How to Reverse Testicular Atrophy

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Scrotal Swelling and Scrotal Masses of Childhood

The clinical significance of varicocele rests primarily with the association between this condition and adult male infertility. While infrequently an immediate concern of the adolescent, there is ample evidence that the risks of testicular hypotrophy, declining semen parameters, and infertility progress the longer the varicocele remains untreated. Therefore, the identification of a varicocele represents an indication for urologic referral in conjunction with the boy's primary care physician. Urologists recommend surgical repair of varicoceles that are (1) bilateral, (2) painful, or (3) associated with a significant disparity in testicular size of greater than 2 cm 3 Rarely, a varicocele may develop as a consequence of an acute increase in inferior vena caval pressure, in turn the consequence of an intra-abdominal tumor or vena caval thrombosis.

Phallic Oathpenis Holding

The French psychoanalyst Jacques Lacan (1901-1981) formulated the phallus theory according to which the phallus penis is a symbol of desire where the Freudian Oedipal complex is revised to involve a conflict between being versus not being a phallus (or having versus not having a phallus), and where it plays a different role in the desires of each of the three parties (child, mother, and father) of the complex (cf., phallic oath penis holding - according to anthropological evidence, this refers to the swearing of an oath, or a greeting, accompanied by one's own hand on one's own penis or testicles, or on someone else's penis, as a sign of respect and or a gesture of solemnity). The erect phallus penis is considered, traditionally, as a symbol of masculinity, potency, or generation (cf., the term linga, which is the Hindu equivalent for the phallus and is manifested in the phallic image of the Hindu god Shiva). According to Freudian theory, during the phallic stage of...

Testicular and Scrotal Injuries

Early exploration, evacuation of blood clots, and repair of testicular rupture tend to result in an earlier return to normal activity, decreased hematoma infection, and less testicular atrophy than does conservative management. Testicular salvage following penetrating trauma is on the order of 35 percent. 23 Scrotal skin avulsion is managed by housing the testicle in the remaining scrotal skin even though the reconstruction places the skin under tension. Usually the scrotum returns to nearly normal size within a few months. In complete scrotal skin loss, the testicles are placed in pouches in the inner thighs.

Gender Assignment of Newborns and Children

The gender assignment of John Joan has received a great deal of attention (Colapinto, 1997). In 1966 a physician burned the penis of boy beyond repair during a circumcision that involved an electrocautery needle. Fearful of what the boy's life would be like, his parents took him Johns Hopkins University for evaluation. The psychologist John Money proposed gender reassignment from male to female on the assumption that the loss of the penis was so damaging that it would be better for the child to be raised as female he also believed that gender identity can be shaped after birth. With the consent of the parents, in 1967 physicians removed the boy's testicles at the age of 22 months, repositioned the urethra, and induced a preliminary vaginal cleft. The parents selected a girl's name and began to treat and raise the child as female (Colapinto, 2000).

Nutrients in the soil in the absence of permanently cultivated fields hotcold health systems See humoral medicine human

A ceremony which marks the passage of an individual from one status to another. Male initiation ceremonies are often required of all boys in a society and mark the transition from boyhood to manhood. In societies with age-sets, initiation ceremonies may mark a series of transitions to different stages of life. Male initiation ceremonies often involve trauma such as hazing, genital operations, or tests of manliness. Female initiation ceremonies, which commonly occur after the onset of menstruation, are usually for one individual at a time. intensive agriculture. Food production characterized by the permanent cultivation of fields and made possible by the use of the plow, draft animals or machines, fertilizers, irrigation, water-storage techniques, and other complex agricultural techniques. in vitro fertilization. Fertilization that occurs in a laboratory.

Other Cross Sex Relationships

Another especially significant cross-sex relationship is that between grandchild and grandparent. These individuals normatively have a joking relationship that is especially pronounced in the case of a cross-sex pair. The joking is frequently insulting and or sexual, even for young children. In fact, babies sometimes learn their first words from their cross-sex grandparent who teaches the tot lewd insults that the baby is expected to repeat. You black testicles, You red vagina, and other such sexual insults are not infrequently a toddler's first mangled words, aimed with good effect at the opposite-sex grandparent, to the general delight of all present.

