Spermatoceles

What are Spermatoceles (Spermatic Cysts)?

Spermatocele on the Epididymis

Spermatoceles are also known as spermatic cysts. They are fluid-filled masses, often painless, and they grow near the testicles. They tend to be benign (not cancerous). These cysts are found near the top and behind the testicle, but are separate from the testicle. They can be smooth, filled with a whitish, cloudy fluid, and most often hold sperm. Their size can vary. If their size becomes a bother or causes pain, then there are some ways to fix the problem. As a rule, they are not a serious medical issue.

The male reproductive tract handles the growth, maturation and delivery of sperm. Faults in the male reproductive tract can cause a mass to grow. If a mass forms in the scrotum, it may mean nothing or it could be a sign of something serious. A set course of action is needed to learn the nature of the mass and the best treatment. For example, if the mass is testicular cancer, it is a source of great concern and requires action. Other masses, such as varicoceles, can cause pain or harm reproductive function. Spermatocele masses are not cancerous, and do not increase your risk of testicular cancer, but they may be a nuisance.

What is Premature Ejaculation?

Ejaculation is the release of semen from the body. Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex. Occasional PE is also known as rapid ejaculation, premature climax or early ejaculation. PE might not be a cause for worry. It can be frustrating if it makes sex less enjoyable and impacts relationships. But it happens often and causes problems, your health care provider can help.

In the U.S., about 1 in 3 men 18 to 59 years old have problems with PE. The problem is often thought to be psychological, but biology may also play a role.

How Does Ejaculation Work?

Ejaculation is controlled by the central nervous system. When men are sexually stimulated, signals are sent to your spinal cord and brain. When men reach a certain level of excitement, signals are then sent from your brain to your reproductive organs. This causes semen to be released through the penis (ejaculation).

Ejaculation has 2 phases: emission and expulsion.

Phase 1: Emission

Emission is when sperm moves from the testicles to the prostate and mixes with seminal fluid to make semen. The vasa deferentia are tubes that help move the sperm from the testicles through the prostate to the base of the penis. (When you are talking about just 1 of these tubes, it is called a vas deferens.)

Phase 2: Expulsion

Expulsion is when the muscles at the base of the penis contract. This forces semen out of the penis. Usually, ejaculation and orgasm (climax) happen at the same time. Some men climax without ejaculating. In most cases, erections go away after this step.

Premature Ejaculation and Erectile Dysfunction (ED)

Sometimes PE is a problem for men who have erection problems (erectile dysfunction or ED). This is when men are not able to get or keep an erection that’s firm enough for sex. Since an erection goes away after ejaculation, it can be difficult to know if the problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated.

What is Overactive Bladder (OAB)?

Overactive bladder (OAB) is a common condition that affects millions of Americans. Overactive bladder isn’t a disease. It’s the name of a group of urinary symptoms. The most common symptom of OAB is a sudden urge to urinate that you can’t control. Some people will leak urine when they feel the urge. Leaking urine is called “incontinence.” Having to go to the bathroom many times during the day and night is another symptom of OAB.

There is another common bladder problem called stress urinary incontinence (SUI), which is different from OAB. People with SUI leak urine while sneezing, laughing or doing other physical activities. More information on SUI can be found at www.urologyhealth.org/SUI/.

Key Statistics

About 33 million Americans have overactive bladder. As many as 30% of men and 40% of women in the United States live with OAB symptoms. But the real number of people with OAB is most likely much larger. That’s because many people living with OAB don’t ask for help. Some are embarrassed. They don’t know how to talk to their health care provider about their symptoms. Other people don’t ask for help because they think there aren’t any treatments for OAB.

How OAB Can Affect Your Life

OAB can get in the way of your work, social life, exercise and sleep. Without treatment, OAB symptoms may make it hard to get through your day without lots of trips to the bathroom. You may feel nervous about going out with friends or doing everyday activities because you’re afraid you may not find a bathroom when you need one. Some people begin to shy away from social events. This can make them feel lonely and isolated.

