What is Scrotox and why are men getting this procedure. How does Scrotox work and what are the potential benefits and risks. Is Scrotox safe and effective for male enhancement.

The Rise of Scrotox: Understanding the Latest Male Cosmetic Trend

In recent years, a new and controversial cosmetic procedure for men has emerged – Scrotox. This treatment involves injecting Botox into the scrotum, purportedly to enhance its appearance and sensitivity. But what exactly is Scrotox and why are some men opting for this unusual procedure?

What is Scrotox?

Scrotox is a cosmetic procedure that involves injecting botulinum toxin (Botox) into the scrotal skin and muscles. The goal is to relax the dartos muscle, which controls the contraction of the scrotum. This relaxation causes the scrotum to hang lower and appear smoother and larger.

How is the Scrotox Procedure Performed?

The Scrotox procedure is typically performed as follows:

1. A topical anesthetic cream is applied to numb the area
2. Several small injections are made into the scrotal skin using a fine needle
3. The botulinum toxin is injected into the dartos muscle, not into the testicles themselves
4. The procedure is usually quick with minimal downtime

Potential Benefits and Motivations for Scrotox

Why would men consider getting Scrotox? There are several reported benefits that are driving interest in this procedure:

• Cosmetic enhancement – smoother, less wrinkled scrotal skin
• Perceived increase in testicular size as the scrotum hangs lower
• Reduction in excessive sweating in the groin area
• Possible increased sensitivity and improved sexual experience

While the cosmetic effects are the primary motivation for most, the potential for enhanced sensation has sparked curiosity among some men. However, it’s important to note that these benefits are largely anecdotal and not scientifically proven.

The Controversy and Risks Surrounding Scrotox

As with any cosmetic procedure, especially one involving such a sensitive area, Scrotox is not without controversy and potential risks. What are some of the concerns surrounding this treatment?

Medical Risks

While Botox is generally considered safe when administered by trained professionals, injecting it into the scrotum carries some risks:

• Infection at the injection site
• Allergic reaction to the botulinum toxin
• Temporary numbness or loss of sensation
• Uneven results or asymmetry

Ethical Concerns

Some medical professionals and ethicists have raised concerns about the growing trend of cosmetic procedures targeting male genitalia. They argue that such treatments may exploit men’s insecurities and promote unrealistic body standards.

The Evolution of Male Cosmetic Procedures

Scrotox is part of a broader trend of cosmetic procedures marketed towards men. How has the landscape of male aesthetic treatments changed in recent years?

Growing Acceptance of Male Cosmetic Treatments

Over the past decade, there has been a significant increase in men seeking cosmetic procedures. This shift reflects changing attitudes about male grooming and self-care. Popular treatments for men now include:

• Botox for facial wrinkles
• Hair transplants
• Body contouring procedures
• Non-surgical fat reduction treatments

Scrotox represents a new frontier in this expanding market, targeting an area traditionally considered off-limits for cosmetic enhancement.

The Psychology Behind Scrotox: Body Image and Masculinity

The emergence of Scrotox raises interesting questions about male body image and societal expectations of masculinity. Why might men feel pressure to alter this part of their anatomy?

Influence of Media and Pornography

Some experts argue that increased exposure to pornography and idealized male bodies in media has contributed to men’s insecurities about their genitals. This may drive some to seek out procedures like Scrotox in an attempt to measure up to perceived standards.

Changing Notions of Masculinity

The willingness of men to undergo such intimate cosmetic procedures may also reflect evolving ideas about masculinity. As traditional gender roles shift, some men may feel more comfortable exploring treatments traditionally associated with women.

Medical Perspectives on Scrotox

What do medical professionals think about Scrotox? Opinions within the medical community are divided.

Skepticism from Some Doctors

Many urologists and plastic surgeons express skepticism about the necessity and safety of Scrotox. They argue that the potential risks outweigh the purely cosmetic benefits.

Support from Proponents

Doctors who perform Scrotox argue that when done properly, it is a safe procedure that can boost men’s confidence. They emphasize the importance of seeking treatment from qualified professionals.

The Future of Male Genital Cosmetic Procedures

As Scrotox gains attention, it raises questions about the future direction of male cosmetic treatments. What might we expect to see in coming years?

Potential for New Treatments

The success of Scrotox may pave the way for other genital cosmetic procedures marketed towards men. This could include both surgical and non-surgical options targeting various aspects of male anatomy.

Regulatory Concerns

As these treatments become more popular, there may be increased scrutiny from regulatory bodies. This could lead to more standardized guidelines for performing and marketing such procedures.

Making an Informed Decision About Scrotox

For men considering Scrotox, it’s crucial to approach the decision with caution and thorough research. What steps should potential patients take?

Consult with Multiple Professionals

It’s advisable to speak with several qualified medical professionals, including urologists and plastic surgeons, to get a balanced perspective on the procedure.

Consider Motivations and Expectations

Men should carefully examine their reasons for wanting the procedure and have realistic expectations about the results. It’s important to remember that Scrotox is not a solution for underlying body image issues or relationship problems.

Understand the Risks and Limitations

Potential patients should be fully informed about the possible side effects and limitations of the procedure. They should also be aware that the effects of Scrotox are temporary, typically lasting 3-4 months.

As Scrotox continues to gain attention, it remains a controversial topic in the world of male cosmetic enhancement. While some men report satisfaction with the results, the medical community remains divided on its value and safety. As with any cosmetic procedure, it’s crucial for individuals to carefully weigh the potential benefits against the risks and to make decisions based on thorough research and professional medical advice.

The emergence of treatments like Scrotox reflects broader societal shifts in attitudes towards male grooming and body image. As these trends evolve, it’s likely we’ll continue to see new and potentially surprising developments in the field of male aesthetic procedures. Whether Scrotox becomes a widely accepted treatment or remains a niche trend remains to be seen, but it has undoubtedly sparked important conversations about masculinity, body image, and the limits of cosmetic enhancement.

Nutscaping sees men taking photos of their balls in front of stunning landscapes

It’s your balls’ time to shine. (Picture: nutscapes.com)

At some point in your travels, you’ll come across a sight that’s so beautiful, it takes your breath away.

In those moments there’s only one thing to do. Take a photo. With your balls out.

Nutscaping is a photo-taking trend which involves dropping your trousers, whipping out some testicles (yours, if you have them), and gently hovering above the camera so your balls hang down like a majestic moon in the sky.

Nutscapes.com is a website dedicated to capturing the phenomenon, and has even shared a handy guide on how it’s done:

How to Nutscape

1. Find yourself somewhere awesome

2. Turn your back to the awesome scene

3. Drop your pants

4. Bend over and shoot Nutscape through your legs

Diagrams are to come, in case you need some help perfecting the technique, and there are a few rules. Like no dick tips. Just interested in the balls, here.

Lone testicles overlook some rocks. (Picture: nutscapes.com)

The creators of nutscapes also have a few pointers (not a double entendre. Again, balls. Not penises) to offer, advising loose clothing for easy whipping out, and the use of a friend when needed.

The trend first appeared back in 2007, but is seeing a resurgence in popularity. Because, balls.

It’s art, really.

This one’s quite soothing, if you ignore the pubes. (Picture: nutscapes.com)

And people are willing to brave chilly temperatures….

Such bravery. (Picture: nutscapes.com)

…and terrifying heights in order to capture the perfect nutscape.

Good composition on this one. (Picture: nutscapes.com)

It’s a new take on freeballing.

Balls on the beach. (Picture: nutscapes.com)

That allows your balls to take in nature and the beauty of the world around them.

Balls in the mountains. (Picture: nutscapes.com)

Balls deserve a break, too.

Balls at large. (Picture: nutscapes.com)

And their time in the limelight. Because dick picks are so passé.

Balls gone wild. (Picture: nutscapes.com)

And really, if you’re not dangling your bits in front of some cliffs at sunset, we’re just not interested.

Balls. (Picture: nutscapes.com)

Head over to Nutscapes if you fancy some more nutspiration, or fancy submitting your own.

MORE : Follow the adventures of one man’s intrepid penis with the Things My Dick Does Tumblr

MORE : 12 fascinating facts you never knew about balls

MORE : Can you spot all the peens in this New York Fashion Week show?

