December 1st, 2015
Urologic surgeons are trained in the evaluation and management of disorders of the genitourinary tract, including the variety of disorders that affect the testicles in men. Some of the common testicular disorders treated by urologists include testicular torsion, epididymitis, varicocele, hydrocele, testicular cancer, scrotal swelling and darkened semen.
Testicular torsion occurs when blood vessels supplying the testicles become twisted, causing obstruction of the testicular blood supply. Testicular torsion is a surgical emergency. Treatment of testicular torsion must occur emergently or the testicular tissue will die from lack of oxygen, which is carried in the blood to all of the body’s cells and organs. Testicular torsion occurs most commonly in men between the ages of 15 and 35. Delay in treatment with loss of the testicle can impact fertility in this age group.
Varicocele is condition in the veins above the testicles become dilated and engorged, forming a lump or bulge. It is usually a harmless condition, but it has a potential impact on fertility and may cause mild to moderate pain in some patients. Varicocele may form a more prominent bulge when you are “bearing down.” If you notice an unusual lump or bulge, it’s always important to seek help from your doctor, since the diagnosis may be something serious.
Hydrocele refers to a collection of fluid around the testicle. It is usually a harmless condition, but it can result in pain or pressure if it enlarges. Some men develop hydrocele after trauma to the area, but most men with a hydrocele do not recall any injury or obvious cause.
Epididymitis is an inflammation or infection of the long and coiled tube that lies above and behind each testicle. The epididymis collects and stores sperm formed in the testicles until ejaculation. The cause of epididymitis varies with age. Young children who develop epididymitis usually have an associated urinary tract infection. In young men who are sexually active, epididymitis is frequently associated with sexually transmitted infections. In older men, enlargement of the prostate gland or bacterial infections also cause epididymitis. Injury to the groin can also result in epididymitis. It is characterized by pain and swelling in the scrotum that increases over time. Some men may experience fever, chills, frequent urination, painful urination, or a discharge from the penis. The symptoms often depend upon the cause of the infection. A culture of any discharge and tests that include a urinalysis and urine culture will help determine the source of infection. Epididymitis is treated with antibiotics, bed rest, and anti-inflammatory medications.