Testicles and epididymides
Testicles and epididymides
Testicles and epididymides are important components of male reproductive system. Testicles are paired organs, male sex glands, in which male reproductive cells, sperm are formed. Male sexual hormones e.g. testosterone are also formed here. Epididymides are also paired. They serve as a reservoir for sperm and pass the sperm on into the vas deferens. Vas deferens is a canal which passes the sperm into the urethra during ejaculation. Testicles and epididymides are located in the scrotum a skin bag under the penis, where the temperature is lower. The lower temperature is essential for the sperm production.
During pregnancy, the testicles are located in the abdomen of the fetus. During the last two month the testicles descend into the scrotum. During this process the testicles wrap into the layers of the abdominal wall, which form the coverings of the testicles. Testicles descended in the scrotum signify a mature fetus. Size of the testicles depends on age and levels of hormones. The testicles grow slowly till the puberty, when their growth accelerates. They reach their maximum weight between the 20 and 30 year of age. Their length is approximately 4-4.5 cm, width 3-3.5 cm and depth 2.5 cm. The weight is 18-25 grams. The left testicle is heavier and therefore it sits lower. They are the site of spermatogenesis or production of sperm, which lasts at least 82 days. The sex hormones or androgens are also produced by testicles. The main androgen is testosterone. It has numerous functions. Its presence ensures a development of a fetus into a male individual and it stimulates the descent of the testicles into the scrotum. Development of male secondary sex characteristics also depends on testosterone. It ensures spermatogenesis and is responsible male behavior, muscle growth and strengthening of the bone mass.
Diseases of the testicles
Testicles may be affected by various unpleasant diseases. Namely: torsion, inflammation, tumor, varicocele and hydrocele. They will be described one by one.
Testicular torsion is an acute painful condition, which usually affects boys until the age of 18 years. Torsion means a rotation of the testicle around its axis, which causes cutting of the testicle’s blood supply. Testicular torsion often arises from unknown cause and at rest. It is manifested as an acute severe pain, which may radiate in the thigh. The condition requires an immediate intervention. Sometimes doctors succeed to restore the testicles position non-invasively, but a quick operation is usually required. The testicle is returned into its proper position and fixed in it, so that the torsion cannot repeat. The torsion of the testicle is dangerous, because the compromised blood supply can result in death of the testicle.
Inflammation of the testicles
Inflammation of the testicles (orchitis) is an unpleasant condition usually caused by the mumps virus or by bacteria from the epididymis and the urinary tract. Orchitis manifests as high fever, painful swelling of the testicle and reddening of the scrotal skin. Treatment consists of antibiotic therapy, bed rest, lowering of the temperature and pain relief. In case of viral infection antibiotics are useless and corticoids are used.
Tumor of the testicle
Testicular tumors represent approx. 1% of tumors in men. It is usually malignant. The main symptoms are a non-painful stiff enlargement of the testicle. A backache in the lumbar region can also occur. As the tumor mass enlarges, problems with urination a defecation may arise. Common generalized symptoms are fatigue, increased temperature and weight loss. The major risk factor is cryptorchidism or non-descended testicle. Surgery, chemotherapy (aggressive anti-tumor drugs) and radiotherapy (irradiation) are combined in the treatment.
Varicocele and hydrocele
Varicocele is a dilatation and multiplication of veins draining blood from the testicles, epididymis and scrotum. Varicocele resembles varicose veins of legs and hemorrhoids. Blood cannot be properly drained and accumulates in the affected veins. This leads to increased temperature in the scrotum and to defective sperm production. It may cause male infertility. Varicocele is normally without symptoms, sometimes pressure and pulling pain may occur. Hydrocele arises from accumulation of fluid between the testicular coverings in the scrotum. It manifests as non-painful swelling, which can impinge vessels and compromise blood supply or drainage. The cause of hydrocele is an injury or abnormal fluid production. Both varicocele and hydrocele are treated by surgery.
Epididymis resembles a tightly coiled canal. It is situated on the top and the back side of the testicle. It leads into the vas deference. Vas deference is a thin canal which passes the sperm into the urethra during ejaculation. Epididymis serves as a reservoir of semen. Epididymis can be also affected by inflammation. The inflammation of epididymis is an unpleasant and painful problem, which most commonly arises from infections of the urinary tract. It manifests as increased temperature, painful enlargement, reddening of the affected side of the scrotum and nausea. Infection of the epididymis commonly affects the testicle too. If left untreated it may cause male infertility.