Inguinal Hernia

An inguinal hernia (ING-gwuh-nul HER-nee-uh) is caused when the intestine pushes through the opening in the abdominal wall into the inguinal canal (the inguinal canal was originally used by the testes when they descended into the scrotum shortly before birth). This can happen during heavy lifting or straining. When it does, the intestine pushes down onto the testicles and causes a bulge or lump in the scrotum. The bulge may change shape and size depending on what the man is doing, because it can slide back and forth within the testicle. Other symptoms include pain and possible blockage of the intestine. Depending on the size and the pain associated with the bulge, surgery may be necessary to remove the intestines and restore blood supply to the intestines.

Hydrocele

A hydrocele (HI-dra-seal) is a condition in which there is an excessive accumulation of fluid within the tissue surrounding the testicle, which causes a scrotal mass. This accu­mulation could be due to an overproduction of fluid or poor reabsorption of the fluid. Some men experience pain and swelling within the testicle. Treatment involves remov­ing the built-up fluid.

Cancer of the Male Reproductive Organs

Cancer is a disease in which certain cells in the body don’t function properly—they di­vide too fast and/or produce excessive tissue that forms a tumor. There are a number of different cancers that can affect the male reproductive organs. Let’s now look at testic­ular, penile, and prostatic cancers. In this section we will also review preventive mea­sures for detecting or avoiding common male health problems. In Chapter 14 we will discuss how these illnesses affect men’s lives and sexuality.

Testicular Cancer

Testicular cancer is the most common malignancy in men aged 15 to 44 (Garner et al., 2005; McCullagh & Lewis, 2005). It was estimated that there would be 8,010 new cases of testicular cancer diagnosed in the United States in 2005 (American Cancer Society, 2005c). There are few symptoms until the cancer is advanced, which is why early detection is so important. Most men first develop testicular cancer as a painless testicular mass or a harder consistency of the testes. If there is pain or a sudden in­crease in testicular size, it is usually due to bleeding into the tumor. Sometimes lower back pain, gynecomastia, shortness of breath, or urethral obstruction may also be found.

Though the incidence of testicular cancer has continuously increased during the last few decades, cure rates have significantly improved (Kormann, 2001). In fact, tes­ticular cancer is one of the most curable forms of the disease (American Cancer Society, 2005d). Treatment may involve radiation, chemotherapy, or the removal of the testicle (although radiation and chemotherapy can affect future fertility, the re­moval of a testicle does not). If removal of the testicle is necessary, many men opt to get a prosthetic testicle implanted, which gives the appearance of having two normal testicles. Early diagnosis is very important, as the treatment is less severe early on, and one’s chance of being cured is greater (review Sex in Real Life, “Testicular Self­Examination”).

e have already discussed the importance of testicular self­examination in the early detec­tion of testicular cancer. Testicular can­cer is the most common type of cancer found in young men between the ages of 15 and 34. Following are the stories of two men, both of whom were diag­nosed with and treated for testicular cancer.

Lance Armstrong, who has won the Tour de France a record number of times, was diagnosed with testicular cancer when he was 25. A scan revealed that the cancer had spread from his testicle to his lungs and brain. Armstrong underwent aggressive surgery, first to remove the ma­lignant testicle and later to remove the cancer that had spread throughout the rest of his body. He was also treated with an aggressive form of chemotherapy. At the time, his doctors gave him a 50/50 chance of survival. One year after his can­cer ordeal, he began racing again. Even though Lance had to have a testicle removed and undergo chemotherapy, he was still able to have three children through in-vitro fertil­ization (see Chapter 12).

Armstrong is committed to his role as a spokesperson for testicular cancer. Had he known about the importance of early de­tection, he would have never ignored the swelling and pain in his testicle. Testicular cancer caught early has a 98% success rate. But many men ignore such pain, thinking that it will go away on its own.

Tom Green, a comedian and actor who was once married to Drew Barrymore, is an­other avid spokesperson on testicular can­cer. Green was diagnosed with testicular cancer at the age of 28. Like Armstrong, Green ignored the testicular pain and swelling, convincing himself that he had somehow injured his testicle. Green’s strange sense of humor pulled him through as he joked and laughed about his cancer. He started a fund to raise money for testic­ular cancer, calling it the Nuts Cancer Fund. He also went public with a show called The Tom Green Cancer Special, which included taped footage of his hospital stay and the surgery to remove his testicle.

Both Armstrong and Green urge all men to regularly check their testicles for swelling, pain, and any changes in structure or size. Remember, early detection is key!

Question: Can a man who has been treated for testicular cancer still have children?

Many men with testicular cancer also have fertility problems. Cancer treatments can cause scarring or ejaculation problems that will inter­fere with later fertility. During radiation or chemotherapy, sperm pro­duction does drop off significantly, and some men have no sperm in their semen. However, for the majority of men, sperm production generally returns to normal within 2 to 3 years. Because many men with testicular cancer are in their repro­ductive prime, waiting 2 or more years might not be an option. For this reason, many healthcare providers recommend sperm banking before cancer treatment. Many men who have been treated for testicular cancer do have children after their cancer treatment, as you’ll see in Sex in Real Life, "Testicular Cancer."