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Home >> Men's Health >> Testicle Problems >> Treatment
 Testicle Problems - Treatment
Overview | Diagnosis | Treatment | FAQ
Testicular Cancer
Depending on the type and stage of the cancer, along with overall health and age, different methods will be used to treat testicular cancer.
Surgery
As part of the diagnostic process many patients experience inguinal orchiectomy. The surgeon will remove the testicle through an incision in the groin during this procedure. The tissue will then undergo microscopic examination by a pathologist. In cases where the patient is concerned about changes to the physical appearance of the genitals, an artificial testicle may be implanted inside the scrotum. Further surgery, chemotherapy and/or radiation may be necessary if the cancer has moved beyond the testicles.
Chemotherapy
In most cases, testicular cancer responds positively to chemotherapy. This treatment kills cancer cells that have spread beyond the testicle to other parts of the body. Patients normally undergo intravenous infusions of the chemotherapy drugs. For stage II or III cancer, chemotherapy for 9 to 12 weeks may be needed. After completing the drug regimen, surgery or radiation may be required to remove remaining tumor masses.
 Radiation Therapy
In radiation therapy, high-dose X-rays kill cancer cells. Patients with seminoma cancer typically respond well to radiation therapy.
Retroperitoneal Surgery
This surgery may be very difficult and requires the skills of experienced surgeons. During retroperitoneal surgery, professionals remove lymph nodes in the abdomen that have potentially been tainted by the testicular cancer.
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Hypogonadism
Testosterone replacement therapy can reverse the symptoms of hypogonadism listed above and
improve quality of live. In addition, normalizing testosterone levels may prevent or improve
certain chronic diseases associated with aging such as diabetes and obesity and thereby improve
longevity.
- Injectable options include: Pellets, testosterone cypionate, testosterone enanthate, testosterone
undecanoate
- Adverse effects include: potential infections, protrusion, peak and trough mood
swings, and pain at injection
- Topical options include: topical gel (androgel® and Testim®)
- Adverse effects include: potential transference to partner
- Oral options include: Buccal system, Fluoxymesterone
- Adverse effects include: alterations in taste, irritation of gums, liver toxiciy
Click here to download a PDF with more information on treatments available for hypogonadism, new window will open.
Side effects of Testosterone replacement therapy:
Testosterone replacement can thicken the blood, worsen sleep apnea, promote prostate
growth, prevent sperm production and shrink the testicles, and cause acne, breast swelling, and
fluid retention.
Monitoring Testosterone replacement therapy: 
As long as a man is being treated with testosterone replacement therapy, serial monitoring of
blood tests and physical examinations are required according to the following schedule:
- One month after initiation of therapy: total and free testosterone, CBC, PSA
- Six months after initiation of therapy: total and free testosterone, CBC, PSA plus prostate
and breast examination
- Yearly there after: total and free testosterone, CBC, PSA plus prostate and breast
examination
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Infertility
Infertility treatment depends on the cause, how long you've been infertile, the age of the partners as well as personal preferences. Some infertility causes may not be corrected. Medical or behavioral approaches are used to care for these problems. These fertility care methods are commonly used to ease male issues.
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Increase frequency of intercourse. Men may experience improved fertility by having intercourse two to three times a week. Conversely, too-frequent ejaculation can lower sperm quality. An egg can be fertilized for up to 24 hours after ovulation, and sperm live in the female reproductive tract for up to 72 hours.
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Common sexual problems. Dealing with impotence or premature ejaculation can lead to improved fertility.
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Low sperm count. Typical management of low sperm count can be through surgery or hormones to correct the problem or use of assisted reproductive technology.
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Intracytoplasmic sperm injection. In cases where irregular semen analysis can be attributed to infertility, intracytoplasmic sperm injection (ICSI) may be an option. Sperm is taken directly from the testicles or recovered from the bladder and injected into an egg in the laboratory setting.
- Intrauterine insemination. An office procedure in which semen undergoes a "cleansing" process, after, the sperm are then placed into the uterus using a small plastic catheter inserted through the cervix. This method typically used when couples possess slightly abnormal semen analyses. In instances where the male partner has no sperm at all, or the numbers are extremely low, the process can also be performed using anonymous donor sperm.
Complementary Therapies:
Dietary and lifestyle changes plus selected vitamins and nutritional supplements can improve sperm quality, sperm motility, sperm count, sperm morphology, and decrease sperm DNA damage.
Click here to download a lecture entitled Non-surgical Therapy of Infertility that Dr. McClure presented to the Society for the Study of Male Reproduction in Chicago, Illinois, new window will open.
For further information about male infertility testing, click on the following link to Carolina Conceptions.
Varicocele Repair
 Surgical repair of the varicocele is performed as an outpatient either under general anesthesia or IV sedation. After adequate anesthesia has been established, a long acting local anesthetic is first used to temporarily deaden the nerves that supply sensation to incision and underlying tissue. This serves two purposes: By first blocking the pain fibers, less general anesthesia is required. This is desirable since it allows for a quicker recovery from the effects of general anesthesia. A second benefit is that the local anesthesia continues to work for 4 to 6 hours after the general anesthesia has worn off.
A small incision is made in the inguinal canal (see diagram). The dilated spermatic veins are then identified and tied off. The procedure may also be performed with the aid of an operating microscope. The skin is closed beneath the surface using a suture that will gradually dissolve. A sterile gauze pad is placed over the incision and is held in place by a plastic dressing. The procedure takes about 45 minutes. The time between check-in and check-out will be considerably longer.
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