w
  


 
  


- occurs when a testicle is mobile and the

spermatic cord twists, cutting off the
blood supply.
- most common testicular disorder in
children.
- an emergency requiring immediate
surgical intervention.

6Mtiology: sports; strenuous activity

6jssessment:
The testis feels tender to palpation
and edema begins to develop.
Usually arise suddenly with acute
scrotal swelling and severe pain as
blood supply to the testicles is
interrupted.
Perhaps nausea and vomiting from
the severity of the pain.
6wntervention:
Boys need to be educated about the
phenomenon so that they report
symptoms promptly.
wf testicular torsion is suspected, a
testicular scan and Doppler
ultrasonography are performed to
assess the blood supply.
 ×aparoscopic surgery is
necessary to reduce the torsion
and reestablish circulation. The
spermatic cord is untwisted and
the testicle is immobilized by
suturing it to the scrotum
(orchiopexy).
|ithout prompt surgery, the
testicle may atrophy or develop an
abscess.
wf the testicle is necrotic, it is
removed. Since the other testicle
will be susceptible to torsion, it is
also affixed to the scrotum at the
time of surgery.
 a

- rare, acute testicular inflammation.
- Mumps orchitis occur in about 30% of
men who develop mumps after puberty
which is usually bilateral. jn acute phase
may last for about a week.
- Permanent sterility- bilateral
- decreased fertility- unilateral
6Mtiology: usually caused by a viral
infection
6clinical manifestations:
Reveals edematous and extremely
tender testicles.
Reddened scrotal skin
Fever and prostration

6×aboratory study findings: Specimen

culture results may be positive for
bacteria.
6wntervention:
Mncourage bed rest, sitz baths (local
heat to the scrotum), ice, and scrotal
elevation with scrotal bridge (scrotal
support).
jdminister prescribed pain
medications, including anti-
inflammatory medications.
jdminister medications for fever and
infection which may include
antimicrobial medications.
 jdvise client to avoid sitting for
long periods, straining and lifting.
Discourage sexual activity until
infection resolves.
Mncourage treatment for the clientǯs
sexual partners, if indicated.
 M  

- more common than orchitis.
- an cute or chronic inflammation of
the epididymis
- the infective organism passes
upward through the urethra a
ejaculatory duct, along the vas
deferens to the epididymis
6Mtiology: a complication of
prostatitis
urethral instrumentation such
as catheterization or
transurethral surgeries
Sexually transmitted organisms
usually c

 frequently
cause the condition in men
younger than age 35
UTw; Urinary pathogens are the
cause in older men
Trauma is a noninfectious cause
6jssessment:
jlmost always unilateral.
Marly in the disease, a client has local pain
and swelling.
js it progress, the testes becomes involved
(epididymitis-orchitis), the entire scrotum
becomes reddened and painful, and an
inflammatory hydrocele can occur.
jfter the acute phase, fibrosis and
occlusion may result, with subsequent
sterility.
6Pathophysiology for prosthitis, orchitis
and epididymitis
Microorganisms may be carried up the
urethra to infect the prostate, epididymis
and testis, or may be spread through the
bloodstream.
 chemical irritation and
inflammation of these organs
results from extravasation of
urine, possibly secondary to
urethral stricture or prostatic
hyperplasia.
 Poor diffusion of
antimicrobial medications
into the prostate gland may
cause relapsing infection in
chronic prostatitis
 x   
- painless collection of clear, yellow
fluid in the scrotum.

noncommunicating hydrocele-
residual peritoneal fluid is trapped
with no communication to the
peritoneal cavity w/c usually
disappears at the age of 1.
 communicating hydrocele-
associated with a hernia that
remains open from the scrotum
to the abdominal cavity.
- decreases in size when the man
lies down
6Mpidemiolgy:
Opening between the peritoneum
and the tunica vaginalis.
6jssessment:
The soft intrascrotal mass is
translucent to light and it shines red.
wn communicating hydrocele, a
bulge in the inguinal area or the
scrotum that increases with crying
or straining is prominent and
decreases when the child is at rest.
6Medical Mgt: jspiration or surgical
drainage is done when constant
discomfort, embarrassment or
impaired circulation occurs.

6Postoperative interventions:
Provide ice bags and a scrotal
support to relieve swelling and pain.
 wnstruct the child and
parents to avoid tub bathing
until the incision heals and to
avoid strenuous physical
activities.
 x   
xematocele is a collection of blood
in the tunica vaginalis.
6Mtiology:
wt may develop as a result from an
abdominal surgical procedure
Scrotal trauma
j bleeding disorder
Testicular tumor
6jssessment:
xematocele are less likely than
hydroceles to be transilluminated
on light examination.
Scrotal skin is dark red or purple.

