Nerve Stimulation (PTNS)

PTNS is used to treat overactive bladder and the associated symptoms of urinary frequency, urinary urgency, and urge incontinence.


Our board-certified physicians are specially trained to diagnose and to provide medical and surgical treatment for problems such as incontinence, pelvic organ prolapse, urinary tract infections, kidney stone disease, disorders of the prostate, bladder, and kidneys, urethral stricture disease, infertility and impotency matters, and all aspects of urologic disease. Some disorders are best treated with surgery. Here you will find links to some of our most common surgeries.









Testicular self examination – Better Health Channel

Performing regular testicular self-examination (TSE) can help you to become familiar with the usual feel of your testicles so that you can recognise any changes, if they occur. All men should check their testicles regularly. Around 200 Victorian men are diagnosed with testicular cancer every year, most commonly between the age of 20 and 50. This rare cancer has a high cure rate and is more easily treated in its earlier stages. If you recognise changes in your testicles, see a doctor as soon as possible.It is a good idea to perform TSE even if you have had testicular cancer or are currently being treated for it, because cancer may develop in the other testicle.

Risks of testicular cancer

Men who had undescended testicles at birth, or who are infertile, are at greater risk of testicular cancer. If you belong to either of these groups, be vigilant and regularly examine your testicles for unusual lumps or swellings. 

Checking your testicles using testicular self-examination

Testicular self-examination only takes a minute. Aim to perform TSE about once every four weeks or so. Choose a day that’s easy to remember, like the first day of every calendar month. If you have been treated for testicular cancer, still examine your remaining testicle because you have a one in 25 chance of developing cancer in this testicle also. See your doctor for further information or instruction on TSE, and for prompt diagnosis of any testicular lumps or swellings.

Testicle anatomy

The anatomy of the testicle includes:

  • testicle (or testis) – small, oval-shaped sex gland that produces sex hormones and sperm 
  • epididymis – a series of small tubes attached to the back of the testicle that collect and store sperm. The epididymis connects to a larger tube called the vas deferens
  • scrotum – the skin sac that houses the testicles. Sperm production needs a temperature around 2°C lower than the body, which is why the testicles are located outside the body in the scrotum.

What to expect when performing testicular self-examination

Become familiar with the look, feel and shape of your testicles; this will help you notice any abnormalities. 

The characteristics of healthy testicles include:

  • Each testicle feels like a smooth, firm egg. 
  • Adult testicles range in size from about 15 mL (similar to a bird egg) to 35 mL (similar to a small chicken egg).
  • One testicle may be slightly larger than the other.
  • Commonly, one testicle hangs lower than the other.
  • There should be no pain or discomfort when the testicles and scrotum are handled gently.

How to perform testicular self-examination

Generally, the TSE procedure includes:

  • Make sure your scrotum is warm and relaxed. You may like to perform TSE after showering or bathing.
  • It may help to do TSE in front of the mirror, so you can see as well as feel what you’re doing.
  • Check one testicle first, then the other.
  • Gently roll one testicle using the fingers and thumbs of both hands.
  • Feel along the underside of the scrotum to find the epididymis that sits at the back of the testicle. It should feel like a little bunch of tightly curled tubes.
  • Perform TSE on the other testicle.

TSE shouldn’t be painful or uncomfortable. If one or both testes have become tender or painful, see your doctor. 

Symptoms of testicular cancer and testicular self-examination

Symptoms of testicular cancer include a testicular lump that is usually painless (about one in 10 are painful), a sensation of heaviness in the scrotum, and a persistent ache in the affected testicle. 

Take notice of anything unusual, such as:

  • a lump or swelling in or on the testicle itself
  • change in testicular size
  • change in testicular shape
  • change in the consistency or feel of the testicle.

Testicular conditions other than cancer

It’s important to remember that testicular cancer is relatively uncommon, so don’t panic if you find a lump or anything else that seems unusual. See your doctor for a prompt diagnosis. 

Some non-cancerous conditions that may affect the testicles include: 

  • cyst – an abnormal but harmless collection of fluid
  • varicocele – varicose veins. About 10 to 15 per cent of men have varicose veins of the scrotum
  • haematocele – a blood clot caused by trauma or injury to the testicles or scrotum
  • epididymo-orchitis – infection of the epididymis, testicle or both that causes inflammation and pain. Treatment is usually antibiotics
  • testicular torsion – the cord that attaches the testicle to the body twists and cuts off the blood supply. This extremely painful condition needs urgent medical attention
  • undescended testicles – either one or both testicles are missing from the scrotum and are lodged instead inside the lower abdomen. Premature and low-weight newborn boys are most prone to undescended testicles. This condition is known to increase the chance of testicular cancer later in life and is also linked to infertility.

Where to get help

Which specialist should be consulted early in cases of suspected testicular torsion?

  • Schick MA, Sternard BT. Testicular Torsion. 2020 Jan. [Medline]. [Full Text].

  • Ta A, D’Arcy FT, Hoag N, D’Arcy JP, Lawrentschuk N. Testicular torsion and the acute scrotum: current emergency management. Eur J Emerg Med. 2015 Aug 11. 37-41. [Medline].

  • Barbosa JA, Denes FT, Nguyen HT. Testicular Torsion-Can We Improve the Management of Acute Scrotum?. J Urol. 2016 Jun. 195 (6):1650-1. [Medline].

  • Acute Scrotum. American Urological Association. Available at https://www.auanet.org/education/acute-scrotum.cfm. June 2018; Accessed: October 30, 2020.

  • Sheth KR, Keays M, Grimsby GM, Granberg CF, Menon VS, DaJusta DG, et al. Diagnosing Testicular Torsion before Urological Consultation and Imaging: Validation of the TWIST Score. J Urol. 2016 Jun. 195 (6):1870-6. [Medline].

  • Barthold JS. Abnormalities of the Testis and Scrotum and their Surgical Management. McDougal WS, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell- Walsh Urology. 10th ed. Philadelphia, PA: WB Saunders; 2012. 642-5.

  • Uguz S, Yilmaz S, Guragac A, Topuz B, Aydur E. Association of Torsion With Testicular Cancer: A Retrospective Study. Clin Genitourin Cancer. 2016 Feb. 14 (1):e55-7. [Medline].

  • Sauvestre F, André G, Harran MH, Hemard M, Carles D, Pelluard F. Prenatal Testicular Torsion: Not Always in the Late Third Trimester. Urology. 2016 Mar. 89:132-3. [Medline].

  • Dogra V, Bhatt S. Acute painful scrotum. Radiol Clin North Am. 2004 Mar. 42(2):349-63. [Medline].

  • Roth CC, Mingin GC, Ortenberg J. Salvage of bilateral asynchronous perinatal testicular torsion. J Urol. 2011 Jun. 185(6 Suppl):2464-8. [Medline].

  • Kar A, Ozden E, Yakupoglu YK, Kefeli M, Sarikaya S, Yilmaz AF. Experimental unilateral spermatic cord torsion: the effect of polypolymerase enzyme inhibitor on histopathological and biochemical changes in the early and late periods in the ipsilateral and contralateral testicles. Urology. 2010 Aug. 76(2):507.e1-5. [Medline].

  • Beni-Israel T, Goldman M, Bar Chaim S, Kozer E. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med. 2010 Sep. 28(7):786-9. [Medline].

  • Cubillos J, Palmer JS, Friedman SC, Freyle J, Lowe FC, Palmer LS. Familial testicular torsion. J Urol. 2011 Jun. 185(6 Suppl):2469-72. [Medline].