SCROTOX – Before & After Pictures

Aesthetic treatments of the scrotum, including Scrotox are gaining popularity among Great Seattle area men.

We offer Scrotox procedure for male patients who prefer a lower hanging and more relaxed scrotum for cosmetic reasons.

IMH Doctors

Innovative Men’s Clinics
Innovative Doctor’s Group

What is Scrotox?

The latest trend in extreme grooming has crossed over from Europe and is becoming quite popular stateside. In fact, doctors are expecting this new procedure to become significantly more popular in 2017. Informally called Scrotox, the procedure involves injecting Botox into the scrota.

WHY WOULD SOMEONE INJECT BOTOX INTO THEIR SCROTA?

Scrotox – Testicular Botox has many purported benefits. One reported benefit is as a treatment for excessive sweating but the primary benefit seems to be that it smooths out the wrinkles on their testes and makes them look bigger. And then there is this – apparently, there are those who have reported that it has improved their sex life. Yup – the buzz is that it increases sensitivity in the boys downstairs… and that… has people talking.

Scrotox Before and After Picture

The clinical pictures below show the results that can be achieved with Scrotox. Results may vary among patients.

As well as smoothing the skin, Scrotox allows the testicles to hang down further and appear bigger.

So how does this all go down?

The procedure is painless and involves applying a topical cream to numb the area. Then there are several small injections made with a fine needle into the testicle skin (but not into the sack itself). The downtime is virtually non-existent and the result is a smoother and larger appearance.

Botox is injected in the scrotal skin (NOT in the testicles), mostly into the dartos muscle. A strong topical anesthetic cream is applied to the scrotum, so injections are painless.

People that have done the procedure have said they tried it because they heard others talk about improved appearance and increased sensitivity. Whether or not curiosity is what brings them in… The end result seems to be bringing them back.

Are there drawbacks?

One Dr warned that if you were trying to have children, there is a possibility that it could temporarily lower your sperm count. Your testicles expand and contract as a means of regulating heat. Scrotox causes your testicles to hang lower and appear more full but this may have a temporary effect on temperature regulation which, in turn, can impact your sperm count.

How long does it last?

Much like regular BOTOX injections, the results will typically last for around 4 months. “The results don’t happen immediately”, one man was quoted as saying “but later that week I noticed my scrotum was more relaxed.” The same patient was also kind enough to elaborate on our questions about sensitivity. “The sex was great!” he said.

SCROTOX PROCEDURE

The procedure usually takes about 45 minutes. IMH’s doctors perform Scrotox at either one of our offices in Seattle, Bellevue, Lynnwood or Federal Way. Schedule an appointment today.

SCHEDULE AN APPT.

Men are adorning pictures of beautiful landscapes with their testicles and we are grossing out – ReshareIt

Look at this picture.

Did you find anything odd with it?

See again!

Nutscaping, an act of taking a picture of a beautiful landscape with a man’s nuts hanging on the top of the picture like a dark cloud, has gained all the popularity. It started in 2007 and it has just got popular now! Men are posting their pictures and it has become quiet a fad. Twitter handle dedicated to nutscaping, @nutscapes, has been sharing some really interesting pictures to gross you out of men nutscaping in their vacation spots. Oh, god! No!  The page even gives basic step by step guide on how to drop your testicles the right way for a picture.

• How To Nutscape 1: Find yourself somewhere awesome or interesting with the urge to get a little…
• How To Nutscape 2: Turn your back to the scenery and whip out your camera device.
• How To Nutscape 3: Bend over, let ’em hang, and snap the pic.
• How To Nutscape 4: Share with your friends

Take a look at some of the ballsy pictures shared by this popular Twitter handle!

 1.

Not all bodies of water should be swam in… #nutscapes #patagonia #shrinkage @patagonia @CHILETOURISM_LH pic.twitter.com/ixWr0TBJYN

— nutscapes (@nutscapes) July 3, 2014

2.

#Summertime is here! Cue DJ Jazzy Jeff and the Fresh Prince. #nutscapes @djjazzyjeff215 pic.twitter.com/t2DZf4aego

— nutscapes (@nutscapes) July 3, 2014

3.

#ballinonabudget #imonaboat #nutscapes pic.twitter.com/d2ZobbiYTf

— nutscapes (@nutscapes) July 3, 2014

4.

The new #thighgap is here #nutscapes #summerdiet pic. twitter.com/xbga5g81Nh — nutscapes (@nutscapes) July 3, 2014

5.

Happy 4th! #redwhiteblue #letfreedomring pic.twitter.com/Q7tJ8xg5KG

— nutscapes (@nutscapes) July 4, 2014

6.

We out here at #mckayfalls in #bigsur California. #nutscape #letembreathe pic.twitter.com/1aMzrutHj9 — nutscapes (@nutscapes) July 16, 2014

7.

Greetings from Patagonads! #patagonia #ballinout #getoutthere #thighgap pic.twitter.com/HmCX6wBpDq

— nutscapes (@nutscapes) July 25, 2014

8.

These some hairy times were in. #livefreeordie pic.twitter.com/cEr14fetPT — nutscapes (@nutscapes) August 5, 2014

9.

#imhappybecause these boys are #free #freeswag #nutscapes pic. twitter.com/kXhRiPDxCe

— nutscapes (@nutscapes) August 11, 2014

10.

#polarplunge ain’t no thang…. #bringonwinter #thighgap #nutscapes #nuts pic.twitter.com/gf2D3QNpjD — nutscapes (@nutscapes) November 17, 2014

11.

It’s a good day to get back to twitter. #LGM #nutscapes #maroonbells pic.twitter.com/sMz3cvMHRY

— nutscapes (@nutscapes) October 22, 2015

12.

“Walk away quietly in any direction and taste the freedom of the mountaineer” #johnmuir #nutscapes pic.twitter.com/z5m8C7SVz5

— nutscapes (@nutscapes) October 23, 2015

Pretty gross, right?

Clinical pictures: Male genital problems

Epididymal cyst

The epididymal cyst is probably the most common lump seen in male patients. These cysts vary in size from a pea to a peach. This young man, like most, was very worried, having become aware of the swelling while he was in the shower. He was certain that he had a testicular cancer. The swelling was separate from the testicle and clearly benign. An ultrasound scan confirmed the diagnosis and no further action was required.

Penile candida

This man presented with a very painful foreskin. It was extremely uncomfortable every time he developed an erection because the skin split. Topical antifungal cream was effective in controlling the infection and helping the skin to heal. He was advised to ensure that his partner also treated herself, to ensure that he did not become reinfected.

Fixed drug eruption

This patient developed a rash on his glans. Other than its alarming appearance, it was asymptomatic. He had recently been prescribed the COX-2 inhibitor etoricoxib for gout. A dermatologist considered this might be the cause because no other likely culprits were apparent. Withdrawal of the drug was followed by resolution of the rash, which did not reappear. The patient has subsequently taken colchicine for his acute gout.

Orchitis

This man required catheterisation following surgery. A few days later, he developed a very tender, swollen testicle, due to acute orchitis. He was quite unwell, with a pyrexia. He was treated with a combination of amoxicillin and metronidazole, covering aerobic and anaerobic organisms. He improved over a few days, but it took several weeks for the testicle to become normal.

Penile ulcer

This 75-year-old man had endstage renal failure requiring haemodialysis. He also developed a penile ulcer. It was thought to be due to herpes simplex and related to his immune-suppressed state. Viral and bacterial swabs were negative on culture and antiviral therapy was not effective. The ulcer eventually healed on its own, although the patient’s general health continued to deteriorate and he died a little while later.

Fordyce spots

Teenagers can be very concerned about the appearance of these spots. They are caused by sebaceous gland hyperplasia and may also be seen in the mouth. They often cause anxiety and are mistaken for warts or other STIs. They are very common and of no significance. Reassurance and explanation are normally all that is required.

Bruising

This man sustained a ‘groin strain’ playing rugby. The actual injury is probably due to a tear in the adductor muscles. This was moderately severe and would probably be graded two on a scale of one to three. He was alarmed to find this rather dramatic bruising. Advice to rest and use a combination of ice and warmth helped to heal the injury and he was playing rugby again in three weeks.