6Medical Mgt: Drainage of the

blood
6Postoperative interventions:
Provide ice bags and a scrotal
support to relieve swelling and
pain.
wnstruct the child and parents to
avoid tub bathing until the
incision heals and to avoid
strenuous physical activities.
J   
- a cystic dilation at the end of the
epididymis that contains a milky
fluid and dead spermatozoa.
- located above, posterior and
separate to the testis and is attached
to the epididymis
- may be solitary or multiple and
usually are less than 1 cm in diameter.
6jssessment: They are freely
movable, painless and should
transilluminate.
6wntervention: Surgery is usually
not required. xowever, if it is a
large one and may become
painful, excision is necessary.
 


   




  

- most common congenital testicular
condition
- One or both testicles fail to descend or
may be arrested in the abdomen, inguinal
canal (camalicular), low pelvis, or high
scrotum.
- Many resolve by the first year of life.
rectractile testicle - descends into the
scrotum but pulls back into the inguinal
canal because of a hyperactive cremasteric
reflex. wt usually descends and stays in the
scrotum by puberty and surgery is not
required.

complete absence of a testicle is also

possible.
6Mtiology:
wt occurs in 4% of full-term male infants
and is more common in premature
infants.
wnguinal hernias and torsion commonly
occur with undescended testicles.
6jssessment:
wf bilateral, the child should be assessed
for intersexuality (an intermingling of
female and male characteristics with
external characteristics often
contradictory to internal characteristics),
especially if condition is associated with
other genital abnormalities.
- associated with infertility. xigh body
temperature, endocrine
understimulation, and an abnormal
epididymis that seems to accompany an
undescended testicles cause changes that
prevent normal fertility in the future. The
incidence of testicular cancer is high in
men with this condition if not corrected
before puberty.
6Medical Mgt.:
j surgery, inguinal incision, is used so
that additional repair (i.e., hernia repair
or excision of connective tissue bands) or
orcheictomy (should the testicle look
abnormal) can be done.
xc has sometimes been used to
promote passage of the testicle in the
scrotum.
6èursing Mgt:
Provide client teaching.
wnform parents that continuous follow-up
through the childbearing years is
necessary to detect malignancy and to
deal with infertility issues if they arise.
clients and their parents should learn
how to do testicular self-examination.
’
w
w  
 ’


- occurs when the penile foreskin
(prepuce) is constricted at the opening,
making retraction difficult or impossible.
- not usually painful but can lead to
obstructive uropathy if it is severe enough.
- Prolonged phimosis caused by chronic
inflammation and irritation predisposes to
penile cancer.
6Mtiology: congenital or a result of
inflammation, infection or local trauma.
6jssessment: edema, erythema,
tenderness and purulent discharge
6Medical Mgt.
controlling infection with local
treatment and broad-spectrum
antimicrobial drugs.
circumcision
6èursing wnterventions: jdvise
uncircumcised male patients to
clean the penis by pulling the
foreskin back gently and washing
the area with a washcloth daily.
 ’ 


Paraphimosis is a condition
wherein the foreskin is so tight and
constricted that it cannot cover the
glans. j tight foreskin can constrict
the blood supply to the glans and
lead to ischemia and necrosis.
6 Mtiology:
Many cases results from the foreskin being
retracted for an extended period
rigorous cleaning
masturbation
sexual intercourse
catheter insertion in uncircumcised males
cystoscopy if the foreskin is not returned to its
normal position.
6jssessment:
Swelling of the glans/ edema
Pain on the area

6èursing wntervention:
The foreskin can be gently compressed
either manually or with an elastic wrap.
The client can do manual reduction by
gently pulling the foreskin.
Medical Mgt: Surgical incision of
the foreskin with local anesthesia
may be necessary if the condition
does not resolve.
 ’


 


Prosthitis is the inflammation of
the foreskin while balanitis is the
inflammation of the glans penis and the
mucous membrane beneath it.

6Mtiology: irritation and invasion of

microorganisms
6jssessment: swelling and possible
discharge
6wnterventions:
jdvise patient to have good hygiene and
thorough drying of the penis.
wt is important to assess for DM, which
predisposes client to secondary infection.
jntibiotics may be prescribed and
circumcision may be necessary.
  

wt is caused by urethral scarring or
narrowing.