Animal Byproduct Processing

By-products are usually classified as edible or inedible. Edible by-products, such as heart, liver, tongue, oxtail, kidney, brain, sweetbreads, and tripe, that are segregated, chilled, and processed under sanitary conditions are called variety meats (or in some countries, offals). Chitterlings and natural casings (intestines) and fries (lamb or calf testicles) can also be eaten. In some countries, the blood and or blood fractions from healthy animals, processed hygienically under conditions specified by the appropriate regulatory authority, can be an edible byproduct. Some by-products must be processed or refined before they can be eaten. Examples include stomachs for tripe, bones and skin pieces for gelatin manufacture, and fatty tissue for edible fat. Most noncarcass material, if cleaned, handled, and processed in an appropriate manner, could be edible.

External Male Reproductive Organs

The external male reproductive organs consist of the penis and two testicles. The two testicles are located in a sac called the scrotum. When a male baby is born, his penis is fully formed and his testicles have usually descended from his pelvis and into the scrotum. Testicles The two testicles are egg-shaped glands held within the scrotum. The scrotum is located underneath the penis and hangs outside of the body cavity. The testicles should hang outside of the body cavity to optimize sperm production because sperm production is most effective when performed at slightly below body temperature. Unfortunately, placement of the scrotum outside of the body cavity puts the testicles at greater risk for injury. Therefore, the testicles should be protected with a jockstrap or protective cup during sports or other strenuous activities. The testicles serve two primary functions the production of the hormone testosterone and the production of sperm. The testicles are sometimes referred to as...

Clinical Features

Physical findings of acute hepatitis are often limited to moderate enlargement of the liver and tenderness. Chronic liver disease is accompanied by a host of physical findings, including sallow complexion, appendicular wasting, palmar erythema, distinctive cutaneous spider nevi, parotid gland enlargement, and testicular atrophy and gynecomastia in males. Ihe liver may be uniformly enlarged and firm or, in advanced cirrhosis, shrunken and grossly nodular. Splenomegaly and ascites accompany portal hypertension.

Pituitary Gland Abnormalities

Pituitary gland abnormalities are a rare cause for male infertility. In such circumstances, the pituitary gland fails to release hormones necessary to promote sperm production. The pituitary gland in the man produces two important hormones for sexual reproduction luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The primary function of LH is to act on specialized cells within the testicles to manufacture the male hormone testosterone. FSH has the main purpose of stimulating the production of sperm. In most cases of pituitary gland abnormalities, either LH or FSH or both are greatly reduced. This drop in hormones results in lowered testosterone levels and also reduced sperm production.

Regulation Of Testicular Function

Testicular function, as we have seen, depends on stimulation by two pituitary hormones, FSH and LH. Without them, the testes lose spermatogenic and steroi-dogenic capacities and either atrophy or fail to develop. Secretion of these hormones by the pituitary gland is driven by the central nervous system through its secretion of the gonadotropin-releasing hormone (GnRH), which reaches the pituitary by way of the hypophysial portal blood vessels (see Chapter 38). Separation of the pituitary gland from its vascular linkage to the hypothalamus results in total cessation of gonadotropin secretion and testicular atrophy. The central nervous system and the pituitary gland are kept apprised of testicular activity by signals related to each of the testicular functions steroidogenesis and gametogenesis. Characteristic of a negative feedback, signals from the testis are inhibitory. Castration results in a prompt increase in secretion of both FSH and LH. The central nervous system also receives...

Cultural Construction of Gender

Iatmul recognize two genders male (ndu) and female (tagwa). From one angle, these genders are exclusive, distinct, and complementary (Weiss, 1994). Men fish with spears, women set traps men stand in canoes, women sit men carve, women weave etc. This omnipresent dichotomy is also natural and biological men have penises and testicles, women have vaginas and wombs. The traditional and modern person is unambiguously gendered through clothing, personal adornment, treatment of the body, and even gait and verbal intonation. Today, men wear pants and often go shirtless, while women don skirts and, unless elderly, mission-derived floral blouses. Little boys run naked girls never do. Many men are scarified, as I discuss below, while women may tattoo themselves with soot. During rituals too, men and women are differentiated by ornamentation such as body paint. Even when men and women ritually switch their stereotypical garb, as in the famous naven rite that celebrates first-time cultural...