Orchidopexy

This 44-year-old man had a long history of problems with his testicles. The left side had been operated on in childhood to repair the scrotum. He had for some years been troubled by discomfort from the right testicle because it often rode upwards out of the correct position in the scrotum. The testicle was normal and his fertility had not been impaired. He underwent orchidopexy to fix the testicle into the scrotum once and for all.

• Dr Marazzi is a GP in East Horsley, Surrey

A Rare Case of Polyorchidism: Four Testes

Pol J Radiol. 2016; 81: 39–41.

Mahmut Duymuş

¹Department of Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey

Mehmet Sait Menzilcioğlu

¹Department of Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey

Mehmet Çetinçakmak

²Department of Radiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey

Serhat Avcu

¹Department of Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey

¹Department of Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey

²Department of Radiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey

Author’s address: Mahmut Duymuş, Department of Radiology, Gazi University Hospital, Ankara, Turkey, e-mail: moc. oohay@hsumyudtumham

^AStudy Design

^BData Collection

^CStatistical Analysis

^DData Interpretation

^EManuscript Preparation

^FLiterature Search

^GFunds Collection

Received 2015 Aug 6; Accepted 2015 Aug 25.

This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited.

This article has been cited by other articles in PMC.

Summary

Background

Polyorchidism or supernumerary testis means more than two testes. It is very rare and to the best of our knowledge, there have been only about 200 cases reported.

Case Report

In this case report we want to present radiological features and assessment of a patient with four testicles.

Conclusions

If the vascularity and echogenicity of the scrotal mass is similar with the normal testis parenchyma, multitestis should be considered. The MRI might not provide us with additional information to USG or CDUSG, thus it is not necessary to perform it if there is no suspicion of malignancy.

MeSH Keywords: Magnetic Resonance Imaging, Scrotum, Testicular Diseases, Ultrasonography, Ultrasonography, Doppler

Background

Polyorchidism or supernumerary testis means more than two testes. It is very rare and to the best of our knowledge there have been only about 200 cases reported. In this case report we want to present radiological features and assessment of a patient with four testicles.

Case Report

A 40-year-old man admitted to the urology out-patient department with a complaint of a mass in the left scrotum. There was no remarkable urological history except for the mass. The patient was married and had two children, thus there was no infertility condition. The urological physical examination was unremarkable, except for the mass. After physical examination the patient was referred to the radiology clinic. Testis ultrasonography (USG), color doppler ultrasonography (CDUSG) and pelvic magnetic resonance imaging (MRI) were performed.

USG revealed two mass lesions in the left scrotum. One of them was in the back of the penis on the left side (Lesion 1), and the other was inferiorly to the left testis (Lesion 2). The parenchymal echogenicity of those lesions was similar to that of normal testis parenchyma (), except for scattered macro- and microlithiasis foci. Both lesions were well circumscribed. The size of lesion 1 was 35×24×14 mm, and lesion 2 was 22×10×10 mm. The lesions did not show any significant or pathological vascularity in CDUSG (). The vascularity of the lesions was similar to the normal testis parenchyma. After USG and CDUSG, contrast-enhanced MRI was performed in the patient. In MRI, those lesions showed the same intensity and diffusion restriction pattern with those of a normal testis in all sequences (, ). The diagnosis was multitestis. Three testes were in the left scrotum and one was in the right. There were some concomitant disorders accompanying multitestis. The disorders included: bilateral epididymal cysts, grade I varicocele on the right side and grade III varicocele on the left side. The patient was managed with one-year period of follow-up.

40-year-old man with polyorchidism. Vertical ultrasonography image of normal testis (N) and extra testis (E). In this image the extra testis is situated inferiorly to the left testis. The scattered microlithiasis foci are seen as submilimetric echogenities.

40-year-old man with polyorchidism. The vertical color Doppler ultrasonography image of an extra testis shows similar vascularity pattern with normal testis parenchyma.

40-year-old man with polyorchidism. The coronal T2-w eighted magnetic resonance image shows an extra testis located to the back of the penis (arrow), near the upper pole of the left testis.

40-year-old man with polyorchidism. The axial diffusion weighted magnetic resonance image of the extra testis posteriorly to the left testis. The diffusion restriction pattern of the extra testis is similar with normal testis parenchyma.

Discussion

Polyorchidism was first decribed by Blasisus in 1670 in an autopsy material where it was found incidentally. The first histological description was made by Ahlfeld in 1880, and the first clinical case was reported on by Lane in 1895 [1–5]. The etiology of polyorchidism is not clear but could be related with embriological period [2,6].

Extra tesicles can be seen in different regions. The most common region is the scrotum. The extra testis is usually seen on the left side. Three testes (triorchidism) is the most common form. A total of 6 cases with 4 testes have been reported so far [7], and our case is the seventh one.

USG and CDUSG constitute a quick, noninvasive and cheap method to evaluate the mass pathologies. USG is easily available and well tolerated by the patients, unlike MRI. In our case report, the USG and CDUSG features of both lesions were similar to those of normal testicular parenchyma. After USG and CDUSG, our diagnosis was polyorchidism. To support the diagnosis, we performed MRI after USG. The MRI images of the lesions were similar with those of normal testis parenchyma in all sequences. Actually, USD and CDUSG were enough to make the final diagnosis. There is much controversy about the necessity of MRI in polyorchidism. Some papers report that MRI is not required in the absence of suspicion [7], while other authors suggest to perform MRI in all polyorchidism cases [1,8]. In the meta analysis of Bergholz USG was the most common radiological modality and only a few of polyorchidism lesions underwent MRI. In those lesions, MRI did not give any additional information to USG [7].

Conclusions

If the vascularity and echogenicity of the scrotal mass is similar to the normal testis parenchyma, multitestis should be considered. MRI might not present additional information to USG and CDUSG, thus it is not necessary to perform it if there is no suspicion of malignancy.

Footnotes

Conflict of interest

There is no conflict of interest and funding concerning this paper.

References

1. Kumar B, Sharma C, Sinha DD. Supernumerary testis: a case report and review of literature. J Pediatr Surg. 2008;43:e9–10. [PubMed] [Google Scholar]3. Amodio JB, Maybody M, Slowotsky C, et al. Polyorchidism: report of 3 cases and review of the literature. J Ultrasound Med. 2004;23:951–57. [PubMed] [Google Scholar]4. Avargues A, Rogel R, Broseta E, et al. Polyorchidism: the case in a young male and review of the literature. Asian J Androl. 2015;17:511–12. [PMC free article] [PubMed] [Google Scholar]5. Olano Grasa I, Llarena Ibarguren R, Garcia-Olaverri Rodriguez J, et al. [Polyorchidism]. Arch Esp Urol. 2009;62:59–62. [in Spanish] [PubMed] [Google Scholar]6. Arslanoglu A, Tuncel SA, Hamarat M. Polyorchidism: color Doppler ultrasonography and magnetic resonance imaging findings. Clin Imaging. 2013;37:189–91. [PubMed] [Google Scholar]7. Bergholz R, Wenke K. Polyorchidism: a meta-analysis. J Urol. 2009;182:2422–27. [PubMed] [Google Scholar]8. Repetto P, Ceccarelli P, Bianchini A, et al. Three small testes in left hemiscrotum: a rarer case of polyorchidism. J Pediatr Surg. 2010;45:e21–23. [PubMed] [Google Scholar]

‘The man with the 132-pound scrotum’: Unraveling the medical mystery

Story highlights

• Wesley Warren struggled with a medical condition called scrotal lymphedema
• In the United States, it’s caused by blockages in the lymphatic vessels
• A patient’s enlarged scrotum can keep growing if left untreated, doctor says

Imagine carrying a bowling ball between your legs that weighs close to 200 pounds. If that image is too much to stomach, continue reading with caution.

Wesley Warren, 49, spent more than four years with this extra burden before having surgery to repair the damage from a rare medical condition called scrotal lymphedema.

When doctors placed the swollen mass they had cut from Warren’s scrotum on the scale, it weighed 132 pounds. That’s not counting the fluid or smaller pieces of tissue the surgeons had also removed from the Las Vegas man.

“There are a lot of people that will look and laugh and stare in shock and awe and amazement,” Warren says as he walks down the street in a preview for TLC’s upcoming show “The Man with the 132-Pound Scrotum.” The one-hour special airs Monday at 9 p.m. ET/PT.