  • Cost NG, Bush NC, Barber TD, Huang R, Baker LA. Pediatric testicular torsion: demographics of national orchiopexy versus orchiectomy rates. J Urol. 2011 Jun. 185(6 Suppl):2459-63. [Medline].

  • Cattolica EV, Karol JB, Rankin KN, Klein RS. High testicular salvage rate in torsion of the spermatic cord. J Urol. 1982 Jul. 128(1):66-8. [Medline].

  • Ringdahl E, Teague L. Testicular torsion. Am Fam Physician. 2006 Nov 15. 74(10):1739-43. [Medline].

  • Sun J, Liu GH, Zhao HT, Shi CR. Long-term influence of prepubertal testicular torsion on spermatogenesis. Urol Int. 2006. 77(3):275-8. [Medline].

  • Puri P, Barton D, O’Donnell B. Prepubertal testicular torsion: subsequent fertility. J Pediatr Surg. 1985 Dec. 20(6):598-601. [Medline].

  • Coley BD. The Acute Pediatric Scrotum. Ultrasound Clinics. 2006. 1:485-96. [Full Text].

  • Yang C Jr, Song B, Liu X, Wei GH, Lin T, He DW. Acute scrotum in children: an 18-year retrospective study. Pediatr Emerg Care. 2011 Apr. 27(4):270-4. [Medline].

  • Johnston BI, Wiener JS. Intermittent testicular torsion. BJU Int. 2005 May. 95(7):933-4. [Medline].

  • Hayn MH, Herz DB, Bellinger MF, Schneck FX. Intermittent torsion of the spermatic cord portends an increased risk of acute testicular infarction. J Urol. 2008 Oct. 180(4 Suppl):1729-32. [Medline].

  • Creagh TA, McDermott TE, McLean PA, Walsh A. Intermittent torsion of the testis. BMJ. 1988 Aug 20-27. 297(6647):525-6. [Medline]. [Full Text].

  • Schmitz D, Safranek S. Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion?. J Fam Pract. 2009 Aug. 58(8):433-4. [Medline].

  • Barbosa JA, Tiseo BC, Barayan GA, Rosman BM, Torricelli FC, Passerotti CC, et al. Development and initial validation of a scoring system to diagnose testicular torsion in children. J Urol. 2013 May. 189 (5):1859-64. [Medline].

  • He M, Li M, Zhang W. Prognosis of testicular torsion orchiopexy. Andrologia. 2020 Feb. 52 (1):e13477. [Medline].

  • Peretti M, Zampieri N, Bertozzi M, Bianchi F, Patanè S, Spigo V, et al. Mean Platelet Volume and Testicular Torsion: New Findings. Urol J. 2019 Feb 21. 16 (1):83-85. [Medline]. [Full Text].

  • Doehn C, Fornara P, Kausch I, Büttner H, Friedrich HJ, Jocham D. Value of acute-phase proteins in the differential diagnosis of acute scrotum. Eur Urol. 2001 Feb. 39(2):215-21. [Medline].

  • Prando D. Torsion of the spermatic cord: the main gray-scale and doppler sonographic signs. Abdom Imaging. 2009 Sep-Oct. 34(5):648-61. [Medline].

  • Dogra VS, Bhatt S, Rubens DJ. Sonographic Evaluation of Testicular Torsion. Ultrasound Clinics. 2006. 1:55-66.

  • Yagil Y, Naroditsky I, Milhem J, Leiba R, Leiderman M, Badaan S, et al. Role of Doppler ultrasonography in the triage of acute scrotum in the emergency department. J Ultrasound Med. 2010 Jan. 29(1):11-21. [Medline].

  • Turgut AT, Bhatt S, Dogra VS. Acute Painful Scrotum. Ultrasound Clinics. 2008. 3:93-107.

  • Cassar S, Bhatt S, Paltiel HJ, Dogra VS. Role of spectral Doppler sonography in the evaluation of partial testicular torsion. J Ultrasound Med. 2008 Nov. 27(11):1629-38. [Medline].

  • Blaivas M, Sierzenski P, Lambert M. Emergency evaluation of patients presenting with acute scrotum using bedside ultrasonography. Acad Emerg Med. 2001 Jan. 8(1):90-3. [Medline].

  • Moschouris H, Stamatiou K, Lampropoulou E, Kalikis D, Matsaidonis D. Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?. Int Braz J Urol. 2009 Nov-Dec. 35(6):692-702; discussion 702-5. [Medline].

  • Boettcher M, Krebs T, Bergholz R, Wenke K, Aronson D, Reinshagen K. Clinical and sonographic features predict testicular torsion in children: a prospective study. BJU Int. 2013 Dec. 112(8):1201-6. [Medline].

  • Crawford P, Crop JA. Evaluation of scrotal masses. Am Fam Physician. 2014 May 1. 89(9):723-7. [Medline].

  • Altinkilic B, Pilatz A, Weidner W. Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion. J Urol. 2013 May. 189(5):1853-8. [Medline].

  • Nason GJ, Tareen F, McLoughlin D, McDowell D, Cianci F, Mortell A. Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units. Scand J Urol. 2013 Oct. 47(5):418-22. [Medline].

  • McDowall J, Adam A, Gerber L, Enyuma COA, Aigbodion SJ, Buchanan S, et al. The ultrasonographic “whirlpool sign” in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis. Emerg Radiol. 2018 Jun. 25 (3):281-292. [Medline].

  • Terai A, Yoshimura K, Ichioka K, Ueda N, Utsunomiya N, Kohei N, et al. Dynamic contrast-enhanced subtraction magnetic resonance imaging in diagnostics of testicular torsion. Urology. 2006 Jun. 67(6):1278-82. [Medline].

  • Burgu B, Aydogdu O, Huang R, Soygur T, Yaman O, Baker L. Pilot Feasibility Study of Transscrotal Near Infrared Spectroscopy in the Evaluation of Adult Acute Scrotum. J Urol. 2013 Jan 29. [Medline].

  • Ramachandra P, Palazzi KL, Holmes NM, Marietti S. Factors influencing rate of testicular salvage in acute testicular torsion at a tertiary pediatric center. West J Emerg Med. 2015 Jan. 16 (1):190-4. [Medline]. [Full Text].

  • Sharp VJ, Kieran K, Arlen AM. Testicular torsion: diagnosis, evaluation, and management. Am Fam Physician. 2013 Dec 15. 88(12):835-40. [Medline].

  • Filho AC, Oliveira Rodrigues R, Riccetto CL, Oliveira PG. Improving Organ Salvage In Testicular Torsion: Comparative Study Between Patients Submitted Or Not To Preoperative Manual Detorsion. J Urol. 2016 Sep 30. [Medline].

  • Güneş M, Umul M, Çelik AO, Armağan HH, Değirmenci B. A novel approach for manual de-torsion of an atypical (outward) testicular torsion with bedside Doppler ultrasonography guidance. Can Urol Assoc J. 2015 Sep-Oct. 9 (9-10):E676-8. [Medline]. [Full Text].

  • Ameli M, Hashemi MS, Moghimian M, Shokoohi M. Protective effect of tadalafil and verapamil on testicular function and oxidative stress after torsion/detorsion in adult male rat. Andrologia. 2018 Jun 19. e13068. [Medline].