Fertility Testing for

During your first appointment, the fertility specialist will ask you and your partner about your medical conditions, medications, lifestyle choices, and family history. Focus may be placed on identifying certain fertility risk factors, such as a history of mumps, undescended testicles, STD infections, urological surgery, or exposure to toxins.

In vitro Fertilization

Viable sperm are collected from the man and washed in a special solution that activates them so they can fertilize the egg. The process of sperm activation is called capacitation and normally occurs when sperm are ejaculated and enter the female reproductive tract. Capacitation involves activating enzymes in the sperm's acrosomal cap, allowing the sperm head, which contains the sperm's genetic material, to penetrate the outer and inner membranes of the egg (zona pellucida and vitelline membrane). For males with azoospermia, microsurgical or aspiration techniques can directly extract sperm from either the epididymis or the testicles. Azoospermia is the most severe form of male infertility, caused by obstructions in the genital tract or by testicular failure.

Safety and Toxicology

Vomiting, abdominal pain, photophobia, palpitations, muscle twitching, convulsions, miosis, and unconsciousness were described in several reports of nonfatal caffeine poisonings in children who ingested 80mgkg-1 caffeine. In several fatal accidental caffeine poisonings, cold chills, stomach cramps, tetanic spasms, and cyanosis were reported. The likely lethal dose in adult humans has been estimated to be approximately 10 g, which corresponds roughly to 150-200 mg kg-1. With daily doses of 110mgkg-1 given via intragastric cannula to female rats over 100 days, hypertrophy of organs such as the salivary gland, liver, heart, and kidneys was reported. Caffeine also induced thymic and testicular atrophy. Developmental and reproductive toxicity was associated with high, single daily doses of caffeine. The no-effect level for teratogenicity is 40 mg kg-1 caffeine per day in the rat, although delayed sternebral ossification can be observed at lower doses. This effect has been shown to be...

Clinical Description Dm1

Ninety percent of DM1 patients present at adulthood with delayed muscle maturation, distal muscle weakness, wasting, myotonia, cataracts, cardiac abnormalities, smooth muscle dysfunction, insulin resistance, daytime sleepiness, testicular atrophy (low reproductive fitness), ''difficult'' personality, neuropsychiatric disturbances, and frontal balding. 1 Ten percent of the patients present at infancy with hypotonia (floppy infant), oromotor dysfunction, tent-shaped mouth, feeding and respiratory insufficiency (diaphragmatic hypoplasia), arthrogryposis, and mental retardation in those who survive until adulthood (congenital DM). 1 All manifestations show a progressive course. Usually, creatine kinase is elevated. Muscle biopsy shows type 1 predominance, centrally located nuclei, severe fiber atrophy with nuclear clumps, hypertrophic and angulated fibers, and occasionally, necrotic fibers, fibrosis, or fat deposits. Cardiac involvement comprises conduction defects (mostly HV...

Environmental And Occupational Factors

Warmer temperatures tend to hinder sperm production. That's because the temperature in the scrotum must be below the rest of the body for the testicles to produce healthy sperm. Exposing the male genitals to heat, such as the frequent use of saunas, steam rooms, hot tubs, whirlpools, and hot baths, can temporarily lower sperm count. Men who wear tight clothing may be lowering their sperm count as well. That's because the testicles are pressed closely to the body and become warmer than if they were able to hang freely within the scrotal sac. Males with infertility difficulties are often advised not to wear tight-fitting pants or underwear.

Varicocele

Treatment should be offered for multiple indications. Primarily, treatment is given for patients with complaints of signs or symptoms of the varicocele. Adolescents are offered varicocele repair if there is testicular growth retardation secondary to the varicocele. Finally, patients with male factor infertility due to abnormal semen analysis with a varicocele are offered repair (Cayan et al. 2002). Surgical approaches to repair are either suprainguinal (Palomo repair), inguinal, or subinguinal. Magnification is very helpful to avoid inadvertent ligation of the testicular artery and lymphatics. Ligation of lymphatics is likely to cause a hydrocele and ligation of the testicular artery is likely to result in some degree of testicular atrophy. Microsurgical approaches are believed to decrease morbidity and recurrences to approximately 1 (Grober et al. 2004). Interventional radiology approaches have also been used, but are reported to have a higher rate of recurrence, approximately 20...