“It’s tough to deal with it, you know, because essentially, this is a sort of living and breathing freak show.”

It began in 2008, Warren told TLC, when he awoke to a shooting pain in his testicles. The tissue around his penis soon began to swell, eventually growing at an estimated rate of 3 pounds per month.

One doctor told Warren that it might be necessary to castrate him to fix the problem; others told him that he would probably die on the operating table. And the cost of the surgery alone would be in the hundreds of thousands of dollars. After Warren appeared on the Howard Stern radio show, appealing for help, a fellow scrotal lymphedema sufferer referred him to Dr. Joel Gelman, who offered to do the surgery for free.

Gelman, director of the Center for Reconstructive Urology at the University of California, Irvine, specializes in urethral and penile reconstruction surgery.

Although the headline of TLC’s special is catchy, scrotal lymphedema is a very real condition, Gelman said. He hopes media attention surrounding the show will encourage other men with the problem to seek treatment.

Here are some more answers about this condition:

What is scrotal lymphedema?

Scrotal lymphedema, also known as scrotal elephantiasis, is a “massive enlargement” of the scrotum due to thickening of tissue and accumulation of fluid, Gelman said.

What causes it?

Outside North America, scrotal lymphedema is often caused by a parasitic infection called lymphatic filariasis that’s spread by mosquitoes. “Thread-like worms” lodge themselves in the lymphatic system, according to the World Health Organization, where they can interfere with a person’s immune system.

But lymphatic filariasis is virtually unheard-of in the United States, Gelman said. Most cases of scrotal lymphedema here are caused by blockages in the lymphatic vessels that prevent fluid from draining from the area. Doctors are unsure what causes this blockage; in Warren’s case, Gelman believes it was an injury or trauma to his scrotum.

What are the symptoms?

The most obvious symptom is a large scrotum; this can range in size from a grapefruit to a basketball. But the mass doesn’t “max out” at any particular size, Gelman said. It will keep growing until the patient seeks treatment.

Warren’s scrotum was the largest Gelman had ever seen.

“(Warren) didn’t report that he was always in pain, but I think the biggest problem is that the sheer size of the mass made it very uncomfortable for him,” the surgeon said. “It’s like lifting weights to take a step.”

Warren’s penis was “buried” about a foot under his skin, Gelman said, but fully functional. A tunnel of sorts had formed from the tip to the top layer of his swollen skin, allowing Warren to urinate without assistance.

How common is scrotal lymphedema?

It’s rare, especially in the United States. Definite numbers are difficult to come by, and the condition may be underdiagnosed due to physicians’ lack of awareness, Gelman said. Many patients with the condition are also obese and are simply instructed by their doctors to lose weight.

How do you treat it?

Surgery is usually the best option to remove the swollen tissue, Gelman said. A surgeon who specializes in this type of procedure will cut a T-shape in the mass, identify the penis and testicles to make sure they aren’t harmed and then excise the excess tissue. The surgeon will then use undamaged tissue to cover the penis and scrotum.

How is Warren doing now?

Warren is walking again and enjoying life, Gelman said. He’ll need a follow-up surgery to remove some additional skin that was damaged by his condition. Gelman will perform a skin graft to cover the penis and scrotum.

Um, what if I think I have it?

If you are experiencing the symptoms noted above, see a doctor as soon as possible. Ask for a referral to a specialist if your primary care physician is unfamiliar with these types of conditions.

An unusually large scrotum can have a variety of causes, Gelman said. One of the most common is a hernia, in which a small part of the intestines enters the scrotum. Another cause is fluid buildup on one side of a man’s body between the testicle and the skin; this is called hydrocele. All are treatable and usually not life-threatening unless left too long.

4 signs that you could have testicular cancer

None of us ever think that we could be affected by cancer. But the reality is that men, and young ones at that, are dying across the world from testicular cancer and all because while they constantly have their hands down their pants readjusting their tackle, they refuse to learn or just ignore its signs.

Cancer is always associated with something that happens to other, older, men. However, according to Mo Bro, and testicular cancer expert, Ben Bowers has firsthand experience of the disease, having lost both testicles to the disease in the last 11 years.

Speaking to The Sun Online he said that it’s vital every man gets checking their testicles on a regular basis, to stop men dying needlessly.

“Guys out there need to know the risks, and need to get to know their nuts,” he said, adding, “Check them regularly and if there’s anything odd down there get it checked by a doctor.”

Here are the signs of testicular cancer:

A lump or swelling in the testicle: This is the most common symptom. The lump could be as small as a pea, but is often a lot larger. You may also notice a difference between one testicle and the other. Gently feel each testicle individually to check for lumps. If you do find a lump, don’t panic. Only four per cent are actually cancerous – but it’s still definitely worth getting checked out.

A heavy scrotum: It’s normal for one testicle to be slightly larger or hanging lower than the other. But a noticeable change in size or weight on one side may indicate that something is wrong.

A sharp pain in the testicle or scrotum: Testicular cancer is not usually painful, but a sharp pain in your balls is the first indicator for one in five patients.

Changes in shape or texture: This makes it especially important to check yourself over regularly.

Other symptoms:

• If the cancer has spread to lymph glands in other parts of the body, you may develop a backache, a dull ache in the lower tummy and lumps in the collar bone or neck.
• If the cancer has spread to the lungs, you will cough and have difficulty breathing.
• Cancer can produce hormones, leading to tender or swollen breasts and if the cancer has spread to the lymph nodes in the centre of your chest, between the lungs there will be difficulty swallowing, a swelling in your chest.

…
90,000 Testicular structure in men: size, position and function

Any biological creature assumes its main function – reproduction, it is considered the main engine of life. In fact, the same can be said about a person who is born with the aim of further giving birth to offspring. The reproductive system is responsible for these functions, in men, for example, the paired sex gland, the testes, is responsible for the offspring, and everyone should know the structure of the testes in men.

Knowledge of the structure and functions of the organ means a responsible and conscious approach to further childbirth.Every man should know that the testes perform two functions – they form sperm, from which children are then obtained, and are also responsible for the production of sex hormones that are responsible for a man’s sexual activity. More information on the position, size and function of the testicles will be provided below.

Material content:

Shape and position of testicles

The testicles are primarily a paired genital organ in the form of a gland, which the body needs for the maturation of sperm. But in addition to the reproductive function, the testes are also responsible for the production of testosterone, which is responsible for numerous processes in the male body in addition to sexual activity. To begin with, a man should figure out what position and shape these paired glands should have.

In shape, the testicles resemble a flattened oval with a dense content inside. They are located inside the scrotum, where they are separated using a special septum. In addition, the testicles are covered around the entire circumference with a special membrane, the spermatic cord is attached to them.Visually, the testicle is, as it were, suspended with the help of this cord by its posterior cavity, which forms an inclination of the upper part forward and the lateral part backward.

Normally, a man’s testicles will have a slight difference in shape, location and size. Practice shows that the left testicle can be located slightly lower than the right one, and this asymmetry is recognized by medicine as the norm. Thanks to this, when walking, there is no friction and squeezing of the testicles, which protects them from injury and damage.During the period of excitement, the muscles lift the testicles, they are drawn into the groin area.

Expert opinion

Elena Druzhnikova

Sexologist. Family relations expert. Family psychologist.

A medical certificate says that all paired organs of the human body (eyes, ears, fingers, etc.) have slightly different shapes and sizes. A man’s testicles are no exception, they will always differ in size and location, which is the absolute norm.

Testicular structure in men

Particular attention should be paid to such a question as the structure of the male testicles.If you look at the anatomy of the human body and all organs, you can see the following generally accepted norms and the size of male testicles:

• testicle length – from 4 to 6 cm;
• testicle width – from 2.5 to 3.5 cm;
• testicle weight – from 15 to 25 (30) g.

The upper end of these organs is turned outward, but the lower end is inward. According to the structure, the glands pass into the internal and external cavities of the male genital organs, that is, they are both an external organ and an organ inside the scrotum at the same time.The testicles are also considered as the anterior and posterior endings; appendages are provided inside the posterior end.

