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Testicular Disease

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They may be rare, but testicular diseases can be life threatening. Here's how to recognize them.

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Why should I care about testicular disease?

Happily, significant testicular disease is uncommon and usually not serious. But if you have any testicular pain or a change in your testicles -- such as a lump or a firmness -- call your doctor. Even if you're embarrassed, delaying an evaluation is not worth the risk.

As you might guess, testicular cancer is the most serious form of testicular disease. It's also the most common cancer in men ages 18 to 35, accounting for 1% of cancer in men in the U.S. It is usually curable.

Risk factors for testicular cancer include:

  • previous history of testicular cancer
  • undescended testicle as a child
  • a close relative with testicular cancer

More common than testicular cancer is epididymitis, which is inflammation of the epididymis, a tubular structure next to the testicle where sperm mature. About 600,000 men get it each year, most commonly between ages 19 and 35. Unprotected sex or having multiple sex partners increases the risk of infectious epididymitis.

As many as one out of every five men has varicocele, which refers to swollen and dilated veins above the testicles (not unlike varicose veins), a condition that is usually benign. Hydroceles, which come from increased fluid around the testicle, also pose little risk.

What is testicular disease?

Testicular disease can take a variety of forms:

Testicular cancer. Like any cancer, testicular cancer happens when cells in the testicle develop mutations that cause them to "misbehave." The cells may multiply recklessly and invade areas where they don't belong. In testicular cancer, this process usually creates a slow-growing painless lump or firmness in one testicle. In most cases, the man himself discovers it at an early stage. If a man gets medical attention early on, testicular cancer is almost always curable.

Testicular torsion. "Torsion" means twisting -- and for a testicle, that's not a good thing. When testicular torsion occurs, the twisting kinks -- like a garden hose -- and blocks the blood vessels to one testicle. Certain men have a developmental problem that makes them susceptible to testicular torsion. Although testicular torsion is rare, it is an emergency. Sudden testicular pain demands an immediate trip to the emergency room. If treatment is delayed, the testicle can die. Torsion is most common during puberty - between ages 10 and 15 -- so it's important to let young teens know that any pain should be reported, even if they are embarrassed to say so.

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