6Mtiology: congenital or caused by

untreated or severe urethritis or urethral
injury (including urologic
instrumentation e.g. cystoscopy)
6 jssessment: manifestations are caused by
obstruction and these include:
Small-caliber urinary stream
xyperdistended bladder
wnfection
Fever
Dysuria

6 wntervention: urethral strictures are released

surgically by surgical dilation or urethroplasty
 x


 M 


- congenital disorders of the penis
resulting from embryonic defects in the
development of the urethral groove and
penile urethra.
- xypospadias affects approximately 1 in
300 male infants while epispadias are
less common which may occur as a
separate entity.
urethral defect in which the urethral
opening is not at the end of the penis
but on the lower (ventral) aspect of the
penis.
Opening of the urinary meatus
on the dorsal or superior surface
of the penis.
6Mtiology:
Both are congenital disorders.
Mpispadias is often associated with
extrophy of the bladder, a condition
in which the abdominal wall fails to
cover the bladder.
6jssessment:
The termination of the urethra is on the
ventral surface of the penis.
The testes are undescended in 10% of boys
born with hypospadias and chordee
(ventral bowing of the penis).
wnguinal hernia may also accompany the
disorder.
6wntervention:
surgical repair is done between the
ages of 6-12 months
wn a èewborn, M
aa a surgical
procedure in which the urethral is extended to a
normal position. wnitially performed to
established better urinary function.
circumcision is avoided because the
foreskin is used for surgical repair.
j    j 
 -  
 haracterized by varicosities of the
pampiniform plexus, a network of veins
supplying the testes, within the scrotum.
- 90% of varicoceles are left-sided because
the left spermatic vein enters the renal vein
in a 90 degree angle, causing a reflux of
blood back into the veins of the
pampiniform plexus. The force of gravity
resulting from the upright position also
contributes to venous dilatation.
6jssessment:
Pain on the scrotum
On palpation, with the standing
man, it feels like a mass of
torturous veins above and
posterior to the testicle. |hen
the man lies down, the masses
abates.
6wntervention:
Masturbation and sexual intercourse
can relieve the pain.
Use of scrotal support
Surgery is performed if there is
severe pain or if the varicocele is
thought to contribute to infertility.
 -
  M 
J 

 elective surgical procedure to
ensure a permanent method of
contraception.
- wt is sometimes performed after a
prostatectomy to prevent retrograde
epididymitis.
 j small incision is made in the
scrotum involving cutting out
a segment of the vas deferens,
ligating the ends, and tucking
them into different tissue
planes to prevent
reanastomosis.
6jssessment: Postoperative slight pain,
swelling and bruising.

6wntervention:
Discomfort is controlled with ice and a
mild analgesic such as acetaminophen
(aspirin is avoided to prevent bleeding).
Provide a scrotal support to increase
client comfort.
Provide client teaching: The client can
resume heavy lifting and sexual
intercourse about a week after surgery.
Tell the client to practice other means of
birth control until the follow-up semen
analysis shows azoospermia (absence of
sperm) because live sperm are left in the
ampulla of the vas deferens.
 w
 
 a situation in which regular,
unprotected intercourse does not
result in a pregnancy over a 12-month
period.
- j male factor contributes partially
or totally to the coupleǯs inability to
conceive in about 50% of the cases.
6Mtiology:
Pretesticular (hormonal) causes involve
endocrine dysfunction and account for
about 3% to 25% of cases. Mxamples are
pituitary and adrenal tumors, thyroid
disorders, diabetes mellitus, and cirrhosis.
Testicular causes are most common.
Varicoceles are found in 19% to 41% of
infertility cases. congenital
abnormalities, torsion, genitourinary
infection, trauma and exposure to
substances known to interfere with
spermatogenesis (sperm formation).
cryptorchidism is directly related to
infertility.
Post-testicular causes include congenital
blockage of vas deferens and other
malformations of structures distal to the testes.
jdditional causes include infection of the
prostate, epididymis, or testicle, emotional
factors, surgical procedures that cause
retrograde ejaculation, and some medical
conditions such as renal disease or paraplegia.
Testicular trauma as an etiology to infertility is
still a matter of controversy.
The formation of anti-sperm antibodies is one
theory.
chemicals, drugs, and other substances that
affect spermatogenesis are called gonadotoxins
(eg. xeavy use of alcohol, marijuana, and
anabolic steroids. Many medications, including
allopurinol, cimetidine, nitrofurantoin,
sulfasalazine, and chemotherapeutic drugs,
have been related to infertility. ×ead, jgent
Orange (a herbicide used as a defoliant in
Vietnam), and some pesticides affect fertility.
Tobacco smoke, radiation and hyperthermia
also affect fertility.
6 Pathophysiology:
xormonal imbalance between the
hypothalamus, pituitary glands and testicles
can interfere with the production and
maturation of sperm.
xypoxia of the testicle and elevated scrotal
temperature cause germ cell damage.
Seminal |Bcǯs present in genitourinary
infections are believed to release bioactive
cytokines that affect spermatogenesis.
Some viruses and bacteria directly
destroy and cause enough inflammation
to cause tissue necrosis.
STws particularly gonorrhea and
infection with c
 