The testicle itself is covered with a membrane by the peritoneum, it consists of a parenchyma, which is enclosed in a membrane sphere. This sphere consists of a tunica albuginea, while outside experts observe the vaginal membrane. From the posterior wall of the testicles, a thickening of the tunica occurs, which becomes the beginning of the structure of the mediastinum of the testicle. Next comes the process of spreading connective tissue partitions into the duct glands, these partitions are responsible for dividing the paired glands into two sectors.

Lobar spaces or sectors have a conical shape, its base refers to the membranes, and the upper end refers directly to the mediastinum. Each lobar space also has 1-4 spermatic cords, in which spermatozoa mature for further offspring. Here, near the mediastinum, several cords merge into a single seminal system of canals, which passes through the mediastinum, connecting the cords and the canal testicular system. In anatomy, this is called the testicular network.

In the mediastinum there are 12 or 18 testicular ducts passing through the tunica albuginea to the very adventitious head. The accessory duct passes into the vas deferens, after which it connects with the excretory duct of the seminal vesicles, which forms the ejaculatory duct. In the small pelvis, the canal opens into the duct of the seminal vesicles, then passes through the prostate and opens in the urethra.

The testicles are located above the tunica albuginea and the appendages, they are placed in the vaginal membrane, which itself forms the serous zone.The testicle is covered with two plates – in front of the visceral and behind the parietal. The two plates, in turn, form the vaginal outer and inner sheaths of the paired glands. The importance of the structure of the testicles is due to the fact that the function of procreation and sexual activity depends on it.

The structure of the epididymis of the male testicles

It is equally important to know what the appendages look like in the male reproductive system, which are located along the posterior edge of the testicle. The structure of the epididymis considers:

• rounded and slightly widened upper part, which is called the epididymis head – cdput epididymidis;
• the middle part, which is called the body of the epididymis – corpus epididymidis;
• tapering lower part, which is the tail of the epididymis – cauda epididymidis.

The head of the epididymis includes the appendage of the epididymis or appendix epididymidis, which is a rudimentary process of the mesonephral duct. Further along the entire length of the epididymis, blindly ending tubules or grooves can be observed, which are remnants of the mesonephros tubules. Back from the head of the epididymis is a flat, whitish formation in the connective tissue, that is, the epididymis of the testicular appendage.

The serous membrane, which is located in the depression between the testicle and the epididymis, lines the epididymis sinus.And from the efferent tubules of the glands, lobules of the conical appendage are formed. The tubules of the lobules of the appendages enter the duct of the appendage. The duct of the epididymis in its tail region passes into the vas deferens. The structure of the appendages also includes nerve endings and blood vessels.

Testicular ripening

The maturation of the male genital organs, including the paired sex glands, occurs even during the maturation of the embryo, when a pregnant woman is carrying it. The testicles form and mature in the body at 6-7 weeks of gestation, but first, the so-called rudiments of the genital cords appear.By the third month of pregnancy, cells are formed that are responsible for the synthesis of sex hormones.

Hormones, in turn, are responsible for stimulating the formation of external and internal genital organs in the embryo. By the 30th week of pregnancy, the testicles should descend in the fetus along the peritoneum, if there is enough testosterone and the development of the testicular ligamentous apparatus proceeds normally. The prolapse will occur for a long time after childbirth, lasting from 6 weeks – 1 year of the baby’s life.

For your information! During the maturation of the testicles in the baby and their descent, some pathologies may be observed associated with their incorrect descent and location.For example, cryptorchidism, synorchism or monorchism.

Main functions of testicles

The functions of the testicles are why a man needs testicles, that is, what goals and tasks this organ should perform. In anatomy, the structure of the body of a man and in medicine, two types of testicular functions are considered – endocrine function and spermatogenesis function.

Endocrine

The testicles are responsible for the production of sex hormones, in particular testosterone. Accordingly, the endocrine function is as follows:

• development of external and internal genital organs inside the womb;
• Development of a male body type, such as strong muscles, physical stamina, broad shoulders, rough voice, etc.NS.;
• formation and development of a courageous character, aggressiveness in moderate doses, striving for leadership, etc.;
• regulation of cholesterol levels;

90,033 normal level of sexual activity and men.

Do you consider your level of sexual activity normal?

Yes No

In addition to the testes of a man, internal and external factors are responsible for the level of testosterone in the body, for example, a man’s lifestyle, diet and weight, physical activity, general health and the environment.

Spermatogenesis

In the testes, among other things, spermatozoa are formed, which allow a man to have offspring. Spermatogenesis begins at the very beginning of puberty and lasts until old age. One cycle of spermatogenesis is 75 days. For the onset of sperm production, gonadotropic hormones are responsible, which are indirectly related to testosterone.

Spermatogenesis involves several stages:

reproduction – the germ cells of the spermatogonia divide and absorb the necessary substances;

• growth – these cells grow, form spermatocytes of a large and slightly different structure;
• maturation – now spermatocytes into round cells and spermatids and spermatocytes with the required set of chromosomes;
• formation – spermatids attach to the processes of a pear-shaped cell, forming sperm, they are gradually removed from the cell so that they can be motile.

Spermatogenesis is an important process that is responsible for the function of procreation. It is influenced by both external and internal factors, be it a lifestyle, taking certain medications, anomalies in the structure of the genital organs or disturbed endocrine functions.

Output

The male reproductive system consists of many organs, glands and active processes. The testicles are important paired glands that immediately carry two functions, namely the formation of genitals and spermatozoa, which are necessary for procreation.The testicles begin to mature in the embryonic period, they assume a special structure, location and size that every man should know about.

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Sexologist. Family relations expert. Family psychologist.

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Why and how to massage the testicles

What you need to know about the structure and role of the testicles

Before starting the massage, let’s study the theory.

The testicles are paired glands of an oval shape, on average ^{4 cm long, 3 cm wide and each weighing about 20 g. One testicle, as a rule, is larger than the other and is lowered slightly lower.}

The second name for the organ, testicles, comes from the Latin testis – witness. There is a version that in ancient Rome a man, taking an oath to tell the truth, put his hand to the testicles – a proof of his masculinity.

Indeed, it is the testicles, not the penis, that are the source of male energy and the center of the entire reproductive system.Inside them are narrow tubes – tubules in which sperm are continuously produced. And between the tubules are Leydig cells responsible for supplying the male hormone testosterone.

Usually the most important organs are safely hidden inside the body, under armor of bones or at least soft tissue. But this trick did not work with the testicles: at normal human body temperature (about 37 ° C), sperm lose ^{mobility and vitality. As a result, nature had to bring the testicles out, placing them in a skin sac under the penis – the scrotum.}

What protects the testicles

Several lines of defense protect the testicles from external influences. First, it is a dense connective tissue sheath around the testicles themselves. Therefore, they are hard and smooth to the touch.

The second line is the scrotum. Inside it, the testicles are separated by a skin septum, and when one becomes inflamed, the infection is not transferred to the second. There are also bundles of muscle fibers hidden under the skin of the scrotum. If an emergency occurs – the man is frozen, overworked, very frightened – the muscles pull the testicles up, closer to the body.

The increased sensitivity of the organ is also dictated by safety considerations. The body reacts with sharp pain to the slightest threat of injury – and thereby insures the human race from extinction.

What happens to the testicles during sex

During the period of arousal, the testicles are pulled into the abdominal cavity and ^{increase in size. And the closer the orgasm, the higher the testicles. If you pull them down before the climax, then you can prolong the sexual intercourse. This technique is used by lovers of tantric sex.}

When orgasm occurs, the testes push the sperm into the urethra near the prostate gland, where they mix with the semen to form sperm. Further travel takes place without the participation of testicles.

Why massage the testicles

There are several good reasons to massage the testicles not occasionally, but on a regular basis.

• Improves blood circulation. This is good for the health of the testicles themselves, but as a side effect you will get ^{stronger erections and longer intercourse.}
• The semen quality is improved. This is especially true if you are planning to become a father.
• Stimulates testosterone production. Consequently, male libido will not fall, and sex life will be in full swing.
• The man is having fun. In the testicles themselves, and especially in the scrotum, there are many nerve endings, which turns them into an additional erogenous zone.
• You will be able to react to problems in time. Feeling your testicles regularly will not elude you with warning signs such as swelling, abnormal enlargement, or unusual tenderness.All this is a reason to consult a urologist.