OAB may affect your relationships with your spouse and your family. It can also rob you of a good night’s sleep. Too little sleep will leave you tired and depressed. In addition, if you leak urine, you may develop skin problems or infections.

You don’t have to let OAB symptoms change your life. There are treatments available to help. If you think you have OAB, see your health care provider.

The Truth About OAB

Don’t let myths about OAB prevent you from getting the help you need.

OAB is not “just part of being a woman.”
OAB is not “just having an ‘enlarged’ prostate (BPH).”
OAB is not “just a normal part of getting older.”
OAB is not caused by something you did.
Surgery is not the only treatment for OAB.
There are treatments for OAB that can help with symptoms.
There are treatments that many people with OAB find helpful.
There are treatments that can help, even if your symptoms aren’t severe or if you don’t have urine leaks.

What is Neurogenic Bladder?

Millions of Americans have neurogenic bladder. Neurogenic bladder is the name given to a number of urinary conditions in people who lack bladder control due to a brain, spinal cord or nerve problem. This nerve damage can be the result of diseases such as multiple sclerosis (MS), Parkinson’s disease or diabetes. It can also be caused by infection of the brain or spinal cord, heavy metal poisoning, stroke, spinal cord injury, or major pelvic surgery. People who are born with problems of the spinal cord, such as spina bifida, may also have this type of bladder problem.

Nerves in the body control how the bladder stores or empties urine, and problems with these nerves cause overactive bladder (OAB), incontinence, and underactive bladder (UAB) or obstructive bladder, in which the flow of urine is blocked.

What is Male Infertility?

Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant.

About 13 out of 100 couples can’t get pregnant with unprotected sex. There are many causes for infertility in men and women. In over a third of infertility cases, the problem is with the man. This is most often due to problems with his sperm production or with sperm delivery.

What Happens Under Normal Conditions?

The man’s body makes tiny cells called sperm. During sex, ejaculation normally delivers the sperm into the woman’s body.

The male reproductive system makes, stores, and transports sperm. Chemicals in your body called hormones control this. Sperm and male sex hormone (testosterone) are made in the 2 testicles. The testicles are in the scrotum, a sac of skin below the penis. When the sperm leave the testicles, they go into a tube behind each testicle. This tube is called the epididymis.

Just before ejaculation, the sperm go from the epididymis into another set of tubes. These tubes are called the vas deferens. Each vas deferens leads from the epididymis to behind your bladder in the pelvis. There each vas deferens joins the ejaculatory duct from the seminal vesicle. When you ejaculate, the sperm mix with fluid from the prostate and seminal vesicles. This forms semen. Semen then travels through the urethra and out of the penis.

Male fertility depends on your body making normal sperm and delivering them. The sperm go into the female partner’s vagina. The sperm travel through her cervix into her uterus to her fallopian tubes. There, if a sperm and egg meet, fertilization happens.

The system only works when genes, hormone levels and environmental conditions are right.

What is Low Testosterone (Hypogonadism)?

What is Testosterone

Testosterone is the sex hormone that helps boys become men. This hormone is key during puberty and the development of male physical features. Testosterone helps to maintain men’s muscle strength and mass, facial and body hair, and a deeper voice. Testosterone levels can affect men’s sex drive, erections, mood, muscle mass and bone density. Testosterone is also needed for men to produce sperm.

What is Low Testosterone?

Some men have low levels of testosterone. This is called hypogonadism, or low-T.

A man’s testosterone level normally decreases with age. About 4 out of 10 men over the age of 45 have low testosterone. It is seen in about 2 out of 10 men over 60, 3 out of 10 men over 70, and 3 out of 10 men over 80 years old.

What is Hematuria?

During routine visits to your health care provider, you are often asked to give a urine sample for testing. Many tests are done routinely, like checking for sugar (diabetes), bacteria (infection) and blood. Blood in the urine that you do not see is called “microscopic hematuria.” This blood is only visible under a microscope. There are many causes and most are not serious, but may call for care by your health care provider.