,
may account for cases of infertility
because they can cause testicular
atrophy, but the relationship is still
vague.
wmmune responses may prevent the
formation of normal sperm.
onodotoxins can decrease the number
of sperm, decrease motility, or cause
abnormal morphology.
congenital factors and trauma can
impair patency of the ductal system that
extends from the testicles through the
prostate.
6jssessment:
Obtain a detailed occupational, sexual,
medical and reproductive history and
conducting a thorough physical
examination. The presence of testicle and
their size, varicocele or other scrotal and
penile abnormalities, and secondary sex
characteristics are noted.
j prostate massage and specimens of
secretions may be obtained for culture to
check for infection.
j post-ejaculatory urine specimen may
also be checked for the presence of
sperm, which suggests retrograde
ejaculation.
Semen analysis is performed on more
than one specimen. Semen volume and
viscosity, number and concentration of
sperm, motility and morphology are
analyzed.
6Medical Mgt.:
èo treatment is available for primary
testicular failure or hypogonadism.
Testosterone may be prescribed to correct
low testosterone levels. j testosterone
patch is applied directly to the scrotum
(Testoderm) or to the torso or extremities
(jndroderm).
xyperprolactinemia may be treated by
surgical removal of a pituitary tumor or
administration of bromocriptine
(Parlodel).

jbsence of ejaculation or retrograde

(backward) ejaculation may be treated
with drugs such as ephedrine,
imipramine, or antihistamines.
6èursing Mgt.:
Provide support
Provide education. Prevent infertility
by doing the following:
 jvoiding gonadotoxins
 Decreasing exposure to occupational
and environmental hazards
 [eeping the scrotum cool by avoiding
excessive heat, hot baths and tight
clothing
 jvoiding transmission of STDs by
limiting the number of sexual partners
and by using condoms
 Developing effective means of stress
reduction
 Mating a well-balanced, nutritious diet
For oligospermia caused by excessive
frequency of ejaculation, recommend
that the couple have intercourse only
once every 36 hours during the
womanǯs periovulatory period
because it takes 24 hours for a
normal sperm count to be generated
after ejaculation.
wnstruct the client to avoid factors that
depress spermatogenesis such as heat,
drugs, alcohol and marijuana.
Teach patient to keep the testicles cool
by avoiding hot baths and tight clothing
or by using a commercially prepared,
water-dampened scrotal-cooling device
jdvise the client to maintain good
nutrition.
Mjaculatory abnormalities may be
corrected by the split-ejaculate technique.
The first half may be used for artificial
insemination or may be deposited in the
vagina during intercourse, followed by
withdrawal of the penis.
  

- an acute urethral inflammation
commonly associated with STws and is an
associated manifestation of cystitis.

6Mtiology:
onorrhea, chlamydial infection, and
other bacterial infections.
6 jssessment:
Swollen, painful, red and irritated
Pyuria (presence of pus in the urine) is a
common indication.
Manifestations are similar to those described for
cystitis.
urethral discharge.
6wnterventions:
culture and sensitivity testing of the
urine should be performed, and culture
specimen should be obtained to exclude
STws if indicated.
Removing the etiologic mechanism. wf
microorganism is the cause,
administration of systemic or topical
antibiotics is essential.
 jdvice client to avoid coitus until
the manifestation subside or
treatment of the STw is completed.
Sitz bath and an increase fluid
intake are encouraged.
 ’ 
 



- Fibrous plaques are develop in the connective
tissue usually near the dorsal midline of the
penile shaft in middle-age and older men.
- two phases; acute and chronic.
- often associated with Dupuytrenǯs contracture
of the hand tendons.

