Testicle Problems - Diagnosis

Testicular Cancer

Testicular cancer begins as a small pea-sized lump within the testicle that may not be noticed unless self-testicular examinations are performed regularly. As not all swellings or lumps in the scrotum are cancer, noticing a lump isn't necessarily reason to panic. However, it is important to have a physician check out all lumps or hard spots that a man or his partner may detect. Specific blood tests are now available to detect testicular cancer, as well as sound waves, which visualize the testicle for any irregularities.

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Hypogonadism

Tests for hypogonadism:

A first morning blood test (before 10AM) for total and free testosterone is the initial test for hypogonadism. It is not necessary to fast for this blood test.
If the total or free testosterone level is abnormal, the blood test is often repeated since a repeat test is normal up to 50% of the time. In addition, an additional blood test for LH can help determine if the pituitary gland is functioning properly. Another blood test, called a prolactin level may be ordered if the testosterone is abnormally low.
If the LH or prolactin level is inappropriately abnormal, further testing may be indicated, which may include a MRI of the brain to rule out a pituitary tumor.

Infertility

If you and your partner desire to become pregnant and are unable; and a reasonable amount of time has passed to no avail, seek help. The woman's gynecologist or the man's urologist may be able to determine whether there's a problem that necessitates a specialist or clinic that treats infertility problems.

Before beginning infertility testing, please note that a certain amount of dedication is required. Your doctor will typically begin a complete infertility examination of both you and your partner. Your doctor will need to determine your sexual habits and may make suggestions about how you may need to change those habits. The tests and phase of trial and error may take several months.

Fertility assessment can be expensive and in certain cases involves painful procedures; furthermore many medical plans may not reimburse the expenses. It is important to consider that conception is not guaranteed, even after all the testing and counseling.

The testicles of a fertile man produce enough healthy sperm, and the sperm must be ejaculated successfully into the woman's vagina. The below tests for male infertility help determine whether any of these processes are impaired.

A general physical examination is conducted. This includes an examination of your genitals as well as questions concerning your medical history, illnesses and disabilities, medications and sexual habits.
The semen analysis is the most important test for the male partner. You may be asked for one or more semen specimens. Semen is usually obtained by masturbation or by intercourse interruption and ejaculation into a clean container. Your semen specimen is analyzed for quantity, color, and presence of infections or blood by a laboratory. An in depth analysis of the sperm is completed. The laboratory will determine the sperm count and any irregularities in the shape and motility of the sperm. Typically sperm counts will fluctuate from one specimen to the next.
It is common to perform a blood test to determine the level of testosterone and other male hormones.
A transrectal and scrotal ultrasound may be conducted. This may help your doctor look for indicators of conditions such as retrograde ejaculation and ejaculatory duct obstruction.

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Varicose vein / Varicocele

Patients should be examined in a standing position in a warm room. Dilated veins feel like a ‘bag of worms” that is located separate from and above the testicle. Abdominal straining increases blood flow into the testicular veins and makes it easier to feel varicose veins. Varicose veins are more common on the left side but they can be bilateral.

A scrotal ultrasound is not necessary to diagnose a varicocele, but an ultrasound study may be performed to further evaluate other structures in the scrotum. Small varicoceles that are found on a scrotal ultrasound, but that are not palpable on physical examination, are classified as subclinical varicoceles. Most infertility specialists agree that subclinical varicoceles do not require treatment. Varicoceles that are only detectable with abdominal straining are classified as grade 1 varicoceles. Grade 2 varicoceles are not visible but they can be palpated without abdominal straining. Grade 3 varicoceles are visible without palpation. Over time, a varicocele can cause the affected testicle to decrease in size and consistency. Repairing a grade 1,2, or 3 varicocele may improve semen quality and improve the odds of achieving a pregnancy.

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Need more information on health and wellness?
Click here for a link to health and wellness recommendations from the National Institute of Health.