Previous Vasectomy

Unfortunately, it is not just DES daughters who are affected if the woman who took the DES was pregnant with a male child, her son may experience fertility difficulties as well. According to the Centers for Disease Control and Prevention (CDC), the most common research finding for DES sons is that they have an increased risk for benign (noncancerous) growths on their testicles. Sons of women who took this drug have been found to have abnormal sperm type and motility. They also occasionally have testicular abnormalities. If you suspect that your partner has been exposed to DES, please alert your fertility specialist. In rare cases, male infertility may be inherited. This is usually diagnosed through blood samples and by performing chromosomal analysis. For example, a man with cystic fibrosis may have missing or obstructed vas deferens, the tubes that carry sperm. Another example is Klinefelter's syndrome, where the man is born with two X and one Y chromosomes (the normal is one X and...

Ram Reproduction

A breeding soundness exam includes visual appraisal of general health and body condition, as well as a soundness check on feet, legs, eyes, jaws, and dentition. A scrotal circumference measurement is taken, along with palpation of the testicles. The testicles should palpate firm, but not hard, having no signs of abscesses, injuries, orchitis, or any other condition that could affect fertility. The penis and sheath should be examined for posthitis (pizzle rot), ulcerative dermatosis, adhesions, or injury (including shearing trauma). Often, a blood sample is collected during the BSE in order to conduct a serological test for ovine sexually transmitted diseases, i.e., Brucella ovis. Semen samples are collected usually by electro-ejaculation and analyzed microscopically for color, percent live cells, percent motility, and percent abnormal spermatozoa. Upon palpating the scrotum, both testicles should be fully descended into the scrotal sack. At this time, a measurement is taken of the...

An Expanding Gene

Although there is currently no cure for fragile X syndrome, scientists are making great progress in understanding the biology of the disorder. In the mid- to late 1990s, Stephen Warren and colleagues determined that the FMR1 gene product, named FMRP, is an RNA-binding protein that shuttles in and out of the nucleus and is involved in binding various messenger RNAs. Moreover, scientists successfully developed mice that lack the FMR1 gene, which will greatly aid research. Symptoms of fragile X mice include learning disabilities, hyperactivity, and, in males, enlarged testicles. Prevailing hypotheses about FMRP suggest that this protein is involved in forming neural connections in the developing brain.

Mammalian Mechanisms

Early in an embryo's development (four weeks after fertilization, in humans), two groups of cells become organized into the gonad rudiment that will eventually develop into either the ovaries or testicles. These gonads will eventually be the source of gametes in the adult. However, at this early stage they are unstructured organs that lack sex-specific features but have the potential to develop into gonads. Testicles produce Mullerian inhibiting substance, a hormone that causes the Mullerian duct to degenerate. They also produce testosterone, which causes the Wolffian duct to develop into the internal male genitalia, such as the seminal vesicles and the vas deferens. Testosterone also promotes the development of the external male genitalia, including the penis, and it reduces the development of the breasts. In females, where there are no testicles and where there is therefore no Mullerian inhibiting substance, the Mullerian duct differentiates into internal...

Chromosome Disorders

Klinefelter's syndrome is a sex chromosome abnormality that occurs in 1 of 600 males, with a karyotype of 47. Individuals with Klinefelter's syndrome possess an extra X chromosome XXY. Clinical characteristics are variable and include some learning and developmental disabilities, hypogonadism, small testes, and gynecomastia occuring in puberty. The condition can be managed by administering testosterone supplements beginning in adolescence. As with some other sex chromosome abnormalities, adults with Klinefelter's syndrome are usually infertile.

Presentation

Patients generally present with acute testicular pain, often being awoken from sleep with pain. If the patient has mild pain, which has increased over a few days, a torsion of a testicular appendage should be suspected, rather than testicular torsion. If the patient complains of intermittent acute pain, which completely resolves, a diagnosis of intermittent testicular torsion should be suspected (Eaton et al. 2005). In classic testicular torsion, there tends to be nausea and vomiting, along with referred abdominal pain. On inspection, the typical torsion patient is lying quite still on the exam table. A patient who is ambulating easily without pain is unlikely to have torsion. Close inspection of the scrotum may show asymmetric positioning of the testicles with the torsed testicle occupying a high position in the scrotum, which is termed a high-riding testicle. A cremasteric reflex should be elicited next, before palpation, as absence of a cremasteric reflex is associated with...

