^MALE REPRODUCTIVE AND SEXUAL HEALTH

It is a good idea for every man to examine and explore his own sexual anatomy. A gen­ital self-exam can help increase a man’s comfort with his genitals (see Sex in Real Life, “Testicular Self-Examination”). It can also help a man know what his testicles feel like just in case something were to change. We will now discuss diseases and other conditions that may affect the male reproductive organs, in addition to cancer of the male repro­ductive organs.

Diseases of the Male Reproductive Organs

There are several conditions that can affect the male reproductive organs, including cryptorchidism, testicular torsion, priapism, and Peyronie’s disease. It’s important for both men and women to have a good understanding of what these conditions are and what symptoms they might cause.

Cryptorchidism

The testicles of a male fetus begin high in the abdomen near the kidneys, and, during fe­tal development, descend into the scrotum through the inguinal canal (Hutson et al.,

1994) . In approximately 3 to 5% of full-term male infants, the testes fail to descend into the scrotum, a condition called cryptorchidism (krip-TOR-kuh-diz-um; Docimo et al.,

2000) . (A similar condition can occur in males with an inguinal hernia, in which the intestine enters the scrotum through the inguinal canal and may fill it completely, leav­ing no room for the testicles.) The temperature of the abdomen is too high to support sperm production, so if the testes remain in the abdomen much past the age of 5, the male is likely to be infertile. Cryptorchid testes also carry a 30 to 50 times increased risk of testicular cancer. In most infants, cryptorchidism can be identified and corrected

Ithough there are no obvious symptoms of tes­ticular cancer, when detected early, it is treat­able. The only early detection system for testicu­lar cancer is testicular self-examination (TSE). Yet most men do not do regular TSEs. Just like breast self-examinations in women, men should examine their testicles at least monthly. This will enable them to have an understanding of what things feel like under normal conditions, which will help them to find any lumps or abnormal growths, should they appear.

Let’s talk about how to do a testicular exam. First, com­pare both testicles simultaneously by grasping one with each hand, using thumb and forefinger. This may be best done while taking a warm shower, which causes the scro­tum to relax and the testicles to hang lower. Determine their size, shape, and sensitivity to pressure.

As you get to know the exact shape and feel of the tes­ticles, you will be able to notice any swelling, lumps, or un­

usual pain. Report any such occurrence to your physician without delay, but do not panic; most lumps are benign and nothing to worry about.

Figure 5.7 Although the testicles of a fetus begin high in the abdomen, they must de­scend into the scrotum during fetal development. If they do not, the male may become infertile.

Testis retained in abdomen

Partial descent

Descended but not to bottom of scrotum

through laparoscopy to find the undescended testis and then surgery to relocate the testis in the scrotum (Hack et al., 2003). It is recommended that this surgery be done by 6 months of age (Hutson & Hasthorpe, 2005).