Testicle Problems - Frequently Asked Questions

How can I prevent testicular cancer?

Just as women perform monthly self-breast examinations, all men should perform monthly self-testicular examinations. The best time to perform the examination is while taking a warm shower. Using both hands, one should examine each testicle with the thumbs in front and the first two fingers behind the testicle. While feeling for any lumps or bumps, the testicle should be rolled between the fingers and thumb.

In general, the testicle feels like a hard-boiled egg without the shell. When lumps or bumps are discovered, a physician, preferably a urologist, should be consulted at once. The greatest chance of prevention is early detection and treatment.

I have persistent discomfort in my testes during the day, particularly after sitting. Should I be concerned about cancer?

Testicular cancer is all too common in young men and returns as a risk after your 40s. If you experience persistent discomfort, see a doctor to rule out the possibility of cancer. As long as you've been completing monthly self-exams, and no lumps or hard spots have developed, that probably isn't your problem.

A variety of difficulties can lead to pain in one or both testes. Your doctor may check for hernia as well as cancer, hernia can cause similar symptoms.

If you experience pain mostly when you ejaculate, one of two problems is likely. An infection either in the testes or the epididymis is a possibility. Mumps can infect the testes and in some cases lead to infertility. Additionally, sexually transmitted diseases such as chlamydia can infect the epididymis.

Even though many men who complain of testicular pain are offered a simple course of antibiotics as treatment, infections are not that common. If the pain is in both testes, and a course of antibiotics don't seem to be help, resist trying another course of a different antibiotic. If pain is felt in both testicles, it's rarely infection or a hernia.

A general discomfort in both testicles may be caused by muscle spasms. The majority of men do not realize how many muscles there are in the area of the testes. If the symptoms disappear with a hot bath this is a sign of muscle spasms. Regular baths along with medication to relax the muscles will probably be helpful, and wearing a jock strap will offer support. A non-cancer diagnosis will also do a world of good for your ability to relax.

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What else can feel like a lump in the testicle?

The epididymis can be confused with a lump in the testicle. The epididymis is a ‘C-shaped’ structure that is attached to the posterior lateral surface of the testicle. Sperm travel from the testicle through eight feet of tiny tubules located within the epididymis. If the epididymis becomes inflamed or infected -a condition called epididymitis - it becomes swollen and tender. Epididymitis is treated with antibiotics, cold therapy, scrotal support, and anti-inflammatory medication.

An epididymal cyst or a spermatocele can also feel like a lump in the testicle. These cystic structures are found in 30% of men undergoing scrotal ultrasound and the incidence increases with age. Both types of cysts contain fluid. Spermatoceles may also contain sperm. Epididymal cysts and spermatoceles are often associated with a prior history of vasectomy. A physical examination is usually all that is required to diagnose these two conditions. If there is any doubt, a scrotal ultrasound can reliably differentiate these structures from a testicular tumor. Epididymal cysts and spermatoceles do not require treatment unless they cause symptoms, in which case they can be surgically removed through a small incision in the scrotal sac.

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What is a hydrocele?

A hydrocele is a fluid filled sac within the scrotum. The testicles are bathed by an ounce or so of fluid that is contained within a special sac called the processus vaginalis. The body constantly forms and reabsorbs fluid within the processus vaginalis. If the testicle or epididymis becomes inflamed, or rarely if there is a testicular tumor, more fluid accumulates within the processus vaginalis than can be absorbed. If a hydrocele becomes large enough, the testicle can’t be felt on examination. A scrotal ultrasound can reliably diagnose a hydrocele and demonstrate the testicular anatomy. A hydrocele can be surgically removed through an incision in the scrotal sac. Surgery is only indicated, though, if the hydrocele is causing symptoms. Drainage of fluid by inserting a needle and withdrawing the fluid is not recommended because the fluid will reform within a matter of days and the needle stick can transfer bacteria from the skin and cause an infection.

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How common a problem is male infertility?

In three out of every five couples experiencing infertility, a male factor is involved. Male infertility is the primary factor in two out of five of these couples and furthermore, it is a combination of male and female infertility, in one out of every five couples struggling with fertility. It is prudent to exam both the male and female partner when dealing with this issue.

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What lifestyle changes can be made to improve sperm count and quality?

Quit smoking
Stop using recreational drugs
Reduce alcohol consumption
Avoid using lubricants while trying to conceive
Moderate aerobic and resistance exercise
Avoid high temperatures, i.e. saunas and hot tubs
Take supplemental vitamins (antioxidants)

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Are there any other natural treatments that can improve sperm count and quality?

Although results vary, a variety of vitamins and nutritional supplements may improve sperm count and quality. For further information, click here for a presentation that Dr. McClure gave about natural treatments for male infertility at an annual meeting of the Society for the Study of Male Reproduction.

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How viable an option is vasectomy reversal?

Often times, a vasectomy reversal is the best option for a couple interested in conceiving after the man has undergone a vasectomy. By far, the most natural, least invasive and most economical method of producing a pregnancy. Upon successful reversal, the sperm count may be sufficient to allow for natural conception. Otherwise, there may be adequate sperm for the ejaculate to be processed and placed inside the woman’s uterus through Intrauterine Insemination.

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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.