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November 8, 2009
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The Cleveland Clinic

Male Reproductive Problems: Testicular Disorders

Doctor to Patient

Testicular Cancer Signs and Symptoms

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Discover the signs and symptoms of testicular cancer.Cancer of the testicles (testicular cancer) is an uncommon condition that accounts for only about 1% of all cancers in men. Each year, 7,000 to 8,000 new cases of testicular cancer will occur in the U.S., leading to approximately 400 deaths.

Doctors do not know the exact cause of testicular cancer, but a number of risk factors for development of this disease have been identified. Young men between the ages of 15 and 39 are most often affected. White men are affected more than men of other races, although the disease can occur in men of any age and race, including children. Men who have an undescended testicle (termed cryptorchidism), even if surgery has been performed to remedy the condition, have an increased risk for the development of testicular cancer. Other risk factors include the genetic condition known as Klinefelter's syndrome, abnormal development of the testicles, and having relatives with testicular cancer.

Testicular cancer is highly curable when detected early, and 95% of patients with testicular cancer are alive after a five-year period. However, about half of men with testicular cancer do not seek treatment until the cancer has spread beyond the testicles to other locations in the body (as in the case of seven-time Tour de France winner Lance Armstrong).

Most testicular cancers are found by men themselves. Doctors recommend that men perform an examination of their testicles once a month (referred to as TSE or testicular self-examination) to facilitate detection of testicular cancer in its early, treatable stage. The TSE involves gentle examination of the testicles, one at a time, holding each testicle between the thumb (on top) and middle and index fingers below. Look for any small, hard lumps within the testicles or changes in the feel of the testicles.


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Doctor to Patient

Introduction

There are two primary disorders that affect the male reproductive external organs. These include penis disorders and testicular disorders. Disorders of the penis and testes can affect a man's sexual functioning and fertility.

The testicles, also called testes, are part of the male reproductive system. The testicles are two oval organs about the size of large olives. They are located inside the scrotum, the loose sac of skin that hangs behind the penis. The testicles make male hormones, including testosterone, and produce sperm, the male reproductive cells. Problems with the testes can lead to serious illnesses, including hormonal imbalances, problems with sex, and infertility.

What Disorders Affect the Testes?

Some of the more common conditions that affect the testes include testicular trauma, testicular torsion, testicular cancer, epididymitis, and hypogonadism.

What Is Testicular Trauma?

Because the testes are located within the scrotum, which hangs outside of the body, they do not have the protection of muscles and bones. This makes it easier for the testes to be struck, hit, kicked or crushed, which occurs most often during contact sports. Males can protect their testicles by wearing athletic cups during sports.

Trauma to the testes can cause severe pain, bruising, and/or swelling. In most cases, the testes -- which are made of a spongy material -- can absorb the shock of an injury without serious damage. A rare type of testicular trauma, called testicular rupture, occurs when the testicle receives a direct blow or is squeezed against the hard bones of the pelvis. This injury can cause blood to leak into the scrotum. In severe cases, surgery to repair the rupture -- and thus save the testicle -- may be necessary.

What Is Testicular Torsion?

Within the scrotum, the testicles are secured at either end by a structure called the spermatic cord. Sometimes, this cord gets twisted around a testicle, cutting off the blood supply to the testicle. Symptoms of testicular torsion include sudden and severe pain, enlargement of the affected testicle, tenderness, and swelling.

This condition, which occurs most often in young males less than 25 years of age, can result from an injury to the testicles or from strenuous activity. It also can occur for no apparent reason.



Next: How is testicular torsion treated? »

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