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==Clinical significance== {{anchor|Disease}} ===Protection and injury=== {{Further|Testicular pain}} * The testicles are very sensitive to impact and injury. The pain involved travels up from each testicle into the abdominal cavity, via the [[spermatic plexus]], which is the primary nerve of each testicle.<ref name="Kulkarni">{{Cite book|last=Kulkarni|first=Neeta V|title=Clinical Anatomy: A Problem Solving Approach Author|date=2015|publisher=JP Medical Ltd|isbn=978-9-35-152966-8|page=621|url=https://books.google.com/books?id=vrlEDwAAQBAJ&pg=PA621|access-date=2022-07-07|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629160801/https://books.google.com/books?id=vrlEDwAAQBAJ&pg=PA621|url-status=live}}</ref> This will cause pain in the hip and the back. The pain usually fades within a few minutes. * [[Testicular torsion]] is a medical emergency. This is because the longer it takes to access medical intervention with respect to extending ischemia, the higher the chance that the testicle will be lost. There is a 90% chance to save the testicle if de-torsion surgery is performed within six hours of testicular torsion onset.<ref name="Ovadia">{{Cite book|last1=Ovadia|first1=Aaron E|last2=Yang|first2=Hailiu|last3=Neiderberger|first3=Craig S.|last4=Ho|first4=Christina|last5=Sabia|first5=Michael|last6=Seftel|first6=Allen D.|title=Urogenital Pain: A Clinicians Guide to Diagnosis and Interventional Treatments|chapter=Scrotal Pain|date=2017|publisher=Springer|isbn=978-3-3-1945794-9|page=108|chapter-url=https://books.google.com/books?id=ZPKhDgAAQBAJ&pg=PA108|access-date=2022-07-12|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629160807/https://books.google.com/books?id=ZPKhDgAAQBAJ&pg=PA108|url-status=live}}</ref> * [[Testicular rupture]] is severe trauma affecting the tunica albuginea.<ref name="Bucci">{{Cite book|last1=Bucci|first1=Stefano|last2=Rizzo|first2=Michele|last3=Liguori|first3=Giovanni|last4=Umari|first4=Paolo|last5=Chiriaco|first5=Giovanni|last6=Bertolotto|first6=Michele|title=Atlas of Ultrasonography in Urology, Andrology, and Nephrology|chapter=The Testicles: Trauma, Inflammation and Testicular Torsion|chapter-url=https://books.google.com/books?id=fa-MDgAAQBAJ&pg=PA500|date=2017|publisher=Springer|isbn=978-3-31-940782-1|page=500|access-date=2022-07-07|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161041/https://books.google.com/books?id=fa-MDgAAQBAJ&pg=PA500|url-status=live}}</ref> * Penetrating injuries to the scrotum may cause [[castration]], or physical separation or destruction of the testes, possibly along with part or all of the penis, which results in total sterility if the testicles are not reattached quickly. In an effort to avoid severe infection, ample application of [[Saline (medicine)|saline]] and [[bacitracin]] help remove debris and foreign objects from the wound.<ref name="Wessells">{{Cite book|last=Wessells|first=Hunter|title=Urological Emergencies: A Practical Approach|date=2013|publisher=Springer Science & Business Media|isbn=978-1-62-703423-4|page=96|url=https://books.google.com/books?id=RapDAAAAQBAJ&pg=PA96|access-date=2022-07-12|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161013/https://books.google.com/books?id=RapDAAAAQBAJ&pg=PA96|url-status=live}}</ref> * [[Jockstrap]]s support and protect the testicles. ===Diseases and conditions=== {{Infobox medical condition (new) |name = Testicular disease |synonym = |image = |image_size = |alt = |caption = |pronounce = |specialty = [[Urology]], [[Reproductive medicine]] |symptoms = |complications = |onset = |duration = |types = |causes = |risks = |diagnosis = |differential = |prevention = |treatment = |medication = |prognosis = |frequency = |deaths = }} * To improve the chances of identifying cases of [[testicular cancer]], [[neoplasms]], and other health issues early, regular [[testicular self-examination]] is recommended. * [[Varicocele]], swollen vein(s) from the testes, usually affecting the left side, the testis usually being normal.<ref name="DK">{{Cite book|title=Medical Symptoms|date=2022|publisher=Penguin|isbn=978-0-74-406302-8|page=211|url=https://books.google.com/books?id=nbVYEAAAQBAJ&pg=PA211|access-date=2022-07-13|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161300/https://books.google.com/books?id=nbVYEAAAQBAJ&pg=PA211|url-status=live}}</ref><ref name="Kamaya">{{Cite book|last1=Kamaya|first1=Aya|last2=Wong-You-Cheong|first2=Jade|title=Diagnostic Ultrasound: Abdomen and Pelvis E-Book Diagnostic Ultrasound|date=2021|publisher=Elsevier Health Sciences|isbn=978-0-32-379403-9|page=938|url=https://books.google.com/books?id=SydHEAAAQBAJ&pg=PA938|access-date=2022-07-13|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161034/https://books.google.com/books?id=SydHEAAAQBAJ&pg=PA938|url-status=live}}</ref> * [[Hydrocele testis]] is swelling around testes caused by accumulation of clear liquid within a membranous sac, the testis usually being normal. It is the most common cause of scrotal swelling.<ref name="Kumar">{{Cite book|last1=Kumar|first1=Vinay|last2=Abbas|first2=Abul K.|last3=Aster|first3=Jon C.