How to massage the testicles

Massage can be part of a love game (eg oral sex) or a separate enjoyable procedure. In any case, try to adhere to the following rules.

Get rid of rings and long nails

The skin of the scrotum is extremely thin and delicate. It is easy to scratch or pinch it painfully, especially in a fit of passion. Therefore, do not forget to remove the rings. Yes, and with a predatory manicure it is better not to climb into this sensitive area.

Warm up your hands and testicles themselves

Massage should be done with clean and warm hands. The testicles themselves and the area around them are also recommended to be warmed up using a warm towel.

Use lubricant

To reduce friction, apply lubricant to your hands by rubbing it in your palms to warm up the lubricant.

Start by stroking

Hold the testicles in the palm of your hand and use your thumbs in a circular motion as if smoothing the skin.

Experiment with different techniques

During the massage, you can:

• gently pull down, grabbing the scrotum at the base;
• squeeze gently;
• Knead delicately;
• lightly tap with your fingers;
• “draw” all kinds of shapes on them with your fingers.

The main thing is that all movements are soft, without sudden jerks or pinches. Watch your partner’s reactions carefully and stop at the slightest hint of pain.

If done well and with love, after a five-minute massage, the scrotum will stretch slightly, and the testicles will hang lower than usual, become heavier and increase in size due to blood flow.

Massage the testicles regularly

To maintain health, repeat the procedure three times a week before bed. And if you want to achieve some noticeable results – for example, improve erection or improve sperm quality – then every day.

Remember the contraindications

This massage is contraindicated for diseases of the genitourinary system (testicles, prostate, bladder, urethra) in the acute stage, pain in the scrotum, problems with the rectum (hemorrhoids, proctitis).

Read also 🍌

Testicular torsion: photo, surgery and symptoms

Testicular torsion is an abnormality in which the testicle is twisted in the scrotum, as a result of which the blood supply to the testicle is blocked. Without adequate blood flow, the testicle may die due to lack of oxygen, and in severe cases, it may need to be removed. Therefore, suspected testicular torsion should be treated as a medical emergency .

Most often affected are newborns, children and adolescents, although it can occur at any age and for no reason.

The most common symptom of testicular torsion is 90,079 sudden pain on one side of the scrotum, 90,080 sometimes accompanied by nausea and vomiting.

Diagnosis of testicular torsion is usually based on physical examination and ultrasound examination of the scrotum. Treatment consists of an operation to rotate the testicle and move it into the scrotal sac. The operation must be performed as soon as possible to prevent permanent damage to the testicle. With early diagnosis and surgery, most people recover completely.

Testicular torsion is not common and only about 1 in 4,000 people under the age of 25 is affected.

Good to know: There are established risk factors for testicular torsion, but this can happen spontaneously without any risk factors present.If you suspect, always see a doctor immediately.

Symptoms

The most common primary symptom or sign of testicular torsion is sudden and severe testicular pain. Typically, pain occurs on only one side of the scrotum. This is because usually only one testicle is affected.

After the onset of pain, patients may also experience a number of other symptoms, including:

• Nausea and vomiting
• Scrotal edema
• Discoloration of the scrotum, in particular redness or darkening
• Testicle changes position, or is higher, or licks at an unusual angle
• Private urination
• Fever

Some people may experience severe but temporary testicular pain that lasts only a few minutes.This could be the result of the testicle curling but returning to normal on its own. Short-term, any sharp pain or discomfort in the testicles is a sign that medical attention should be sought immediately.

Reasons

Testicular torsion occurs when the testicle moves freely within the scrotum, twisting the spermatic cord to which it is attached. When the spermatic cord is twisted, blood flow between the abdomen and the affected testicle becomes restricted.The testicle without blood supply is quickly damaged and, if blood flow is not restored in time, it can die.

Testicular torsion can cause bruising and trauma to the scrotum, as well as abdominal tension and abrupt movements.

Operation

Testicular fixation is a quick and uncomplicated procedure performed under general anesthesia. The operation is performed, as a rule, in two cases: testicular torsion and cryptorchidism.

During the operation, the testicle is fixed in the scrotum to prevent recurrence.It is important not only to fix the testicle, but also to give the opportunity to fully develop.

Most testicular fixation operations are performed during infancy. It is during this period that the two diseases described above are found.

Before the operation, the child will undergo an ultrasound scan, if testicular torsion is suspected, a physical examination.

Photo of dropsy of the testicle – IMS Clinic

To begin with, we present a photo of interesting cases of dropsy of the testicle, described in the medical literature.

Giant inguinal hernia or giant dropsy of the testicle?

A fifty-year-old man came to the clinic for the treatment of an inguinal hernia. According to the patient, he suffered from an inguinal hernia for seven years. After examination, the patient was found to have dropsy of the testicle, not a hernia.

Photo: Giant hydrocele.

The photo below shows the state of the scrotum after aspiration (suction) of the contents of the hydrocele.

Dropsy of the testicle on the left

Photo (a) shows repeated dropsy of the testicle in a sixty-year-old patient before drainage.Due to the aggravated history (heart disease, smoking, alcohol dependence, etc.), the patient was repeatedly aspirated instead of surgery. During aspiration, 640 ml of straw-colored fluid was obtained, while the scrotum was significantly reduced in size (photo b).

Abdominal scrotal dropsy of the testicle

We will cite this case rather as an interesting fact for acquaintance, because this type of hydrocele is extremely rare.

A young man of thirty-five years old came to the clinic with a complaint of a gradually increasing in size neoplasm in the abdomen, which appeared 4-5 years ago.Over the past year, the swelling has spread to the scrotum. Also, the patient was worried about the feeling of fullness in the stomach, chronic dull pain in the abdomen. When performing an ultrasound examination in the abdominal cavity, a cystic formation measuring 30 * 15 * 15 cm, filled with liquid, was found. Computed tomography confirmed the ultrasound data, and also found that the cyst descends along the inguinal canal into the scrotum.

During surgery, the hydrocele was isolated and removed.And the study of its wall and contents did not reveal any pathological malignant phenomena.

Relapse of dropsy of the testicle

The photo shows repeated dropsy of the testicle in a forty-five-year-old patient who underwent surgery for a hydrocele on the left. On the left you can see the scar left after the operation from the inguinal access.

Dropsy of the spermatic cord

A sixty-five-year-old patient came to the clinic with complaints of enlargement, redness and tension in the left half of the scrotum.The scrotum increased in volume gradually over 6 years. The examination revealed an oval-shaped formation, smooth and painless to the touch. An ultrasound examination revealed an accumulation of fluid in the scrotum above and to the left of the testicle.

During the operation, it was revealed that the accumulation of fluid is located along the spermatic cord, on top of the testicle and does not communicate with the testicular sheath. This is the so-called spermatic cord hydrocele.

Giant testicular dropsy associated with inguinal hernia.

In the photo, a seventy-seven-year-old man shows a significant enlargement of the scrotum.

Examination revealed a large dropsy on the left and an accompanying inguinal hernia. The scrotum was 40 cm long and 52 cm in diameter. The man underwent hydrocelectomy and hernioplasty. During the operation, 2 liters of light yellow fluid were obtained. Three months after the operation, a good cosmetic effect was noted.

Photo of dropsy of the testicle in children

Dropsy of testicle in newborn

Photo of dropsy of the testicle in adults

Surgical treatment of dropsy of the testicle – Clinic 29

Dropsy of the testicle in men occurs when fluid accumulates in a thin saccular formation in the scrotum around the testicle.The disease is manifested by a painless increase in the size of the scrotum on the diseased side due to a violation of the outflow of the produced fluid. Dropsy, or hydrocele, often develops on one side of the scrotum, but bilateral fluid accumulation is also possible. Congenital dropsy occurs in about 10% of boys and 1% of men over the age of 40. Moreover, in most of them, the disease goes away on its own within 1 year. The second peak incidence in men is over 40 years of age.In this case, the disease occurs due to inflammatory diseases and trauma to the scrotum. In the absence of timely treatment, hydrocele can progress over the years, taking on huge sizes (10 cm in diameter or more).