  • Ghasemnejad-Berenji M, Ghazi-Khansari M, Pashapour S, Jafari A, Yazdani I, Ghasemnejad-Berenji H, et al. Synergistic effect of rapamycin and metformin against germ cell apoptosis and oxidative stress after testicular torsion/detorsion-induced ischemia/reperfusion in rats. Biomed Pharmacother. 2018 Sep. 105:645-651. [Medline].

  • Park K, Choi H. An evolution of orchiopexy: historical aspect. Korean J Urol. 2010 Mar. 51(3):155-60. [Medline]. [Full Text].

  • Dajusta DG, Granberg CF, Villanueva C, Baker LA. Contemporary review of testicular torsion: New concepts, emerging technologies and potential therapeutics. J Pediatr Urol. 2012 Oct 5. [Medline]. [Full Text].

  • Lian BS, Ong CC, Chiang LW, Rai R, Nah SA. Factors Predicting Testicular Atrophy after Testicular Salvage following Torsion. Eur J Pediatr Surg. 2015 Oct 28. [Medline].

  • Kozminski DJ, Kraft KH, Bloom DA. Orchiopexy without Transparenchymal Fixation Suturing: A 29-Year Experience. J Urol. 2015 Dec. 194 (6):1743-7. [Medline].

  • Why You Should Ask Your Doctor For A Testicular Exam

    Testicular cancer is a relatively rare type of cancer, accounting for just 1% of all cancers that occur in men. Testicular cancer is unusual compared with other cancers because it tends to affect younger men. Around 2,300 men are diagnosed with testicular cancer each year in the UK, though when it is caught early enough it is 97% curable. The best way to catch this early is to regularly perform a testicular exam.

    Signs of testicular cancer may include:

    • A painless lump on your testicle
    • Swelling or a feeling of weight in your scrotum, with or without pain
    • Fluid collecting in your testicles
    • Pain or a dull ache in your scrotum or groin
    • Soreness or changes in breast tissue
    • Early signs of puberty in a younger boy

    Doctors are not sure what exactly causes testicular cancer, although some studies suggest that you’re more likely to get it if you have:

    • Testes that didn’t form or descend the way they should
    • A father or brother who had it

    Healthcare services have encouraged men to look out for tumours by performing a testicular exam themselves, and if that is something you feel confident about, the testicular exam guide from Dr Jeff’s website offers some beneficial advice on how to go about it. It is recommended that men should check their testicles approximately once a month:

    1. It is normal for one testicle to be larger than the other
    2. One testicle may sit lower than the other.
    3. Examine each testicle by using both hands to roll it between your thumb and fingers.
    4. Start at one end and work up or down.
    5. The epididymis is the rubbery cord-like structure behind each testicle and is usually palpable.
    6. If you do feel a lump or something like a piece of gravel, you should contact your doctor. Most are cysts, but we would always advise this is checked.

    Rather disturbingly, despite men being encouraged to self examine, the pick-up rate of cancer from such explorations is very low. In fact, self-examination can cause high levels of anxiety, as false positives are very high. Many men report feeling anxious when finding anomalies in their testicles, however, there are various reasons for lumps and bumps and most of them are totally innocent. Testicle lumps are most commonly caused by fluid collecting, an infection, or swelling of skin or veins. However, it is not possible to diagnose the cause of a lump at home and this is why you should ask your doctor for a testicular examination, which in the vast majority of cases it will be a benign cause.

    Unfortunately, there is no other method of initial diagnosis for testicular cancer than either self-examination once a month or by asking your GP to check them, and so the anxiety caused by self-examination is an unfortunate but unavoidable side effect if you want to reduce your overall risk. If you do find a lump during self-examination, do not ignore it. Ask your doctor to check it and he can advise you on what you need to look for, the changes that you would expect to see if it was something serious, and you can go home better informed and hopefully reassured about what is normal and what to look out for.

    For more information, or to book a consultation or Male MOT with Dr Jeff Foster to discuss your concerns, you can get in touch by calling 01926 801111 or [email protected] co.uk. You can also follow Dr Jeff on social media!

    Lump on Testicle (Scrotal Masses): Causes & Treatment


    What is a lump on the testicle (scrotal mass)?

    A lump on the testicle, or a scrotal mass, can form in your scrotum (the pouch of skin containing the testicles). It can be a symptom of other medical conditions, most of which aren’t serious. The majority of scrotal masses are benign (not cancerous) and don’t pose a risk to your health.

    Some, however, can affect fertility in men, and in rare cases, be a sign of a serious condition such as cancer. That’s why your healthcare provider should examine any lump you may discover in your scrotum.

    Where would a lump on my testicle be, and what would it feel like?

    Lumps can be located anywhere around the testicles and vary in size. Some can be as small as a pea or marble, but some can grow larger.

    Most lumps are soft and fluid-filled and may make your scrotum look a little swollen; these are usually harmless and often go away without treatment. Some lumps are solid and may feel attached to one of your testicles. Harder lumps can be a sign of something more serious.

    If you feel lumps or swelling, let your provider know.

    Possible Causes

    What are the possible causes of a lump on the testicle (scrotal mass)?

    A lump on the testicle can be a symptom of several disorders. Most of these conditions are harmless.

    In rare cases, a scrotal mass can be a sign of a more serious condition such as testicular cancer. Other causes of scrotal masses include:

    • Cyst: Fluid-filled sacs in the testicle.
    • Epididymitis: Infection or inflammation (swelling) of the tube that stores sperm.
    • Hernia: Tissue pushes into the scrotum through a weak spot in the abdominal wall.
    • Varicocele: Swollen veins inside the testicle.

    How are scrotal masses diagnosed?

    Doctors will ask about your medical history. They also use several tests to identify the cause of a scrotal mass. These tests include:

    • Blood or urine test: A doctor takes a sample of blood or urine to look for an infection or signs of other conditions such as cancer.
    • Imaging: Ultrasound tests can show a lump’s location and help doctors rule out conditions such as a hernia or cancer.
    • Physical exam: A doctor feels the scrotum and its contents to learn about the makeup of the mass.
    • Transillumination: A doctor shines a bright light from behind the scrotum to see a mass’s location and size, and whether fluid has built up.

    Care and Treatment

    How are lumps on the testicle managed or treated?

    Treatment for a scrotal lump depends on the cause. Some cases don’t need treatment. Standard therapies for scrotal masses and testicle pain include:

    • Medication such as antibiotics to treat an infection.
    • Pushing the protruding part of a hernia back into place.
    • Surgery to remove, drain or repair a mass.
    • Surgical removal of the testicle, for testicular cancer.

    When to Call the Doctor

    When should I call the doctor about a lump on my testicle?

    If you have a scrotal mass, a doctor should examine it. Some scrotal masses are more serious than others. Contact your doctor immediately if you have a scrotal mass that:

    • Appears suddenly.
    • Becomes infected.
    • Causes pain or discomfort.
    • Forms inside the testicle and not on the skin.

    Testicular Cancer Doctor | Moffitt

    Several different medical professionals can be considered a testicular cancer doctor. Often, the term is used to describe a urological oncologist, although a surgeon, medical oncologist or radiation oncologist can also be considered a testicular cancer physician. Because testicular cancer requires a highly specialized approach to treatment, most men are referred to one of these specialists if they are experiencing unusual urological symptoms or have found a lump in their testicles.

