Why does testicular atrophy occur and how to treat it?

Testicular atrophy is a pathological condition of the male reproductive system, manifested in a decrease in the functional tissue of the testicles and resulting in a decrease in the size of the male reproductive glands. Atrophy of the testicles causes irreversible changes in the process of sperm production, which is the cause of infertility, and has a negative effect on the overall hormonal background of a man due to a decrease in testosterone production.

Causes of pathology

In people it is believed that atrophy of male glands threatens only those male representatives who take anabolicskie drugs to build muscle while you exercise( as the athletes themselves - "after a course of testicular atrophy").But this is only one of many reasons.

The atrophic process proceeds for a long time;With a careful attitude to their health and timely diagnosis it can be prevented or suspended.

The causes of development of testicular atrophy can be congenital and acquired.

Congenital Causes of

Cryptorchidism - non-admission of the testicle.

With congenital testicular atrophy, pathology is established during embryogenesis( development of the fetus), which leads to the development of cryptorchidism( unilateral or bilateral).Normally, the testicles descend into the scrotum at the time of birth, this serves as one of the criteria for the maturity of the fetus. If the testicle( testicles) lingers in the abdominal cavity, they talk about cryptorchidism( the testes are not implanted into the scrotum, it happens, respectively, from one or both sides).

Nature ordered that the testicles, for normal functioning, should not be exposed to high temperatures. Therefore, the scrotum is located outside, outside the abdominal cavity, and its skin is thin enough and without adipose tissue. Violation of the topography( location) of the testicles leads to pathological heating of the male genital glands, which adversely affects their development and causes atrophy( see "What can cause overheating of the testicles?").

Acquired causes

Injuries, inflammation

Testicular atrophy may be a consequence of trauma and frequent inflammatory diseases of the organs of the scrotum( orchitis, orcoepidymitis).To atrophy also leads to a dull scrotal injury.

Blood circulation and innervation disorders

Varicocele can lead to testicular atrophy.

The blood supply of the testicle is carried by a vascular plexiform plexus. When varicocele , due to the pathology of the valve apparatus and changes in the vascular wall, the pathological expansion of the veins of the lobate plexus occurs. Atrophy of testicles with varicocele develops due to stagnant pathological changes in the vessels. With this pathology, the consequence is tissue hypoxia, trophic disturbance and testicular overheating due to increased constant blood flow.

When stenosis ( narrowing) feeding the testicle of a large artery is likely the development of atrophy. The narrowing of the lumen of the spermatic artery often develops due to its compression during surgical interventions for the plasty of the inguinal canal and operations performed on the organs of the scrotum.

In the case of , the spinal injury of the traumatic character in the lumbosacral section, which led to a violation of the blood supply to the testicle, disrupts the nutrition of the male sex glands, and the development of pathological processes is inevitable.

Dysfunction of the hormonal balance

There is a disease in which a man is forced to take blocking the production of androgen preparations , this is a tumor pathology of the prostate( prostate cancer).

The obesity expressed by as a result of a metabolic disorder leads to a decrease in the level of testosterone in the blood, which leads to a "drying out" of the testicles. The most dangerous for a man is fat, which is deposited around the waist. In adipose tissue testosterone passes into estrogen. The larger the fat layer, the more estrogen will be contained in the blood of a man. It is believed that:

• if a man's waist is less than 94 cm, the blood testosterone level is normal;
• from 94 to 102 cm - reduced;
• at more than 102 cm - a pronounced deficiency, the prevalence of female sex hormones.

With , the regulation of the production of male sex hormones is likely to develop testicular atrophy. Due to certain interactions between the hypothalamus and the pituitary( important areas of the brain), a team is sent to produce a hormone to testicular cells producing testes. But sometimes the command function of these zones is lost or restricted. With this pathology, the male sex glands are inactive, which leads to atrophy.