|title=Robbins Basic Pathology E-Book Robbins Pathology|date=2017|publisher=Elsevier Health Sciences|isbn=978-0-32-339413-0|page=692|url=https://books.google.com/books?id=YYZMDgAAQBAJ&pg=PA692|access-date=2022-07-13|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161106/https://books.google.com/books?id=YYZMDgAAQBAJ&pg=PA692|url-status=live}}</ref> * [[Spermatocele]] is a retention cyst of a tubule of the [[rete testis]] or the head of the [[epididymis]] distended with barely watery fluid that contains spermatozoa.<ref name="Kamaya"/> * [[Endocrine disorders]] can also affect the size and function of the testis. * Certain inherited conditions involving mutations in key developmental genes also impair testicular descent, resulting in abdominal or inguinal testes, which remain nonfunctional and may become cancerous.<ref name="Jameson">{{Cite book|last1=Jameson|first1=J. Larry|last2=De Groot|first2=Leslie J.|title=Endocrinology: Adult and Pediatric|date=2015|publisher=Elsevier Health Sciences|isbn=978-0-32-332195-2|page=2363|url=https://books.google.com/books?id=xmLeBgAAQBAJ&pg=PA2363|access-date=2022-07-14|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161307/https://books.google.com/books?id=xmLeBgAAQBAJ&pg=PA2363|url-status=live}}</ref> Other genetic conditions can result in the loss of the [[Wolffian ducts]] and allow for the persistence of [[Müllerian ducts]]. Both excess and deficient levels of [[estrogen]]s can disrupt [[spermatogenesis]] and cause [[infertility]].<ref>{{Cite journal | last1 = Sierens | first1 = J. E. | last2 = Sneddon | first2 = S. F. | last3 = Collins | first3 = F. | last4 = Millar | first4 = M. R. | last5 = Saunders | first5 = P. T. | title = Estrogens in Testis Biology | doi = 10.1196/annals.1336.008 | journal = Annals of the New York Academy of Sciences | volume = 1061 | pages = 65–76 | year = 2005 | issue = 1 | pmid = 16467258 | bibcode = 2005NYASA1061...65S | s2cid = 24905596 }}</ref> * [[Bell-clapper deformity]] is a deformity in which the testicle is not attached to the scrotal walls, and can rotate freely on the spermatic cord within the tunica vaginalis. Those with Bell-clapper are at a higher risk of testicular torsion.<ref name="Soto">{{Cite book|last1=Soto|first1=Jorge A|last2=Lucey|first2=Brian|title=Emergency Radiology: The Requisites E-Book|date=2016|publisher=Elsevier Health Sciences|isbn=978-0-32-339008-8|page=202|url=https://books.google.com/books?id=6MiUCwAAQBAJ&pg=PA202|access-date=2022-07-14|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161307/https://books.google.com/books?id=6MiUCwAAQBAJ&pg=PA202|url-status=live}}</ref><ref name="Melmed">{{Cite book|last1=Melmed|first1=Shlomo|last2=Koenig|first2=Ronald|last3=Rosen|first3=Clifford|last4=Auchus|first4=Richard|last5=Goldfine|first5=Allison|title=Williams Textbook of Endocrinology E-Book|date=2019|publisher=Elsevier Health Sciences|isbn=978-0-32-371154-8|page=669|url=https://books.google.com/books?id=j-u9DwAAQBAJ&pg=PA669|access-date=2022-07-14|archive-date=2023-06-29|archive-url=https://web.archive.org/web/20230629161307/https://books.google.com/books?id=j-u9DwAAQBAJ&pg=PA669|url-status=live}}</ref> * [[Orchitis]] is inflammation of the testicles * [[Epididymitis]] is a painful inflammation of the epididymis or epididymides, frequently caused by bacterial infection but sometimes of unknown origin. * [[Anorchia]] is the absence of one or both testicles. * [[Cryptorchidism]], or "undescended testicles", is when the testicle does not descend into the scrotum of an infant boy.<ref name="Winkler"/> *Testicular enlargement is an [[sensitivity and specificity|unspecific]] sign of various testicular diseases, and can be defined as a testicular size of more than 5 cm ([[Anatomical terms of location#Axes|long axis]]) × 3 cm (short axis).<ref>[https://books.google.com/books?id=safNmcP3lakC&pg=PA559 Page 559] in: {{cite book|title=Introduction to Vascular Ultrasonography|author=John Pellerito, Joseph F Polak|edition=6|publisher=Elsevier Health Sciences|year=2012|isbn=9781455737666}}</ref> *[[Blue balls]] is a condition concerning temporary fluid congestion in the testicles and [[prostate]] region, caused by prolonged [[sexual arousal]]. [[Testicular prostheses]] are available to mimic the appearance and feel of one or both testicles, when absent as from injury or as treatment in association to [[gender dysphoria]]. There have also been some instances of their implantation in dogs. Scientists are working on developing lab-grown testicles that might help infertile men in the future.<ref>{{Cite web |last=Dewan |first=Pandora |date=2024-02-19 |title=Scientists create lab-grown testicles |url=https://www.newsweek.com/scientists-creat-lab-grown-testicles-1871324 |access-date=2024-02-20 |website=Newsweek |language=en}}</ref> ===Effects of exogenous hormones=== To some extent, it is possible to change testicular size. Short of direct injury or subjecting them to adverse conditions, e.g., higher temperature than they are normally accustomed to, they can be shrunk by competing against their intrinsic hormonal function through the use of externally administered [[steroidal]] hormones. Steroids taken for muscle enhancement (especially [[anabolic steroids]]) often have the undesired side effect of testicular shrinkage. Stimulation of testicular functions via [[gonadotropin|gonadotropic-like hormones]] may enlarge their size. Testes may shrink or atrophy during [[Hormone therapy|hormone replacement therapy]] or through [[chemical castration]]. In all cases, the loss in testes volume corresponds with a loss of spermatogenesis.
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