    At Moffitt Cancer Center, patients in need of a testicular cancer doctor can consult with several different medical professionals in a single, convenient location. We have some of the most highly specialized testicular cancer doctors in the field, including:

    • Testicular cancer surgeons
    • Medical oncologists and radiation oncologists who specialize in treating cancers of the male reproductive system
    • Pathologists and radiologists who conduct diagnostic tests behind the scenes

    We treat patients at all stages of the diagnostic and treatment process. Whether a patient needs to consult with an testicular cancer doctor about potential symptoms, get a second opinion regarding a testicular cancer diagnosis or get started on treatment, he or she can turn to Moffitt for individualized medical attention.

    As part of our commitment to providing our patients with the most advanced, tailored treatments possible, we are heavily involved in testicular cancer research, and many of our top clinicians are also active researchers. Moffitt is the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, making it possible for our patients to receive world-class, evidence-driven treatment from top specialists close to home.

    No referral is necessary to schedule an appointment with a testicular cancer doctor at Moffitt. To request a visit, call 1-888-663-3488 or complete a new patient registration form online.


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    Your questions are answered by a urologist

    To everyone who cares about their health : a new project of the newspaper “Komsomolskaya Pravda in Belarus” is starting – “Ask the Doctor” . Your questions are answered by the urologist of the 1st qualification category of the medical center “Exana” Gavrusev Andrey Alexandrovich.


    My scrotum hurts. What should I do? Is there any way I can do without a doctor?

    A.A. Gavrusev

    You will not do it.And self-medication can only worsen the situation.


    I have pains in my left testicle. And it feels like a knot has formed on it. Tell me what it can be and which specialist to contact?

    A.A. Gavrusev

    To the urologist. The earlier the better.


    I have had problems with my left testicle for about two years now. It started with intermittent mild pain. To the touch – a seal, as if adhered to the main testicle.When I realized that it would not go away by itself, I turned to the urologist at the clinic. After examining the prostate and probing the testicle, the doctor said that everything would resolve, prescribed aloe intramuscularly, and Vishnevsky’s ointment, applied to the testicle itself. A little time passed, but it did not get better. I went to a paid urologist, who, without telling me a specific diagnosis, took up my treatment. I ordered tests, I didn’t find anything in the smear, I found something in the blood, I don’t remember anymore. For 1.5 months I went to him every day for various procedures, including prostate massage, while taking the drugs prescribed by him (in my opinion, from all at once).Then he went on vacation, and said to come in a month. But there was no improvement with the testicle, and I did not go to him anymore, besides, it was not cheap. Six months have passed. Now I don’t know what to do. Go to the next urologist for “experiments”? As of today, there is practically no passing pain in the left testicle, a constantly changing seal in size, to the touch as if stuck to the testicle. The testicle itself is denser and larger in size, in contrast to the right one. I also cannot feel the cord, as if it had become inflamed and became that seal.Sometimes this pain in the testicle radiates to the leg. I’m already thinking about removing it, maybe then these pains will end? Also, I have not seen an erection in the morning for a long time, and in general, the desire to have sex does not arise. What can you advise?

    A.A. Gavrusev

    Make an ultrasound of the testicle with the determination of blood flow. Such manifestations can be with several different diseases: inflammation, cyst, tumor, tuberculosis.


    I am 31 years old.For 14 years I have been suffering from an overactive bladder, with periodic improvements after taking the medication. The last time the course of treatment was two years ago, and after that I felt more or less normal. I am now 8 weeks pregnant. First pregnancy. The state of health has deteriorated sharply. Urine tests are normal as usual. But the amount of urination just goes off scale: in the daytime 25-35, at night 10-15. I practically cannot sleep. I know that it is better not to take medicine during pregnancy, but I have no more strength. Please advise what can be done in my situation?

    A.A. Gavrusev

    Unfortunately, drugs for the treatment of OAB during pregnancy are contraindicated. Try antispasmodics and blood circulation medications after consulting a gynecologist.


    I am 26 years old, for about 3 years I have had a strong itch under the testicles and further between the legs to the anus. It itches very much. I don’t know what it is. Tell me what it can be and how to treat it?

    A.A. Gavrusev

    To be treated by a dermatologist. And the sooner the better. Why suffer for three years?


    I have chronic cystitis. After the accident, there was no irogenic bladder. Can this be cured? Or is it for life?

    A.A. Gavrusev

    To make a diagnosis, you need to know what the injury was, where, whether there is residual urine in the bladder, and more. Then recommendations are given.


    Doctor, I cannot cure thrush for four years.He took tests (blood, smears) – everything is fine. I took medications, used ointments. After a week passes, and then everything is new. The wife was checked – everything is in order. The doctor says that it is necessary to be treated only with this. What should I do?

    A.A. Gavrusev

    A healthy man cannot have incurable candidiasis. It is likely that you and your wife have performed an incomplete examination and the cause of the disease has not been identified.


    I have multiple sclerosis.For almost 5 years I have been emptying my bladder for three years – partially, and for the last two years I have been constantly emptying my bladder with the help of a catheter. Treatment is carried out in courses. During this period, the filling of the bladder was good, but from May 2012, almost to July, my bladder did not fill well with urine, or even for days there was no urine in the bladder at all. On ultrasound, the residual urine for 2 days was about 36 ml. Tell me what to do in such a situation and where does the urine go? I live in a very small town in Belarus.

    A.A. Gavrusev

    Lack of urine flow into the bladder is called anuria and can be in acute renal failure.Nephrologist needs treatment.


    Passed a general urine test. All indicators were negative with the exception of nitrites. Explain, please, what this means and what needs to be done?

    A.A. Gavrusev

    You did an express test, take a urine test in the clinical laboratory of the polyclinic.


    For the last week I have been feeling aching pain in the perineum with a return to the buttocks-bottom. Now it seems to have become smaller, but I noticed that my testicles rose, as if they were stretched, especially on the left.If you pull them on the left, then they lower a little. But sometimes the left sinks and deeper and it can be pushed down. Previously, this happened to him, but for a longer time they were between the bottom and top of the scrotum, but in tightness. What could it be and is it not dangerous?

    A.A. Gavrusev

    Pain in the perineum occurs with prostatitis. The testicles are pulled up to the inguinal canal by a special muscle that lifts the testicle.


    The girl was diagnosed with a papilloma virus, therefore, I also had to be tested.I passed tests for all infections (the highest risk, vom, for all sorts of herpes), passed urine to check the kidneys, nothing was found. For prophylaxis I got pierced. What’s the question. Constantly slight pain in the penis, discomfort, therefore it is unpleasant to have sex (sex only in a condom during treatment was and after it too). The lips of the urethra are slightly inflamed.

    A.A. Gavrusev

    If the cause of urethral inflammation has not been identified, i.e. infections, it means that you were poorly examined. Contact another laboratory where the urologist performs the collection of tests, and the examination is carried out by several methods.


    Please comment on the analysis of the smear: a large amount of epithelium was found. Everything else is normal, STIs by PCR are negative. Which doctor should I go to?

    A.A. Gavrusev

    The epithelium should be in the smear, it gets there when the analysis is taken. The amount of sloughing epithelium in a woman depends on the phase of the menstrual cycle.


    What can a guy have if white sand comes out with pain when urinating, and this does not happen all the time, but after a certain time.

    A.A. Gavrusev

    No doctor will answer your question without examination. See a urologist and go through examinations, get tested. Only the results will tell you what it is.


    The boy is 5 years old. Often runs to the toilet to pee, sometimes it turns out only 3 drops.Thought cystitis, passed urine and total blood tests, the doctor said everything is perfect. Urination is painless. What could it be?