6 Mtiology: unknown. xowever, thereǯs theory

that it is caused by an abnormal fibrotic
reaction to trauma.
6 jssessment:
Pain is present during the initial phase as
plaques begin to develop which last about 12 to
18 months. Pain usually subsides during the
chronic phase, but fibrosis is increased.
The man may have penile curvature during
erection.
Painful erection
Unsatisfactory vaginal penetration
6 wntervention:
Reassure client that this is not a
malignant condition and does not lead to
development of cancer.
wf the client does not have discomfort and
has soft plaques and minimal curvature,
the physician may advise waiting several
months before instituting therapy.
Medical treatment includes vitamin M,
para-aminobenzoic acid, tamoxifen, and
colchicines.
wntralesional injections, utrasonography
and local radiations have also been
used.
Surgical correction is necessary when
previous treatments have failed and the
client is unable to perform sexually.
 ’ 

 prolonged, persistent penile erection without
sexual desire which lasts for hours or even days
and may be very painful.
- The high-flow arterial priapism, the less
common type, usually occurs after trauma and
is less painful. - The low-flow veno-occlusive
priapism on the other hand is more common
and extremely painful making it an emergency
situation. ×ow-flow priapism must be resolved
within 24 hours to prevent complications.

6 Mtiology:
Sometimes associated with leukemia or sickle
cell anemia.
Self-injection of medications (mainly
papaverine) to treat impotence is the other
common cause.
wt may also result from the use of some
medications such as anticoagulants, alcohol,
phenothiazine, alpha-adrenergic blockers and
marijuana.
6 jssessment:
For low-flow priapism, circulation is
compromised, predisposing to penile ischemia,
gangrene, fibrosis and permanent MD.
client may also be unable to void.
6 wntervention:
×ow-flow priapism
 Surgical treatment, aspiration of blood from
the penis followed by serial intracavernosal
injections of phenylephrine is required to
prevent permanent damage.
 xigh-flow priapism
 wt can be treated with ice and compression. wf
these measures are unsuccessful, the client may
require selective embolization or ligation of the
traumatized artery
 Be sensitive to the embarrassing nature of the
problem.
 Be understanding and try to make the client
comfortable while decreasing his
embarrassment.
j 
 ’


- inflammation of the prostate. wt may be acute or
chronic. js estimated 35% of men older than age 50
suffer from chronic prostatitis.

6 Mtiology:
Microorganisms such as bacteria, viruses, fungi, or
parasites cause genitourinary infections. The most
common bacterial offenders are gram-negative
organisms.
Sexually transmitted organisms can also cause this
infection.
6 clinical Manifestation:
Sudden onset of fever and chills (eg.acute
prostattitis)
Dysuria, urinary urgency and urinary frequency
Perineal pain or low back pain
Tender, swollen, warm indurated prostate on
palpation
×aboratory study findings: Urine culture is
positive for bacteria and |Bcǯs.
6 èursing Mgt/ intervention:
jdminister prescribed medication to treat
infection, which may include antimicrobial
medications.
Minimize the risk for infection.
Provide pain relief by administering the
prescribe pain medications, including the anti-
inflammatory medications.
Mncourage bed rest.
Provide client teaching. Mncourage
avoidance of foods or liquids that have
diuretic action or increase prostatic
secretions (eg. jlcohol, coffee, tea,
chocolate, cola, spices).
jdvise client to avoid sitting for long
periods, straining and lifting.
Discourage sexual activity until infection
resolves. (xowever, sex may be beneficial
for men with chronic prostatitis.)
 ’
 
 
- rare and sometimes develops in sexual
partners.
6 Mtiology:
wt usually affects the foreskin of older,
uncircumcised men who have suffered
chronic irritation and have poor hygiene
practices.
xuman Papillomavirus (xPV)
 J

 
 
There are 4 stages of cancer of the penis

· Stage 1 penis cancer. Malignant cells are found

only on the surface of the penis
· Stage 2 penis cancer. Malignant cells are found
on the surface, tissues beneath the surface and in
the shaft of the penis.
· Stage 3 penis cancer. Malignant cells have
spread to the lymph nodes in the groin.
· Stage 4 penis cancer. Malignant cells have
spread through the penis, lymph nodes in the
groin and to other parts of the body.
6jssessment: jny dry, wart-like, painless
growth on the penis or foreskin that fails
to respond to antibiotics should be
assessed for cancer.

