Diseases of the testes

Diseases of the testicles - the pathology of the scrotum and its contents, appendages, cephalic cords, which are closely related to blood and lymph circulation, innervation and function.

The scrotum has a very delicate richly innervated skin, is an erogenous zone, therefore it is often traumatized even with a slight mechanical effect, testicular diseases may not occur, as they are easily displaced and pulled upward. Fiber is loose, richly supplied with blood vessels, so even a small effect on this organ leads to rapid development of edema or bruising, which can reach large sizes, spread to the perineum, penis, hips and abdomen. At the same time, the diseases of the testicles and the contents of the scrotum lead to an increase and deformation with swelling and the transition of inflammation to the skin of the scrotum. The formation of gas in the subcutaneous tissue, for example, with pneumothorax, leads to its accumulation in the cellulose of the scrotum. Allergic reactions with the development of Quincke's edema are also accompanied by a sharp and rapid edema. The presence of a large number of sweat and sebaceous glands determines the predisposition to inflammatory processes: dermatitis, intertrigo, eczema, erysipelas, up to the development of phlegmon and gangrene of the skin and scrotum, as the process is always prone to deepening. Rare, but specific diseases of the testicles, usually associated with damage to the contents of the scrotum: tuberculosis, actinomycosis and other mycoses (rubrophytic, epidermophytosis, candidiasis), syphilis can develop. Viral defeat is accompanied by the formation of genital warts. Tumors, both benign and malignant, occur rarely and do not cause diagnostic difficulties.

Lightning-fast gas gangrene (Fournier gangrene) can also develop with the association of clostridial microflora with Escherichia coli, streptococcus, and others.

The disease develops suddenly, quickly, at any age. It begins with severe and progressive intoxication, swelling, skin of the perineum, thighs, abdomen. The skin acquires a cyanotic, violet-brown color with a black tinge, often gas palpation is determined by gas crepitus. Micturition may be impaired, and in some cases, an acute urethral perineal fistula is formed.

Illnesses of the testicles are quite diverse, for the most part, diagnostics and treatment of disorders are handled by doctors-sex therapists.

Surgical pathology includes common testicular diseases - orchitis, and if the appendages are involved in the process - orchoepidemitis. In most cases, orchitis is secondary, rarely purulent, more often infectious-allergic in case of epidemic parotitis, brucellosis, typhus and paratyphoid, hepatitis, scarlet fever, chicken pox, some types of purulent inflammation, especially if allergenoactive viruses and fungi are present in the microflora association. Diseases of the testicles can occur with trauma, blood circulation in the area of the spermatic cord (after hernioplasty, with a sharp contraction of the muscles of the anterior abdominal wall, with prolonged sexual arousal without ejaculation, with a twist).

Illnesses of the testicles have a vivid clinic: sharp pains radiating to the seminal cord, inguinal canal, lateral thigh area, lumbosacral region. General information

The reaction proceeds according to the type of purulent-resorptive fever. The testicles are enlarged in size, dense, sharply painful on palpation, the scrotum over it is not changed. In the case of suppuration or necrosis of the testicle, the pains become indomitable, the character is pulled, the scrotum swells, hyperemia appears, palpation is determined

Foci of softening. The general reaction of the organism proceeds with the development of the syndrome of intoxication. .

Differentiate is necessary with a dropsy, at which it is increased, but not painfully, at palpation an elastic consistency, fluctuation is determined. With isolated epidimitis (it is rare), a dense and painful infiltration is determined on the posterior surface of the testicles. When the testicle is twisted, the pains are very sharp not only in the entire testicle, but also in the seminal cord, which is palpated in the form of a dense, sharply painful strand. There may be neuralgia of the testicle (Astley-Cooper syndrome), which is manifested by sudden transient pains in the form of lumbago into it and along the course of the spermatic cord at the slightest touch, disappears after blockage of the spermatic cord with novocaine, is prone to relapse, but no visible changes in the testicles are noted.

Illnesses of the testicles caused by a specific infection (tuberculosis, syphilis, actinomycosis) are characterized by typical changes: moderate pain, testicle enlarged in size, slightly painful, with foci of compaction, on the scrotum ulcers and fistulas with characteristic discharge are often formed. Atrophy of male testicles is developing quite rapidly.

Diseases of the testicles associated with the spermatic cord, are quite rare, they are more often associated with other structures of the scrotum.

The most frequent pathology of the spermatic cord is varicocele - varicose veins, detected in 1-6% of men aged 18-30 years, mainly engaged in lifting weights and high physical loads. It is more often localized on the left. Diagnosis is not difficult, because the varicocele is visible by eye. The clinical picture depends on the degree of the process. At 1 degree, the enlarged veins are localized within the spermatic cord, the cremaster reflex is moderately reduced. Subjective sensations are not present, varikotsele mostly worried as a cosmetic defect. At 2 degrees the expanded veins descend to the lower pole of the testicle, the spermatic cord is thickened, the corresponding half of the scrotum and the testicle itself are considerably lowered, since the cremaster reflex is significantly weakened. Subjective sensations of this testicular disease appear usually after physical exertion: pain, discomfort in the perineum, often a decrease in potency. At grade 3, the testicle is edematous or atrophied, dropped into the flabby and enlarged scrotum, which is completely filled with enlarged knobby veins. Pain in the testicles, perineum, sacrum and waist is constant, impotence is almost complete. Absolutely shown operative treatment only in 3 stages. In other stages, it is either not required at all, or plastic surgery is performed in urological units at the patient's request.

Funiculitis - an inflammation of the spermatic cord, is rarely isolated, most often associated with orchitis.

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