    A.A. Gavrusev

    Get examined by a neurologist and a pediatric urologist (in Minsk, the 2nd children’s hospital).


    I cannot get pregnant. Checked on the female side, everything is in order. My husband had a spectrogram and was diagnosed with asthenozoospermia. How is it treated?

    A.A. Gavrusev

    If the cause of the pathological changes in the sperm is not identified, the treatment will not be effective.The most common cause of pathospermia is chronic genital infections. In a man, it is necessary to examine a smear, a secret of the prostate, ejaculate by several methods (culture, PCR), blood by the ELISA method, do an ultrasound of the prostate, testicles, analysis for sex hormones, antisperm antibodies.


    A week ago they took me away in an ambulance with pain in my right side and fever. They said that the tests were bad. The ultrasound showed that the kidneys were in place and in perfect condition. Diagnosed with acute pyelonephritis on the right kidney, prescribed antibiotics, and five days later, to be tested and see a urologist.Five days later, I got tested and went to an appointment. But at the appointment, the doctor did not explain anything to me. He felt the kidney through his stomach and said that it was a “Wandering Kidney” and there was no pyelonephritis. Analyzes are normal. Again he sent me for an ultrasound scan, only after half a month, and for an appointment a month later, he put me out the door. Tell me what to do? Isn’t it dangerous? And are there any physical limitations with the Wandering Kidney? Suddenly, in a month everything will get even worse and before it’s too late, can you do something else and put it in its place?

    A.A. Gavrusev

    If the tests are normal, then you will not have an acute illness. The kidney can descend with nephroptosis, but such a diagnosis must be confirmed by excretory urography – images of the kidneys with a contrast agent.


    My son at school in the 8th grade was diagnosed with a disease – Varicoceli 3 tbsp. But our parents were not told anything. We are now in the 9th grade. On October 25, there was another prophylactic examination, and only we were told that. On the testicle, the veins bulge out strongly, the child himself did not tell us anything, apparently, did not bother.What should we do? We live in Tynda, Amur Region. There is no pediatric doctor, no urologist or surgeon. The nearest town is Blagoveshchensk. How are we to be?

    A.A. Gavrusev

    Surgical treatment only. The local pediatrician knows where to refer the child.


    A 10-year-old boy began to remove the skin from the glans penis. The head did not appear immediately and not immediately completely, in a week the head shows a little more. Tell me, is it normal that the head did not appear right away?

    A.A. Gavrusev

    If there is no inflammation and narrowing of the skin of the foreskin, then it is better not to touch it. During the growing up period, the head will open naturally.


    The boy of 11 years old began to slowly remove the foreskin from the glans penis. At first, the flesh was not removed, then the edge of the head began to climb out, more and more every day. Is it normal that the foreskin is not removed immediately?

    A.A. Gavrusev

    If there is no inflammation and narrowing of the skin of the foreskin, then it is better not to touch it.During the growing up period, the head will open naturally.


    My gump (went to the urologist) drank medicine, did not help, went to a psychotherapist, drank antidepressants, but my condition became worse (there was a fear of being alone at home). I don’t travel by transport, I don’t go far (because of strong excitement, I want to go to the toilet, my heart starts to beat, it becomes difficult to breathe). I went to the grandmothers. They say severe fright. But whispered water doesn’t help. Please, tell me where else you can go.For the second year I have been tormented by this and my condition is getting worse every day. I have a child, and because of this illness I cannot go anywhere, even to a meeting at school.

    A.A. Gavrusev

    You must first conduct an examination, and then treatment. New drugs are now available for the treatment of OAB. See a urologist.


    Three weeks ago I was admitted to the hospital with a diagnosis of acute gestational pyelonephritis. The gestation was 29 weeks. I stayed in the hospital with a catheter in the right kidney for 10 days, they did not stent after the ultrasound and was discharged.A couple of days ago, there was some discomfort in the right kidney. What could it be? I drink the medicine 3 times a day.

    A.A. Gavrusev

    It is necessary to pass urine analysis, bacteriological urine culture and ultrasound of the kidneys again. If the condition worsens, hospitalization.


    I have cloudy urine, while my left kidney is constantly hurting, pain when urinating. Especially after physical exertion, I crawl straight to bed. I passed a general urine test and a general blood test.I did an ultrasound of the bladder and kidneys. Here are the results. Blood test: roe 20, leukocytes 6, hemoglobin 105. Urinalysis: ubg 13.4, cre 8.8, malb 10, sg = 1.030, ph5.5, vc 0, a: c 3.4 mg / mmol. Ultrasound: said a sluggish inflammatory process. Renal sinus structure: single crystals of salts on both sides. The doctor said that everything was fine according to the ultrasound scan and urine, and according to the blood, he was anemic and prescribed pills. I assume that I have an inflammatory process in the kidney against the background of the transferred ureaplasma and gardnerella. When I was sick, I warmed up the urethra every day, thinking that I had cystitis.But it got worse until the kidneys hurt, and the face and legs began to swell severely. Then I went to the venereologist, underwent treatment, I checked the smear twice, everything is fine, but the kidneys did not stop hurting. I drank herbs for 3 months: knotweed-bearberry-lingonberry leaf, it became easier, but still not 100%. The doctor says that everything is fine, it cannot be that ureaplasma is in the kidney, because according to the tests, everything is fine. I am planning to donate a urine culture tank on my own initiative. Tell me what do you think?

    A.A. Gavrusev

    You have signs of an upper urinary tract infection, i.e. pyelonephritis. Against the background of ureaplasmosis and gardnerellosis, an ascending bacterial infection may develop. It is necessary to do a bacteriological culture of urine, a biochemical blood test, and also be treated by a gynecologist.


    Please help me with the kidney ultrasound. I am now 38 weeks pregnant. Right kidney: the position is typical, the contours are even, the dimensions are 108 * 47, the parenchyma is 17, the ChLS is not dilated, the adrenal glands are not pilot, the focal formations are not.Left kidney: the position is typical, the contours are even, the dimensions are 111 * 50, the parenchyma 17 is compacted, the calyx is expanded to 13 * 18mm, the pelvis is up to 19 * 17mm, the ureter is in prop. parts 3 * 4 mm. Other organs: free fluid in the abdominal cavity is not detectable. Conclusion: signs of pyeloctation on the left, hardening of the structures of the renal sinus of the left kidney (pyelonephritis?).

    A.A. Gavrusev

    During pregnancy there will always be pyelectasis. If there are no complaints and a normal urine test, no treatment is prescribed.


    I have chronic prostatitis, pain in the perineum, more on the left, as well as pain and cramps when urinating. What examinations do I need? Is cystoscopy necessary? How painful is it in men? In what position is it carried out?

    A.A. Gavrusev

    Cystoscopy for prostatitis is usually not performed. The examination includes smears from the urethra and prostate secretions for STIs, bacterial culture, PSA (after 40 years), ultrasound of the prostate.


    My husband’s testicles itch. What could be the reason? And there was no intercourse for another week. He says that the testicle is already twitching or pinching. What’s this?

    A.A. Gavrusev

    In case of itching of the skin of the scrotum, a consultation with a dermatologist is recommended. Such complaints can also be with pubic lice.

    Datsenko Nadezhda Vladimirovna

    My friend has a little problem. He is puzzled that he sometimes has sensations in his penis, when he is in a calm state, as if through the urethra, like “worms” run inside.It is not painful for him. And we don’t know what it is. Maybe it’s sand coming from the kidneys? Although, when he urinates, he has no sensations.