Hormones

The hypothalamus monitors the hormone levels in the bloodstream. Just like all of the hormones within the body, the reproductive hormones are constantly being monitored and adjusted depending on your physical and emotional demands. The hypothalamus sort of acts like the CEO of a corporation, just sitting by and monitoring what's going on and barking orders from time to time. The hypothalamus will send a message in the form of gonadotropin-releasing hormone (GnRH) to the pituitary gland. In this example, the pituitary gland is the worker. It must calculate which hormones are needed and the required amounts of each and release this message in the form of gonadotropins. The specific names of these gonadotropins are follicle-stimulating hormone (FSH) and luteinizing hormone (LH). As discussed in Chapter 1, in men, FSH stimulates sperm production and LH stimulates the testicles to release testosterone.

Pediatric Torsion

Pediatric torsion is usually secondary to the bell-clapper deformity and occurs intravaginally. Prompt recognition and surgical detorsion will prevent atrophy and testicular nonfunction. Orchidopexy within 4 h will result in almost certain complete testicular viability however, some germ and Leydig cell function can still be preserved after 12 h of untreated torsion. Beyond 24 h, nearly complete testicular atrophy occurs despite detorsion and orchidopexy (Rampaul and Hos-

Fourniers Gangrene

Management is emergent (Baskin et al. 1990). Rapid recognition, speedy resuscitation with fluids and oxygen, administration of broad-spectrum antibiotics, and wide debridement of all necrotic tissue are the cornerstones of treatment, along with the recognized need for a second trip to the operating room for a second look within 24 h. Many times additional surgery is required beyond the second surgery. Support in an intensive care unit may be required, including a large amount of fluid resuscitation, ventilatory support, and vasopres-sor support. Antibiotic coverage should include metro-nidazole or clindamycin for anaerobes, a third-generation cephalosporin or aminoglycoside for Gram-negative infections and penicillin for Gram-positive bacteria. Debridement should extend to fresh, vital tissue at every surgical margin. The glans, corpus spongiosum, corpora cavernosa and testes are almost always unin-fected and preserved because of their deep blood supply. However, if the tunica...

Keep The Boys Cool

You've probably already heard that boxers are better than briefs when it comes to fertility concerns regarding men's underwear. That's because the testicles need to be at a slightly lower temperature than the rest of the body to maximize sperm production. It stands to reason that testicles will enjoy slightly cooler temperature conditions when positioned in boxers as compared to the tight confines of briefs.

Alcohol

Consuming alcohol of more than one or two drinks per day can affect the quality and quantity of sperm, lower testosterone levels, and contribute to impotence. A 1996 research study from Finland showed that moderate alcohol consumption can kill off some sperm-producing cells within the testicles and also may cause abnormal sperm shapes. A normally shaped sperm should resemble a streamlined tadpole with an oval head and long tail. Abnormally shaped sperm vary in appearance and may have two tails, a tapered head, a crooked kinky shape, or an unusually large or small head. Any of these abnormalities make it so that the sperm is unable to penetrate the surface of the egg and therefore unable to successfully fertilize the egg. Men who partake in heavy alcohol consumption that is, more than six drinks per day are more likely to suffer from low sperm count, poor sperm motility, and abnormal sperm shape.

Fertility

Given the difficulties of evaluating spermatogenesis by studies requiring semen analysis, valid surrogate variables would be useful. Indeed, semen analysis itself is an imperfect surrogate marker for male fertility for which questionnaire instruments have been developed (Levine 1988, Joffe 1997). Testicular volume provides an excellent surrogate marker of spermatogenesis because seminiferous tubules comprise the bulk of testis volume as noted in the clinical observation that testicular atrophy reliably connotes impaired spermatogenesis in infertile men. Lacking any longitudinal studies of testis size, the largest cross-sectional study indicates that testis volume is little affected by age until the eighth decade, if the

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