Operation Winckelmann

Winckelmann’s operation is usually performed under local infiltration anesthesia in combination with conduction. Infiltration anesthesia is achieved by the introduction of a 0.25% solution of novocaine according to the method of A.V. Vishnevsky along the tissue dissection.For conduction anesthesia, the introduction of 60 – 80 ml of 0.25% solution of novocaine into the thickness of the spermatic cord is used, as well as subcutaneous administration of a solution of novocaine at the root of the scrotum along the anterior, lateral and posterior surfaces of the corresponding half of the scrotum.

A skin incision with a length of 3 – 4 cm to 7 – 8 cm is made in the longitudinal direction along the antero-outer surface of the enlarged half of the scrotum, which is fixed with the free hand of the operating or assistant. With careful movements of the scalpel within the skin incision, the testicular membrane is dissected in layers until the tense, translucent and devoid of vessels, the parietal plate of the testicular sheath is exposed.In a blunt way, they penetrate between it and the internal seminal fascia and excrete the watery sac entirely to the point of transition of the parietal plate to the testicle and epididymis. With a trocar or through a small incision, they penetrate into the water sac, release the accumulated fluid in it, after which, under the control of vision, the parietal plate of the vaginal membrane is dissected and the testicle is exposed.

A thorough visual and palpation examination of the testicle and its epididymis is performed. The edges of the parietal plate of the vaginal membrane of the testicle are connected behind the testicle and the spermatic cord with interrupted or continuous katgut sutures.The sutures are applied so that the edges of the sutured membrane do not squeeze the spermatic cord, and they also cannot turn around and re-form the cavity. A thorough hemostasis is performed. The testicle is immersed in the scrotum. The wound is tightly sutured, capturing together the skin and the testicular membrane separated from the parietal plate. Apply a pressure bandage to the scrotum, giving it an elevated position.

Operation Bergman

Operation Bergman (E. Bergmann) . The technique of anesthesia and surgery up to the moment of exposure of the testicle is described in the description of Winckelmann’s operation.If there are adhesions between the parietal plate of the vaginal membrane of the testicle and the internal seminal fascia, then the allocation of the parietal plate is performed bluntly or sharply after opening and emptying the water sac.

The parietal lamina of the vaginal membrane is excised with tweezers and scissors directly at its transition to the testicle. Stop bleeding thoroughly. The final stages of the operation, including the application of a pressure bandage, are the same as in the Winckelmann operation.

G. S. Grebenshchikov and I. P. Shevtsov (1970) for many years performed the operations of Winckelmann and Bergman , slightly modifying their technique.

Under local anesthesia, the skin and dartos are incised up to the external seminal fascia. A small trocar punctured and emptied the water sac. All membranes are dissected with one incision, after which the testicle is removed into the wound. Under the control of the eye, the membranes are dissected almost to the tail of the epididymis and before the transition to the spermatic cord.After revision of the testicle, its epididymis and membranes, the further course of the operation is determined.

With significant dropsy, the presence of inflammatory changes in the membranes, they are excised, as in the operation Bergman . If the condition of the membranes, especially with small dropsies, allows, then they are sutured according to Winckelmann. It is possible to combine a partial excision of the membranes by the type of Bergman’s operation with suturing the remaining part of the membranes according to Winckelmann.

After the end of these manipulations, the testicle is immersed in the scrotum, for which it is necessary to slightly separate the tissues in the area of ​​its bottom with your fingers.A graduate is introduced into the scrotum to the lower end of the testicle in the form of a strip of thin rubber. Some surgeons drain the scrotum through an additional incision in the area of ​​its bottom, use various drainage tubes, active aspiration of wound discharge. The wound of the scrotum is sutured up to graduation, capturing the dartosis and skin.

Apply a pressure bandage, giving the scrotum an elevated position.

After the operation, the patient is prescribed only pain relievers. The day after the operation, a dressing is performed, usually the rubber graduation is removed.The wound is closed with a kleol bandage, a support is put on the scrotum. The patient is allowed to walk. Removal of stitches is performed 6 days after the operation, and the patient can be discharged under the supervision of the urologist of the polyclinic at the place of residence.

Complications such as bleeding, the formation of scrotal hematomas and their suppuration are prevented by careful hemostasis during surgery, draining the scrotum and applying a pressure bandage on it for 24 hours.

90,000 Inflammation of the testicles and their appendages (orchiepididymitis).Urology

Since these diseases usually appear together, the inflammation of the testicles and their appendages is called orchiepididymitis.

Reasons

Orchitis can develop as a result of past infectious diseases – mumps (mumps), influenza, scarlet fever, chickenpox, pneumonia, brucellosis, typhoid fever. However, most often the cause is inflammatory diseases of the genitourinary system, such as urethritis, prostatitis, etc.

The disease develops as a result of a drift of infection into the testicle with blood flow.The cause of the development of epididymitis is the spread of the infection along the vas deferens from the seminal vesicles, prostate and urethra. Orchitis can also be caused by testicular injury. Orchiepididymitis sometimes occurs after prostate surgery.

What happens when you do this?

Acute and chronic stages of development of orchiepididymitis are distinguished.

The acute stage is characterized by acute pain in the testicle. The scrotum on the affected side noticeably increases, folds are smoothed, the skin on it becomes shiny, taut.Touching an inflamed testicle is extremely painful. A person’s temperature rises, general signs of inflammation are observed – headache, nausea, weakness.

This condition, if untreated, can last for about a couple of weeks, and then turn into a chronic stage. The temperature decreases, the pain passes, however, when the testicle is felt, a compacted painful formation is determined – an inflamed epididymis.

In the worst case, a purulent form of testicular inflammation may develop, as a result of which there is a violation of the patency of its duct. With bilateral damage, it can lead to infertility.

Diagnostics and treatment

The diagnosis is made by an andrologist or urologist during a personal examination. Laboratory diagnostic methods are used, with the help of which the doctor determines the nature of the infection. In addition, ultrasound of the scrotal organs is performed.

The patient is prescribed bed rest, and the scrotum should be in an elevated state, for which, for example, a towel is placed. A diet is prescribed with the exception of spicy, fatty and fried foods, drinking plenty of fluids.

In addition, it is imperative to treat the infectious disease that caused the development of inflammation. Broad-spectrum antibiotics are usually prescribed.

At the end of the acute process, physiotherapeutic treatment is carried out.

With the development of a purulent abscess, it is necessary to dissect and drain the testicle to remove pus. In the worst, neglected case, orchiectomy is performed – removal of the affected testicle. Therefore, you should not delay a visit to the doctor with symptoms of epididymitis epididymitis.

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symptoms, treatment, causes of the disease, first signs

Description

The main function of the testicles (testicles) is the formation of sperm.Sperm are formed and mature in the convoluted tubules located in the testicle, and then accumulate in the seminal vesicles. 12-18 efferent tubules emerge from the testicle, which, intertwining, form the head of the epididymis and flow into the duct of the epididymis. The duct of the epididymis, when exiting the epididymis, becomes the vas deferens, and after it connects with the duct of the seminal vesicles, a self-ejection duct is formed.

Thus, epididymitis is an inflammation of the epididymis itself.It can be complicated by orchitis – this is an inflammation of the testicle or funiculitis – an inflammation of the membranes of the spermatic cord.

Epididymitis rarely occurs on the background of complete health. Basically, epididymitis is described as a complication of severe infectious diseases such as influenza, pneumonia, tonsillitis and others, but against the background of a severely weakened immune system. In this case, the infection enters the epididymis with the blood stream. The causative agents of sexually transmitted diseases can also cause the development of epididymitis.In this case, the disease is most often associated with neglect of contraceptives and frequent changes in sexual partners.

Sometimes the infection that causes inflammation of the epididymis comes from a violation of the peristalsis of the vas deferens. Normally, periodic contractions of the duct are aimed at throwing the contents out. If violated, the contractions go in the opposite direction, bringing fluid into the epididymis. This situation can be caused by long-term and chronic urinary tract infections, instrumental examinations of the bladder, placement of a urethral catheter.

Epididymitis can develop in the presence of testicular injury. In childhood and adolescence, epididymitis occurs as a complication of orchitis, which has arisen as a complication of mumps (mumps).

Symptoms

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Acute epididymitis is accompanied by swelling and pain in the scrotum. In the vast majority of cases, symptoms appear on only one side. The thickened, hot tissue of the epididymis and spermatic cord can be felt through the skin of the scrotum.