Symptoms of

Visual examination shows a decrease in the size of the scrotum, palpation of small dimensions and changes in the texture of the testicles due to sagging. In neglected cases with terminal degree of atrophy, the testicle can be palpated in the form of a flat strand.

It should be noted that the pathology in the spermogram is detected with a single functionally capable testicle, with bilateral atrophy sperm in the semen may be completely absent. In a number of cases, with incomplete atrophy, pathologically altered forms of spermatozoa appear. Violation of the process of spermatogenesis is one of the leading causes of infertility. In the absence of sperm production, artificial insemination methods can not be used.

With a one-sided atrophic process, there is a possibility of loss of functional ability of the second testicle, which tries to perform double work to eliminate hormonal disturbances.

In the behavior of a man, all the signs characteristic of testosterone deficiency will be present:

• depression;
• weakness;
• apathy( indifference);
• increase in body weight( obesity);
• decreased potency, up to the development of impotence;
• loss of libido.

As a rule, at detection of alarming symptoms, the man addresses on reception to the urologist or andrologu independently for inspection and treatment.

Diagnostics

Diagnostics begins with visual inspection and collection of anamnesis.

Especially important is a preventive checkup for the boy: a timely operation with cryptorchidism will help in the future to grow a full-fledged man and have offspring. Prolonged overheating of the testicle in the abdominal cavity is a risk of development of tumor pathology in the testicle.

To determine the pathology of the testicles, their palpation is performed.

For palpation, assess:

• the size of the testicles;
• texture;
• pathological formations;
• congenital anomalies of the situation( cryptorchidism);
• structure anomalies.

ultrasound of the scrotum can help confirm atrophy of the testicles, the presence of varicocele, dropsy, testicles.

To assess the hormonal background, the doctor can prescribe a blood test for hormones and spermogram.

Treatment of

Before starting therapy, it is necessary to establish the cause.

If the cause is in the varicose veins of the plexus plexus, surgical treatment is performed - Ivanisevich's operation. It can be performed in an open manner and with the help of endoscopic technologies. More reliable is open surgery, after it fewer relapses, but the postoperative scar is more pronounced and the recovery period lasts longer.

With cryptorchidism, to evaluate the tactics of treatment, evaluate the functional ability of the testicles. If the atrophy is complete, as confirmed by the study on male sex hormones, a bilateral orchiectomy with subsequent hormone replacement therapy is indicated. If the functional capacity of the male gonads is preserved, then an operation is possible to lower the testes into the scrotum. In the future, a man must undergo scrotal ultrasound 2 times a year to make sure there is no oncological process.

Prophylaxis of testicular atrophy

1. Early diagnosis and timely removal of the causes of pathology.
2. Inadmissibility of taking steroid drugs.
3. Using a condom for casual sexual intercourse.
4. Attentive and careful attitude to boys.
5. Timely therapy of acute inflammatory processes in the male sexual sphere.

Atrophy of testicles and application of steroids

Some athletes, for building muscle mass, use anabolic steroids, which, in addition to the desired increase in muscle, increase potency, increase libido due to artificially added testosterone. Their male sex glands while resting, and the body perceives idle testicles as useless, triggering mechanisms of atrophy.

Prolonged use of any anabolic drug stops the secretion of its own testosterone, and it is not always possible to normalize this condition in the andrologist.

Testicular atrophy when abusing anabolic steroids.

In addition to the negative effect on the synthesis of testosterone, anabolic steroids disrupt the work of the cardiovascular system, liver, kidneys, increase the risk of thrombosis and sudden death. The most unreasonable decision will be the intake of anabolics before reaching the age of 25, as the area of ​​bone growth closes and the growth stops.

Before you start taking steroids, be sure to visit the andrologist and listen to his advice. During hormone therapy, which was prescribed by a doctor, the hormonal background of a man must be checked without fail, changes are evaluated, correction is carried out. With self-administration of anabolic steroids, this is not possible.

Thus, in order to remain a full-fledged man, one must carefully consider one's health.

Urological doctor Mishina V. V.

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