6wntervention:
wf an early diagnosis is made, excision
and circumcision may be all that is
necessary.
Penile shaft resection or sometimes
penectomy and dissection of enlarged
inguinal nodes may also be essential.
xowever, dissection of the pelvic lymph
nodes carries a risk of long term
lymphedema affecting one or both lower
extremities.
 cancer of the Prostate:

type of adenocarcinoma.
Îcommon in men older than 50 years
old
Îrank as high as cause of cancer death
Îslow growing cancer of the prostate
gland is usually androgen dependent
 Risk Factors:

åincreased age
åfamilial predisposition
åa diet increase in red meat and fat
6 jssessment:
üasymptomatic in early stages
ühard, pea sized nodule palpated in rectal
examination.
ühematuria

6 ×ate Symptoms:
ü|eight loss
üurinary obstruction
üpain radiating from the lumbosacral area
down the leg
6 Symptoms Related to Metastasis:

backache
hip pain
perineal, and rectal discomfort
anemia
weight loss
weakness and nausea
oliguria
6 Diagnostic Tests:

Two serum markers:

 *Prostate Specific jntigen (PSj)
 *Prostatic jcid Phosphatase

X Older than 40 years old should have

DRM
 Benign Prostatic xypertrophy
common disorder in older men, varying
from mild to severe form.
jlthough called hypertrophy, the change is
actually hyperplasia of the prostatic tissue
with formation of nodules surrounding the
urethra.
This change related to compression of the
urethra and variable degree of urinary
obstruction.
 Diagnostic Tests:
X Rectal Mxamination

 Signs and Symptoms:

wnitial signs indicate obstruction of the urinary
flow
xesitancy
dribbling
decreased force of the urinary streams are
direct result of the narrowed urethra.
wncomplete bladder emptying leads to
frequency, nocturia, and UTw.
 Treatment:

Surgery: may be recommended when

obstruction is severe.
[F×OMj
 tamsulosin hcl
Testicular cancer
>is cancer that starts in the testicles, the male
reproductive glands located in the scrotum.

> common form of cancer in men between the

ages of 15 and 35. wt can occur in older men,
and rarely, in younger boys.
 
:unknown.
 Factors that may increase a man's risk for
testicular cancer include:
6 jbnormal testicle development
6 xistory of testicular cancer
6 xistory of undescended testicle(s)
6 [linefelter syndrome

 Other possible causes include exposure to

certain chemicals and xwV infection. j family
history of testicular cancer may also increase
risk.
 Two main types of testicular cancer:
seminomas and nonseminomas

 Seminoma

 >This is a slow-growing form of testicular

cancer usually found in men in their 30s and
40s. The cancer is usually just in the testes, but
it can spread to the lymph nodes. Seminomas
are very sensitive to radiation therapy.
 èonseminoma

>This more common type of testicular cancer

tends to grow more quickly than seminomas.
 J   

Discomfort or pain in the testicle, or a feeling of
heaviness in the scrotum
Dull ache in the back or lower abdomen
Mnlargement of a testicle or a change in the way it
feels
Mxcess development of breast tissue
(gynecomastia), however, this can occur normally
in adolescent boys who do not have testicular
cancer
×ump or swelling in either testicle
 Symptoms in other parts of the body,
such as :

the lungs
abdomen
pelvis
back,
brain, may also occur if the cancer has
spread.
 M




j physical examination typically reveals a firm

lump (mass) in one of the testicles. |hen the
health care provider holds a flashlight up to the
scrotum, the light does not pass through the
lump.

 Other tests include:

jbdominal and pelvic cT scan
Blood tests for tumor markers: alpha fetoprotein
(jFP), human chorionic gonadotrophin (beta
xc ), and lactic dehydrogenase (×Dx)
chest x-ray

Ultrasound of the scrotum

j biopsy of the tissue is usually done after the

entire testicle is surgically removed.
  
 :Treatment depends on the Type of
testicular tumor
 The next step is to determine how far the
cancer has spread to other parts of the body.
This is called "staging.Dz
Stage w cancer has not spread beyond the
testicle
Stage ww cancer has spread to lymph nodes in
the abdomen
Stage www cancer has spread beyond the lymph
nodes (it could be as far as the liver, lungs, or
brain)
 Three types of treatment can be used.

Surgical treatment removes the testicle

(orchiectomy) and nearby lymph nodes
(lymphadenectomy). This is usually performed
in the case of both seminoma and
nonseminomas.
6 chemotherapy uses drugs such as cisplatin,
bleomycin, and etoposide to kill cancer cells.
This treatment has greatly improved survival
for patients with both seminomas and
nonseminomas.

6 Radiation therapy using high-dose x-rays or

other high-energy rays may be used after
surgery to prevent the tumor from returning.
Radiation therapy is usually only used for
treating seminomas.