    A.A. Gavrusev

    There can be no sand. It is necessary to pass smears for STIs.

    Pain in the testicles and scrotum in men, enlargement, edema, induration – causes and treatment

    It is important to start treatment of inflammation of the scrotum in the first 5 days!

    It is recommended to see a doctor as soon as the scrotum is sick .The same applies to other symptoms – swelling of the scrotum, bumps, lumps inside the scrotum, redness, itching, burning, etc.

    This is especially important for epididymitis. Treatment should be started within the first 5 days. Otherwise, inflammation very quickly becomes chronic and can lead to male infertility.

    Chronic prostatitis and vesiculitis in the absence of adequate treatment for a long time can cause impotence and infertility.

    Sign up for examination

    1.Male inflammations

    If pain occurs inside the scrotum itself , then one can suspect diseases such as:

    If pain is given to the scrotum , most likely the inflammatory process has arisen in other organs, for example, in the prostate, urethra, kidneys, etc. .d. In such cases, doctors often diagnose:

    All these diseases can occur either one at a time or in combination with each other.

    Urologists-andrologists (in other words, urologists specializing in the treatment of men) are engaged in the treatment of these problems. .With timely treatment, the listed diseases can be cured without surgery, on an outpatient basis.

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    2. Conditions requiring surgical intervention

    In such diseases, urologists, as a rule, refer to a urologist-surgeon. In a hospital or clinic where it is possible to carry out small operations on an outpatient basis:

    • Inguinal hernia
    • Varicocele
    • Hydrocele (dropsy of the testicle)

    3.Conditions requiring urgent care (usually surgical)

    For such diseases, it is recommended to carry out an urgent operation in a 24-hour hospital:

    • Injury of the scrotum and / or testicle
    • Testicular torsion
    • Hematocele

    4. Oncology


    Not far always seals and bumps in the scrotum are signs of cancer. Acute or chronic inflammation is more often diagnosed. Therefore, we recommend that you first visit a urologist-andrologist.

    If there is a suspicion of a malignant origin of the changes, the doctor will recommend an additional examination and contact an urologist-oncologist.

    Pain in the scrotum (testicles) – causes, examination and treatment | Symptoms

    Testicular torsion (testicular torsion)
    Signs: Intense persistent pain that starts suddenly in one testicle. One testicle can be pulled closer to the body compared to the other. Most often occurs in newborns and boys after reaching puberty, but sometimes in adults.

    Torsion of testicular hydatids (twisting of a small piece of tissue attached to the testicles)
    Signs: Pain that usually develops over several days and occurs in the upper part of the testicle. Sometimes swelling around the testicles. Usually occurs in boys aged 7-14 years.

    Epididymitis (inflammation of the epididymis) or orchiepididymitis (inflammation of the epididymis and testis)
    Signs: Pain develops gradually or suddenly in the epididymis and sometimes in the testicle.Possibly frequent urination, pain or burning sensation during urination. Perhaps in men who have recently lifted weights or have exerted a lot. Often scrotal edema. Sometimes discharge from the penis. Usually occurs in boys after puberty and in men.

    Signs: In men with genital trauma. Often scrotal edema.

    Inguinal hernia
    Signs: Usually in men with a painless swelling in the groin for a long time, often in those who already have a hernia.A swelling that is soft to the touch and looks like a balloon, usually increases when people are standing or when pressure in the abdomen increases (straining during bowel movements or lifting weights), sometimes disappears while lying down, may be pushed back into the abdominal cavity. The pain develops gradually or suddenly, usually when the swelling cannot be pressed back into the abdominal cavity.

    Irradiating pain (pain due to abdominal aortic aneurysm, stones in the urinary tract, pressure on the roots of the spinal nerves in the lower spine, appendicitis or tumor, or pain that occurs after removal of a hernia)
    Signs: Normal results found on examination of the scrotum.Sometimes tenderness on palpation of the abdomen.

    Orchitis (viral testicular infection)
    Signs: Pain in the scrotum and abdomen, nausea and fever. Swelling and sometimes redness of the scrotum.

    Necrotizing infection of the perineum (Fournier’s gangrene)
    Signs: Intense pain, painful appearance, fever and sometimes confusion, shortness of breath, increased sweating and dizziness. Redness of the scrotum, blistering or dead tissue in the genital area.Sometimes in men who have recently had abdominal surgery. It is more common in older men with diabetes mellitus, peripheral arterial disease, or both.

    Testicular examination in boys is an important procedure for detecting and preventing cancer and hernia

    The qualifications and experience of the doctor performing the testicular exam is a prerequisite to ensure that all is well. During a routine check-up, your doctor should feel your baby’s testicles to make sure they are developing normally and that the baby is normal.

    Two possible problems that boys may find on examination are testicular hernia (inguinal hernia) and, in rare cases, testicular cancer.

    Testicular hernia or inguinal hernia

    Testicular hernia (inguinal hernia) is a pathology when a part of the intestine through an opening in the abdominal wall “falls” into the groin or scrotum (a bag of skin where the testicles are located). Most hernias are due to weakness in the abdominal wall. The doctor can detect a hernia by palpating the area around the groin and testicles.The doctor may ask your child to cough by pressing or palpating the area.

    Testicular cancer

    Although testicular cancer is rare in adolescents, it can nevertheless happen. In fact, testicular cancer is the most common cancer in men between the ages of 20 and 34; is a reason enough to develop the habit of regularly undergoing testicular examinations.

    It is very important that a doctor examines your child’s testicles at least once a year.The doctor should examine each testicle separately. The doctor may also look at characteristics such as consistency and size differences between the right and left testicles.

    Self-examination of the testicles by palpation

    The doctor will also explain to your son how to self-examine the testicles by palpation. Your child should feel the testicles at least once a month to look for any abnormalities such as nodules or hardness.

    Knowing the size and consistency of an adolescent’s testicles when healthy will help him detect any possible changes or abnormalities in that part of the body.The sooner a testicular nodule or change in testicular size is found, the better the prognosis for survival and the greater the likelihood of a complete cure for testicular cancer.

    Keep in mind that no matter how strange or unpleasant a testicular examination may seem to your son, it is a routine procedure for a doctor. It is possible that when the testicles are examined, the baby will have an erection. Explain to him that this is a condition he cannot control and that this is a normal reaction that boys often have when they touch their genitals.Also tell him that if this happens, so that he does not feel anxious or ashamed.

    how to prepare for the operation, the price of the procedure in Moscow

    Among the main causes of infertility in men, two main ones are distinguished: pathological disorders of the testicles and mechanical obstacles in the way of mature spermatozoa. It is timely and accurate diagnostics that is the basis for success. In the successful treatment of infertility, testicular and spermatic cord biopsies are the most accurate and effective diagnostic procedures.

    With oligospermia (lack of sperm count), azoospermia and reduced function, it is problematic to diagnose the exact type of disorders. The method of invasive collection of testicular tissue allows you to accurately determine the cause of infertility in men and achieve the desired treatment result.

    Indications for biopsy

    The operation refers to microsurgical and is prescribed in cases where, after three examinations of semen, it is not possible to find sperm in it.This condition is called azoospermia. Also, a biopsy is necessary in the following clinical cases:

    • Disorders of spermogenesis.
    • Cryptorchidism.
    • Undetermined causes of infertility.
    • Hypogonadism.
    • Study of lesions to determine whether they are benign or malignant.
    • Sperm collection for IVF or ICSI.