What are Epididymitis and Orchitis?

Pain in the scrotum or testicle (“teste”) might be from epididymitis, orchitis or both.

  • Epididymitis is swelling or pain in the back of the testicle in the coiled tube (epididymis) that stores and carries sperm.
  • Orchitis is swelling or pain in one or both testicles, usually from an infection or virus.

This article will help you manage these health issues with your urologist.

What Happens under Normal Conditions?

Male Reproductive Organs

Male Reproductive Organs

The male reproductive system makes, stores, and transports sperm. Sperm is created with special male hormones in the body. These are made in the two testes in the scrotum,(which is the pouch-like sac at the base of the penis). Sperm start growing in the testes and gain movement and maturity while travelling through the epididymis. The epididymis is a coiled tube behind each teste.

Each epididymis is linked to the ejaculatory duct by a tube called the vas deferens. This tube runs from the lower part of the scrotum into the inguinal canal. It then moves through the pelvis, behind the bladder. This is where the vas deferens joins with the seminal vesicle and forms the ejaculatory duct. When you ejaculate, fluid from the seminal vesicles and prostate mix with sperm to form semen. The semen travels through the urethra and comes out the end of the penis.

What are Epididymitis, Orchitis and Epididymo-orchitis?

Epididymitis is when the epididymis swells. This disease can be acute (sudden) or chronic (long-term) and is typically from a bacterial infection. Acute epididymitis is felt quickly with redness and pain, and it goes away with treatment. Chronic epididymitis typically is a duller pain, develops slowly and is a longer-term problem. Symptoms of chronic epididymitis can get better, but may not go away fully with treatment and may come and go. Most cases of epididymitis are seen in adults.

Orchitis is swelling of the teste alone is uncommon. It almost always comes on quickly and goes away with treatment. Chronic orchitis isn’t well-defined. It’s thought to be part of a health issue called orchalgia (chronic testicular pain).

Epididymo-orchitis is the sudden swelling of both the epididymis and the teste.

How is BPH Diagnosed?

The American Urological Association (AUA) developed a BPH Symptom Score Index. It asks how often urinary symptoms happen. The score rates BPH as mild to severe. Take the test and talk with your healthcare provider about your results.

Your health care provider will review your Symptom Score and take a medical history. There will be a physical exam with a digital rectal exam (DRE). You may also have:

  • Urinalysis (urine test)
  • PSA blood test to screen for prostate cancer
  • Urinary blood test to screen for bladder cancer
  • Post-void residual volume (PVR) to measure urine left in the bladder after urinating
  • Uroflowmetry to measure how fast urine flows
  • Cystoscopy to look at the urethra or bladder with a scope
  • Urodynamic pressure to test pressure in the bladder during urinating
  • Ultrasound of the prostate

You should see your health care provider if you have symptoms. See your health care provider right away if you have blood in your urine , pain or burning when you urinate, or you cannot urinate.

PSA Test

The prostate-specific antigen (PSA) blood test, tests the level of prostate-specific antigen (PSA) in the blood. PSA is a protein made only by the prostate gland. The PSA test can be done in a lab, hospital or health care provider’s office. There is no special preparation. The PSA test should come before the health care provider does a DRE. Ejaculation can raise the PSA level for 24 to 48 hours. So the patient should not ejaculate for two days before a PSA test.

Very little PSA is found in the blood of a man with a healthy prostate. A low PSA is better for prostate health. A rapid rise in PSA may be a sign that something is wrong. One possible cause of a high PSA level is benign (non-cancer) enlargement of the prostate . Inflammation of the prostate, called prostatitis is one more common cause of high PSA levels.

Digital Rectal Exam of the ProstateDRE

The digital rectal examination (DRE) is done with the man bending over or lying curled on his side. The health care provider puts a lubricated gloved finger into the rectum. The health care provider will feel the prostate. They will be looking for abnormal shape or thickness in the prostate. The DRE can help your health care provider find prostate problems.