Acute epididymitis is often accompanied by general manifestations: fever with an increase in body temperature up to 39 ° C and chills, weakness and fatigue.The scrotum increases in size, loses its folding, remains reddened all the time, in some cases, free fluid can be determined inside the scrotum. The pain spreads first to the entire scrotum, and later it can be given to the suprapubic region, lower back, and sharply intensifies when walking.

Chronic epididymitis is much calmer. The main symptom is compaction and an increase in the size of the testicle on the one hand, which the patient notices for quite a long time.The seal is not continuous, but focal in nature, bumpy to the touch. It is accompanied by minor pulling pains in the scrotum, which patients often do not attach importance to, rare increases in temperature not exceeding 37.5 ° C. Chronic epididymitis periodically worsens when the symptoms intensify and make you pay attention, but after 5-7 days the pain decreases, the temperature and swelling go away.

If a patient has chronic epididymitis for several years, with frequent exacerbations, and he does not seek medical help, a serious complication may form – purulent fusion of the scrotal membranes with the formation of a fistula.

Diagnostics

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In diagnostics, it is important to take anamnesis when it turns out that the past mumps, urinary tract infection or unprotected sexual intercourse over the past few months.

On examination, swelling of the scrotum is revealed, its increase in size, more on the one hand, edema and compaction of the testicle, pain on palpation.

A general blood test will show signs of inflammation. Analysis of urine will show the presence of bacteria in it and a sharp increase in the number of leukocytes.Culture of urine on the medium will give rise to the growth of microbes that have caused the inflammation.

Ultrasound of the pelvic organs shows the most accurate picture of the site of inflammation and involvement in the pathological process.

Sometimes, if a neoplasm is suspected, including a malignant one, a biopsy and histological examination may be required.

For differential diagnosis of epididymitis, it is necessary to exclude diseases such as orchitis, spermatic cord cyst, inguinal hernia, testicular torsion, neoplasms.For the latter, there is a specific symptom: when the scrotum is raised, the pain will decrease with epididymitis, and will not change with testicular torsion.

Treatment

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The main treatment for acute epididymitis is antibiotic therapy. First, broad-spectrum antibiotics are prescribed, taking into account their ability to penetrate the tissues of the epididymis and testicles. Upon receipt of the results of the analysis for the antibiticosensitivity of bacteria, the treatment regimen is adjusted in accordance with the effectiveness.

Together with antimicrobial therapy, other methods are used to improve the patient’s condition. During an exacerbation, it is necessary to adhere to bed rest, fix the scrotum in an elevated position. It is justified to apply cold compresses topically to reduce inflammation.

In case of unbearable pain syndrome, the use of novocoin blockade of the spermatic cord is recommended. This injection is often combined with topical antibacterial drugs.

Physiotherapy for epididymitis is very effective.Laser, magnetic, photodynamic therapy is used directly on the scrotum, electrophoresis of anti-inflammatory drugs, ultra-high-frequency wave therapy.

In severe cases, objective data on the accumulation of pus in the epididymis, surgical treatment is indicated. Surgical intervention is minimally invasive and consists in draining the main focus of the disease and making small incisions on the epididymis and tunica albuginea through one small incision in the scrotum.This method allows you to open microabscesses that are not detected by ultrasound examination and prevent relapses of the disease.

A timely visit to a doctor will help to avoid reproductive dysfunction, especially for young children, which requires a lot of attention from the parents.

Medicines

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To start treatment, it is recommended to use fluoroquinolones (Ofloxacin, Levofloxacin), since they penetrate well into the tissues of the genitourinary system and have a fairly wide spectrum of antimicrobial activity.The duration of treatment should be at least 10 days. In case of drug intolerance, fluoroquinolones can be replaced with antibiotics from the macrolide group (Erythromycin, Clarithromycin).

For the treatment of symptoms of inflammation, non-steroidal anti-inflammatory drugs (Ibuprofen, Diclofenac, Analgin, Nimesulide) are used. In a hospital setting, the use of intramuscular injections is justified. For young children, rectal suppositories are used. To enhance the anti-inflammatory effect, it is justified to use these drugs in combination with antispasmodics (Drotaverine, Papaverine) and antihistamines (Diphenhydramine, Clemastin).

In case of severe symptoms of fever, infusion therapy (solutions of sodium chloride, glucose, Ringer and others) with a volume of up to 1-1.5 liters per day is prescribed to replenish fluid losses.

Folk remedies

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To prevent epididymitis and its complications, you should adhere to the following rules:

• Pay attention to your health, seek medical help in a timely manner and carefully follow medical recommendations.
• To carry out antibiotic therapy in full, to carry out antibacterial prophylaxis in the pre- and postoperative period.
• Avoid unprotected sex with unfamiliar partners, timely treat sexually transmitted diseases.
• Frequent hypothermia, a general decrease in immunity (especially during the recovery period after illness) contribute to the development of urinary tract infections (urethritis, cystitis, pyelonephritis). Such infections, if not taken measures, can spread to the prostate, scrotal organs and renal parenchyma.Therefore, it is important to dress for the weather at all times, avoid swimming in cold water, and follow a savings regimen during the recovery period from illness.

Traditional medicine has a large number of recipes, both for combating male ailments and for treating the symptoms of general inflammation that accompany epididymitis.

To relieve pain, swelling, redness and fever use:

• Infusion of a mixture of medicinal herbs. Take crushed birch leaves or birch buds, dried juniper fruits, cinquefoil goose grass, celandine and steel roots.Take only 30-40 grams, pour a liter of boiling water and leave overnight, if possible in a thermos or a place where the infusion will slowly cool down. Strain before use and allow to cool to an acceptable temperature. The resulting infusion is enough for 2 days. It should be consumed 3-4 times a day before meals. Sugar, honey, lemon or spices can be added to enhance the taste.
• A decoction of the leaves of the wintergreen. Bring 100 grams of fresh, or 50 grams of dry leaves of a wintergreen to a boil in 1-1.5 liters of water, leave on low heat for 20 minutes.After cooling down, use 50 ml three times a day. Contraindication to the use of medicines from wintergreen is childhood, hypertension and varicose veins.
• Infusion of tansy flowers, lingonberry leaves and horsetail shoots. The crushed components are mixed, two tablespoons are taken at a time. Brew in a mug, like tea, two to three times a day. This infusion helps relieve tension, relax and ease the symptoms of inflammation.
• For herbal decoction, take herbs St. John’s wort, mint, parsley, lingonberry, horsetail, a total of 50 grams per half liter of water.Simmer for at least 40 minutes. Drink in two doses, you can drink one glass a day.
• Vegetable juices and mixtures thereof are very useful for inflammation of the male genital organs. It is better to prepare juices on your own, immediately before use. Carrots, beets, cucumber, spinach, celery are great for making juice. To enhance the therapeutic effect, it is necessary to consume at least half a liter per day, do not strain the juice from the pulp and prepare mixtures in certain ratios, for example: juice of carrots, cucumber and beetroot 3: 1: 1, spinach and carrots 2: 1, celery and carrots 3: 2.Chopped parsley and green onions can be added if desired.

Folk remedies for strengthening the immune system in chronic epididymitis. Such funds should be taken for a long time, replacing them with coffee, tea and other familiar drinks against the background of complete health to prevent exacerbations.

• Infusion of mint leaves, calamus root, linden flowers, nettles, juniper and elder flowers. Take one tablespoon of each of the plants and leave for 10-12 hours in 1.5 liters of boiling water.
• Dandelion leaves, parsley, shepherd’s purse, anise and bearberry. Make a total mixture and prepare an infusion at the rate of 3 tablespoons of the mixture per liter of water. Also insist 10-12 hours, pouring boiling water. Drink 3-4 times a day in a glass of infusion for a long time.

After epididymitis is cured, the following recipes will be useful to maintain men’s health:

• Infusion of hop flowers. 100 grams of flowers per liter of boiling water, insist for a day in a dark place.Consume 2 times a day after meals, at least 3 months in a row, 100 ml at a time. Strain before use.
• Prepare a collection of black poplar buds, St. John’s wort, elderberry and chamomile flowers, lingonberry leaves and berries. For the mixture, the components are taken in equal parts.