    Biopsy value in IVF

    The importance of testicle biopsy can hardly be overestimated, because thanks to the use of unique techniques, an infertile man can become a father.After taking the material, specialists can obtain sperm and then use them in artificial insemination programs – IVF or ICSI. These are complex processes, the cost of which is absolutely justified.


    There are times when a biopsy cannot be performed. Contraindications can be absolute or relative. Some of them can be eliminated before the study. For example, a patient may be treated for infection, inflammation, and other pathological conditions.Among the contraindications:

    • Inflammatory processes of the genitourinary system.
    • Sexually transmitted diseases.
    • Skin lesions of an infectious nature.
    • Hemorrhagic diathesis.
    • Fever.
    • Pathology related to blood coagulation.
    • Single testicle.

    Preparing for biopsy

    For epididymal biopsy to be as effective as possible, it is important that the patient is completely healthy at the time of the procedure.In this case, the collection of spermatozoa will be effective and the result of the study is objective. Among the preparatory processes:

    • Examination of the urethra by taking a smear on the flora.
    • PCR analysis to help determine the presence of fungi and infectious diseases.
    • Blood test with determination of coagulation, Rh factor and group.
    • Taking tests to exclude sexually transmitted and viral infections.
    • ECG for assessing the work of the cardiovascular system.If a man has features associated with this area, it is important to accurately calculate the dose of anesthesia drugs. In this case, the identification of pathology plays a very important role.

    In addition to research, it is important to pay attention to the patient’s lifestyle. The mode of work and rest should be balanced, proper nutrition also has a significant impact on health and fertility. If all the recommendations are followed, a man gets a chance to accumulate a sufficient number of viable healthy sperm for fertilization.

    To accumulate a sufficient number of capable sperm, it is worth refraining from sexual intercourse for four days. Sauna and alcohol intake are also contraindicated. In some cases, additional therapy is prescribed to stimulate sperm production.

    On the eve of the analysis, you must refrain from eating (after 20:00) in order to exclude the likelihood of vomiting after the introduction of anesthesia.

    In the morning before the operation, it is necessary to shave off the hair on the scrotum and adjacent skin of the thighs and abdomen.

    Carrying out a procedure

    Depending on the indications, a biopsy can be performed by a puncture or open method.

    Open biopsy

    For histological examination of testicular tissue, making an accurate diagnosis and obtaining material for IVF, an open biopsy is often performed in a hospital. If the testicles are the same size, surgery is performed on one side. The patient receives general anesthesia or local anesthesia by introducing novocaine into the spermatic cord.

    During the operation, an incision of up to three centimeters is made from the convex side. For histological studies, a wedge-shaped piece is cut out, after which a cosmetic suture is applied.

    The process takes no more than 20 minutes and after a short observation the patient can go home. Sexual intercourse is not recommended for two weeks. Also, you can not lift weights, play sports.

    With biopsies of both testicles, an incision is made in the center of the scrotum, the organs protrude and a tiny piece of tissue the size of a grain of rice is removed with a cutting instrument.After the shell is sutured.

    An open testicular biopsy is performed using the MESA technique. The specialist determines the largest channel and aspirates the contents. Further studies of the material are carried out using the TESE method. The most effective method for obtaining spermatozoa is considered to be the micro TESE method – a complex process that requires the use of a microscope. It is he who allows you to accurately determine the diameter of the widest tubule in order to gain access to the largest number of germ cells. The resulting sperm can be used for fertilization or freezing.

    Puncture biopsy

    This is a minimally invasive technique widely used to accurately diagnose the nature of the disease. The examination procedure of the male testicle is performed under local anesthesia. The method is also suitable for obtaining reproductive material.

    For the operation, a small section trocar is used in combination with ultrasound equipment to control the process. Using a needle, the aspirate is removed from the epididymis. Two methods of material collection are used:

    • TESA (assumes a puncture of the organ).
    • PESA (puncture of the epididymis).

    If the absence of sperm in the semen is due to testicular dysfunction, the first method is used. In case of obstruction of the seminal ducts, the best result can be obtained using the second biopsy option. A closed biopsy is performed both for diagnostic purposes and for sampling when it is impossible to conceive a child naturally.

    Recommendations after biopsy

    To avoid possible unpleasant consequences and complications after the operation, the patient must follow the following instructions:

    • Follow all medical advice.
    • Wear a support bandage, underwear such as swimming trunks made of natural fabrics.
    • The site of intervention must be treated, protected with a napkin from external irritations and wearing swimming trunks.
    • Do not shower for two days after surgery.
    • Don’t drive for two or three days.
    • Physical activity is prohibited.

    Consequences of biopsy

    Possible consequences of the performed operation may include:

    • Swelling and tenderness at the site of intervention.
    • Hematocele, or hemorrhage in the damaged area.
    • Hematomas and bruises on the scrotum.
    • The appearance of inflammation, epididymitis, or orchiepididymitis.

    If the patient adheres to all the doctor’s recommendations and the procedure was carried out correctly, the consequences are usually minimal.

    If you experience acute pain, redness, fever, you should immediately consult a doctor. If inflammation develops, the patient will need a course of antibiotics and local therapy to relieve symptoms.The cost of this restoration varies depending on the situation. An open biopsy is far less complicated than a puncture biopsy.

    How to choose a doctor?

    A testicular biopsy is often the only chance on the path to paternity. Therefore, choosing the right clinic and doctor is of paramount importance. Specialists of the Central Clinical Hospital of the Russian Academy of Sciences invite men from Moscow and the regions for diagnostics. Here you can count on the professionalism of doctors, take advantage of the diagnostic capabilities of high-tech medical equipment.The site contains patient testimonials that may be useful to those planning to undergo a biopsy. For more information or to sign up for the procedure, call 7 (495) 104-86-19.

    90,000 For what reasons can the right testicle hurt in men

    It is not for nothing that they say that a blow to the balls is the most painful, because they are the most vulnerable place in men. The right testicle can hurt in men, both in old and in adolescence. Pain syndrome can be both aching and acute.Even if the pain subsides, its appearance always causes irritation, hysteria, fear and emotional instability, which are always accompanied by excessive sweating, feeling of weakness, vomiting and nausea. Accordingly, any man definitely needs to know what to do if a testicle hurts.

    Remember, only urologist-andrologist can accurately diagnose and prescribe treatment!

    Functions of the right and left testicles

    The right and left egg in men have other names – testes and testicles, which create a paired gonad – the sex gland, which is located in the soft scrotum.It produces testosterone and sperm. In any of the eggs there are 200 lobules, separated by partitions, where the seminiferous tubules are located. Sperm maturation takes place in them.

    The spermatic cord is located in the upper part of the right and left eggs. They contain nerves, blood vessels and the vas deferens. The appendages are located on the lateral part of the testes. They transport the seminal fluid into the vas deferens and bring the sperm to maturity.

    Why is it important to see a urologist

    In the event that after 7-8 hours after the onset of pain in the testicles, it does not get better, a male representative should immediately contact a urologist to make sure that there are no pathologies or injuries.In severe cases, you should definitely call an ambulance.

    Sign of possible diseases

    Pain in the testicles is not an accurate diagnosis, it is only a symptom of a concomitant disease or injury. The reasons why testicles hurt in men are many and each has its own character.

