Changes in the testis should be examined, not left to wait
The testis is palpable from the outside, and that is an advantage. Changes are noticed early if one looks and feels. Some things are harmless, some urgent, and some are decided within a few hours. We take every finding seriously and tell you clearly whether waiting is justifiable or not.
Testicular torsion: the urological emergency
In testicular torsion, the testis twists around its spermatic cord and cuts itself off from the blood supply. Typical is a sudden, severe testicular pain, often with nausea, frequently at night or from rest. This is not a situation for observation. The testis can be saved surgically if action is taken quickly; the time window is only a few hours. With sudden severe testicular pain the rule is: go to the emergency department immediately, do not wait until the next day.
Testicular tumor
Malignant testicular tumors affect mainly younger men and are the most common cancer in this age group. The prognosis is good, especially when treated early. Usually a painless hardening or increase in size of a testis is noticed, sometimes a feeling of heaviness. We clarify the suspicion promptly with palpation, ultrasound, and tumor markers in the blood. If the finding is confirmed, surgical exposure is performed via the groin. Because treatment can impair fertility, we discuss the freezing of sperm cells before the start of therapy.
Regular self-examination is the most effective early detection you have in your own hands.
Inflammation of the epididymis and testis (epididymitis, orchitis)
A painful, swollen, overheated side of the testis that develops over hours to days points more to an inflammation than to a torsion. The distinction is important and not always clear at first glance, which is why the acute, painful testis should be examined by a physician. The cause is usually an ascending infection via the urinary tract; treatment is as a rule with antibiotics and rest.
Hydrocele
A hydrocele is an accumulation of fluid in the testicular sheaths, usually harmless but bothersome with increasing size. If it becomes too large or uncomfortable, it can be removed surgically.
Epididymal cyst and spermatocele
Cysts on the epididymis are common and benign. They are palpable as smooth, firm-elastic nodules next to the testis and need only be treated if they cause complaints or grow substantially. Important is the distinction from a tumor by ultrasound, which we provide with the examination.
Varicose vein of the testis (varicocele)
In varicocele, blood backs up in the veins of the spermatic cord, almost always on the left side. It can cause a dragging sensation, but above all can impair fertility. Whether and how to treat depends on complaints and a wish to have children. The connections with male fertility we address in the Andrology section.
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Urokompetenz – The Center for Urology
Klinik für Urologie und Urochirurgie der Clinic Bel Etage
Reichsstraße 59
40217 Düsseldorf