INFERTILITY DIAGNOSIS Article · 26 June 2022

Testicular diseases cause male infertility

48 and a half million – more or less so many people around the world are unsuccessfully trying to conceive. It was once thought that infertility affects only women. Today we know that 40% is caused by a male factor. The cause is often testicular disease and associated semen quality reduction.

Testicular diseases cause male infertility

48 and a half million – more or less so many people around the world are unsuccessfully trying to conceive. It was once thought that infertility affects only women. Today we know that 40% is caused by a male factor. The cause is often testicular disease and associated semen quality reduction. Read this article and find out which testicular diseases can lead to male infertility.

 

Inflammation of the testes and epididymitis

 

Inflammation of the testes and / or epididymis is caused by sexually transmitted pathogens such as herpes (herpes simplex virus), chlamydia bacteria, mycoplasmas, gonococci, Proteus sp., Staphylococcus aureus, Escherichia coli or Streptococcus faecalis. Bilateral orchitis is also common in mumps (common parotitis).

 

Acute orchitis and / or epididymitis is mainly manifested by painful swelling and redness of the scrotal skin. It may also be accompanied by elevated body temperature. When acute orchitis becomes chronic, the man may not feel any discomfort. The only symptom suggesting the disease will be low sperm parameters – increased viscosity, low sperm count in the sperm, higher number of dead or motionless sperm, increase in the number of leukocytes in the sperm or abnormalities in sperm morphology. Some men also report sexual problems, including erectile dysfunction and decreased libido.

 

Orchitis / epididymitis is a disease that requires treatment because, if left untreated, it can damage the testicles and clog the ducts leading to the testis and epididymis. This condition may also promote the production of sperm antibodies. Antibiotic therapy and non-steroidal anti-inflammatory drugs are used to treat orchitis / epididymitis. Acute conditions are treated in hospital.

 

Varicocele

 

Varicocele is a disease caused by the widening of the veins of the flagellate plexus. This disease is the most common cause of male infertility (statistically, it occurs in about 40% of infertile men). Much more often, as much as 80%, they concern the left nuclear vein. This is due to the different arrangement of the nuclear veins because of both sides of the body.

 

Varicocele can occur for a variety of reasons, including due to lack or failure of valves in the nuclear vein. A less common reason is compression of the renal or nuclear vein through the aorta and mesenteric artery – we observe here the mechanism of so-called “Nutcracker.”

 

As a result of impaired venous blood circulation and its hypoxia, the temperature in the scrotum increases, which in turn leads to a decrease in sperm parameters. If a man ignores the problem, irreversible changes and infertility can occur. That is why in the case of varicocele ,rapid diagnosis and appropriate treatment are so important. Most often it involves surgical cutting or ligation of the nuclear vein.

 

Testicular torsion

 

We talk about torsion testicular torsion, when there is a sudden, mechanical tightening of the spermatic cord. As a result, blood supply to the testicles is very difficult. Testicular torsion primarily affects adolescent boys between 13 and 21 years old. This does not mean, however, that it cannot happen to an older man.

 

Torsion of the testicle occurs due to sudden movement, e.g. a jump. The most common causes also include insufficient attachment of the testicle in the scrotum and its excessive mobility, testicular failure (cryptorchidism), viral and bacterial infections.

 

Testicular torsion is a very serious condition that requires immediate medical attention. Why? Because testicular ischaemia for several hours may end in necrosis. Torsion of the testicle is manifested by severe testicular pain, sometimes radiating to the groin, as well as swelling of the scrotum and increased sensitivity to touch. In addition, nausea, vomiting, headaches and dizziness may appear. It is diagnosed by means of ultrasound and is surgically treated. Sometimes the nucleus will spontaneously unscrew. Nevertheless, any case of sudden testicular pain should be immediately consulted with a doctor.

 

Testicular cancer

 

Testicular neoplasms are divided by the type of cells they come from. Most often we are dealing with seminoma, which is a cancer derived from cells that form sperm. Other cancers that affect the testicles include germ cell, chorionic and teratocarcinoma. The first symptoms of testicular cancer are often ambiguous and may indicate, for example, inflammation. The nucleus enlarges and is painful, on its surface there are also hardening and unevenness. It happens that a man comes to the doctor with back and stomach aches, coughing or enlarged lymph nodes – this type of symptoms may already indicate metastases to other organs.

 

In many cases, surgical nuclear resection and chemo or radiotherapy are necessary. Unfortunately, cancer treatment is associated with a risk of loss of fertility. Therefore, before starting chemo or radiotherapy, a man should be informed about the possibility of storing sperm in a sperm bank.

 

How to protect yourself from testicular diseases?

 

Almost everyone knows about the need for breast self-control by women. Men, unfortunately, very often forget that they are also subject to monthly self-examination – not breasts, but testicles. Regularly examining his testicles, a man has a chance to detect any irregularities early – papules, bumps, swelling or pain in the testicles. It is good that every 2-3 years a man goes to see a doctor to have such an examination.

 

The testicles are very sensitive not only to all kinds of injuries, but also to external factorsHi. High t temperaturę  can significantly reduce the quality of sperm in an ejaculate. Therefore, a man who wants to maintain fertility should not use the sauna too often. He should also avoid hot baths, wearing underwear that is too tight and restricting movement, holding a laptop on his lap and putting a mobile phone in his pants pocket. A chance to avoid testicular diseases and thus infertility is increased by a healthy lifestyle. Therefore, a well-balanced diet – providing the right amount of calories, deprived of junk food and highly processed foods – and regular physical activity will be equally important.

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