    Mechanical injury

    A pulling pain in the testicle with the left or right indicates an injury followed by a hematoma. A puncture wound and rupture of the membranes are considered dangerous, as evidenced by severe pain and profuse bleeding.

    Testicular torsion

    Torsion is considered the most dangerous symptom. If the patient is not provided with timely assistance, then he may be left completely without one egg. When twisting, the spermatic cord, the vessels inside it, the nerves and the vas deferens are squeezed, which leads to necrosis of the gland tissues. It can occur when the eggs are injured, sudden movements and when the abdominal muscles are strained.


    Cystitis or orchitis is possible with pain syndrome at the end of urination and burning sensation in the scrotum.The disease is provoked by bacteria and viruses. If a man has suffered strong mental or physical stress, hypothermia or little movement, then the disease will not keep itself waiting long. If the right testicle hurts and the body temperature rises, then a pathological process has begun.


    Pain in the testicle in men may be associated with inflammation of the epididymis. The disease most often appears during an active sexual life. The main reason is the presence of a bacterial infection.The following factors contribute to the occurrence of epididymitis:

    • Promiscuous sex;
    • Surgical interventions;
    • Taking medicines.

    There is an acute, recurrent and chronic disease.


    In the event that the right egg hurts and it has increased in size, dropsy is present. In addition, the symptoms of the disease are: fever, lack of appetite, weakness.Excessive physical activity provokes dropsy.


    Manifests itself as pulling pain. A seal appears in the scrotum that is easy to feel. In a man, semen accumulates in the duct of the epididymis and a small cyst develops. It is removed only by surgery.

    Other possible causes

    Causes of testicular pain in men are caused by the following reasons:

    1. If a man feels pain that spreads throughout the scrotum, there is an inflammatory process in the kidneys.
    2. Severe stabbing paroxysmal pain with a return to the lower back indicates urolithiasis.
    3. If the scrotum hurts and there is swelling, the man has an inguinal hernia.
    4. In the presence of dull bursting pain with a return to the scrotum or leg, pubis – there is an inflammatory process, which in some cases requires immediate surgical intervention.
    5. Stagnant processes, if a man abstained from intercourse for a long time, lead to the fact that after sex the testicles hurt.

    If the testicle is pulling, there is aching pain in the testicles or other unpleasant symptoms, a man should not postpone going to the doctor. In no case, you should not ask for advice from acquaintances, friends or the World Wide Web, what to do if the testicles hurt. Otherwise, you can lose them, lose interest in sex, or remain sterile.

    Treatment of infections in men is the profile of our medical center. Make an appointment.

    Surgical treatment of varicose veins of the testis and spermatic cord

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    • Surgical treatment of varicose veins of the testis and spermatic cord

    Varicocele is a varicose veins of the spermatic cord and testicle.

    Varicocele is one of the most common diseases among men, which often leads to very unpleasant consequences. In itself, varicose veins of the spermatic cord is not a big problem, the patient’s life is not threatened and you can safely live your whole life with him without much worry. The problem may be the main complication of this disease – male infertility and pain symptom.

    As with varicose veins in the legs, the only real treatment is surgery in one form or another.

    On the other hand, since varicocele is not a dangerous disease, and as a rule, it is asymptomatic, its detection in an adult man is not an indication for surgery.

    Surgical treatment is required in the following cases:

    1. The presence of pain in the testicle.
    2. Male infertility (due to a decrease in the number, quality and motility of sperm).
    3. Aesthetic defect in the scrotum.
    4. Cessation of growth of the affected testicle during puberty.

    However, many experts believe that in children and adolescents, in order to prevent potential infertility, surgery for varicocele should be done in any case.

    Ivanissevich’s operation

    Taking into account the incompleteness of the formation of the vasculature of the retroperitoneal space and at the same time its high capacity for compensatory restructuring in childhood, in children with varicocele caused by stenotic lesion of the renal vein, the testicular vein is ligated in the lower third.The developing network of venous collaterals above the ligation level compensates for the switched off blood flow through the testicular vein.

    Technique of operation

    At the level of the anterior superior iliac spine on the left, a horizontal skin incision is made 4 cm long; the aponeurosis of the external and internal oblique muscles of the abdomen is dissected with scissors in the longitudinal direction parallel to the inguinal fold for 5 cm. The muscles are bluntly parted along the fibers and stretched with hooks. The parietal leaf of the peritoneal sac moves medially, and in the place of its contact with the inner ring of the inguinal canal is the testicular vein, which lies on the peritoneal sac.At this level, the vein often consists of 2 to 3 trunks emerging from the inguinal canal. The vein is separated a short distance from the peritoneum. The vein trunk is crossed between the two clamps, its proximal end is tied up. In the lumen of the venous trunks of the distal “stump”, the noses of the “mosquito” -type clamps are introduced. During the massaging of the left half of the scrotum with the hand, venous blood squeezed out of the aciniform plexus is jetted out from the vessels of the stump. Emptying of the accumulated blood from the accumulated blood in the aciniform plexus accelerates the emptying and regression of its venous nodes in the postoperative period.

    The stump is stitched, tied up and, after cutting off the ligatures, “goes” into the inguinal canal. The wound on the abdominal wall is sutured in layers.

    Operation Palomo

    Operation Palomo is similar in meaning to Ivanissevich’s method. They differ only in that Palomo suggested making an incision above the inguinal canal, where the testicular vein, as a rule, already emerges from the plexus and ligating the testicular artery together with the testicular vein. The further actions of the surgeon, in fact, are no different from those during the operation of Ivanissevich.

    Thus, it turns out that there are no fundamental differences between these approaches, but, thanks to the somewhat free and more open access to the testicular vein, when using the Palomo technique, the risk of developing a relapse of varicocele, that is, technical errors associated with the remaining unnoticed additional branches of the testicular vein. However, in spite of this, even here it is not possible to identify all the collectors of a possible pathological venous outflow, and therefore the recurrence rate on average reaches 25%.

    The main disadvantage of the Palomo technique is that, in order to minimize the likelihood of a relapse of the disease, the internal seminal (testicular) artery is also ligated during the operation, which reduces the flow of arterial blood to the testicle. This artery has a very small diameter (approximately 0.5-1 mm), and therefore it is sometimes very, very problematic to preserve it. Damage to it often further turns into testicular atrophy.

    Palomo himself was convinced that the indicated blood vessel can be crossed without any risk of such problems, and only in those situations when the artery of the vas deferens is crossed simultaneously with the internal spermatic artery, there is a danger of testicular atrophy

    In addition, stealth often causes damage to thin and almost transparent lymphatic vessels.In this regard, after the treatment of varicocele in children, as well as in adults with the help of Palomo operation, another complication of hydrocele (dropsy of the testicle) is often formed (with a frequency of up to 7%), associated with a violation of lymph outflow.

    This gave an impetus at one time to the creation of a modification of the Palomo-Erokhin operation (1979), when in the process of surgical intervention, special contrasting of the testicular lymphatic vessels is used in order to avoid their trauma during the manipulation.

    On average, Palomo’s operation takes no more than twenty-five to thirty minutes. Like Ivanissevich’s technique, it was quite common until 2000. It was believed that this surgical intervention gives a good cosmetic result and has almost no negative impact on the quality of the patient’s later life. Now some experts believe that the approach developed by Palomo is non-physiological and does more harm than good, namely: it leads to more pronounced and serious circulatory disorders than the presence of untreated varicocele itself.