How to Reverse Testicular Atrophy

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Urogenital Conditions Associated With Testicular Cancer

Cryptorchidism is a common congenital disorder in which one or both testicles fail to descend into the scrotum before birth. Over half of the boys who are born with cryptorchidism experience spontaneous testicular descent during the first year of life. A history of persistent cryptorchidism, in which spontaneous descent does not occur, is the major established risk factor for testicular cancer. Epidemiologic studies consistently find associations between a personal history of cryptorchidism and risk of testicular cancer, and reported estimates of relative risk range from 2.5 to 18.1 5 11 42-60 Some studies found cryp-torchidism to be more strongly associated with seminoma than with other histologic types. istries are inadequate, for two reasons. First, some registries classify cryptorchidism as a minor malformation and record it only when it occurs in conjunction with an additional major malformation. Second, the frequent occurrence of spontaneous testicular descent complicates the...

Reproductive biology

Sifakas are seasonal breeders, mating in December or January. Male testicles begin to increase in size three months before the mating season (when the females come into estrus). Female sifakas have a 10-36 hour interval when they are in estrus, and they may come into estrus 1-3 times each year. In the wild they usually are pregnant after one breeding season. Females have swollen, bright pink vulvas when in estrus. Sifaka mating occurs when a male clasps a female around the waist and thrusts 10-50 times. Indris mate face-to-face, while hanging from a branch. Indris gestate for about six months. The smaller verraux's sifaka has a gestation of five months, while the larger diademed sifaka gestate for six months. A single infant is born fully furred and able to cling. Weights at birth are small, less than 0.2 of the mother's weight. Weaning occurs at about six months of age.

The importance of testicular hormones in nonhuman males

Peasants have known that castration modifies the behavior of domestic animals for centuries. Bulls were turned into oxen for making them more manageable and males of some other species were castrated for improving the taste of their meat. This shows that both behavioral and physiological consequences of testicular products in non-human animals have been known for a long time. Despite the age-old popular knowledge, it was only about 100 years ago that the first experimental study of the behavioral consequences of testicular removal in a mammal was published. Male rats were castrated and their copulatory behavior was found to disappear after some time (Steinach, 1894). The disappearance of sexual behaviors after castration has been confirmed in many mammalian species, including the human as mentioned in the previous paragraphs. A question that immediately posed itself to the scientists performing these studies was what the testicles did in order to maintain sexual behavior. Those who...

Studies on men with spontaneous gene deletions

Interestingly, just as in rodents there exist natural mutations in the androgen receptor gene that lead to a receptor that is entirely non-functional or that has a much reduced function. These rare mutations and their consequences were actually described in humans before similar mutations were found in other mammals. The most frequent of the human variant appears to be a point mutation in the androgen receptor gene localized on the long arm of the X-chromosome (Xq11-13). In addition to point mutations, several other kinds of errors in the androgen receptor gene have been described. In the case of a total loss of function, the complete androgen insensitivity syndrome appears. The affected individuals are born with female external genitalia, while having functional, non-descended testicles, producing amounts of androgens similar to those in a normal male. Since the fetal testicles secreted M llerian inhibiting hormone they lack female internal genitalia, i.e. there are no fallopian...

Mary K Gospodarowicz Md Frcpc Frcr Hon Padraig Rwarde Mb Mrcpi Frcpc

The majority (more than 75 ) of patients with seminoma present with clinical stage I disease that is, no apparent involvement is found outside the testis.1,2 The classic presentation of stage I disease is painless testicular enlargement although up to 30 of patients can have some pain at presentation. The traditional management of patients with stage I semi-noma involves inguinal orchiectomy, which provides detailed information on tumor pathology, information on the extent of primary disease, and local tumor control. Local recurrence in the scrotum following surgery is exceedingly uncommon, at least in the case of surgery performed (and presentation with small- to moderate-sized tumors) in the developed world. The current management options for patients with stage I seminoma include (1) adjuvant postoperative external beam radiotherapy directed to para-aortic lymph nodes alone or to para-aortic and pelvic lymph nodes, (2) surveillance, and (3) adjuvant chemotherapy. The usual approach...

Associations with Other Diseases

Klinefelter's syndrome (KS) is a genetic disorder of men that is characterized clinically by gynecomastia, testicular atrophy, and increased levels of follicle-stimulating hormone40 and is characterized genetically by the 47,XXY karyotype. An association between MNSGCT and KS exists. At Indiana University, 22 consecutive MNSGCT patients had chromosome studies performed on blood or a bone mar

Homosexual behaviors a lesson from history and some observational data pertinent to the issues of classification and

Support for the arbitrariness inherent in the notion of homosexuality comes from history (see e.g. Bullough, 1979 Spencer, 1995). It seems that the concept of homosexuality was created as late as the 19th century, while descriptions of copu-latory behaviors with individuals of the same sex were already common in the distant past. We have no written records of homosexual activities from ages earlier than Greek and Roman antiquity, but considering that some monkeys show what we now call homosexual behaviors, we can assume that humans, too, have engaged in such behaviors for as long as there has been a human species. Despite the existence of the behavior, there was no need to create a particular label for the individuals engaging in it until quite recently. There are, just to take one example, many descriptions of same-sex activities in ancient Greece and Rome, but the concept of homosexuality does not appear in any of them. Literary sources tell us about the close association between...

Evolution and systematics

Some species are uniformly blackish, while others are almost completely whitish other species are rusty reddish, gray, brown, tan, or yellowish brown. Un-derparts are nearly always paler than the dorsum. The venter of the water opossum is silvery white. Two genera have distinct dark blotches above the eyes they are called four-eyed opossums. Some genera have characteristic dark and pale patterns, sometimes broad, dark saddle-like bands across the back, sometimes a longitudinal stripe along the dorsal spine and continuing along the top of the snout and to the tip of the nose. The hair can be short or long depending on the species, but it is always dense. In females of some genera, there is a distinct ventral pouch where young are kept in the developmental stages. The pouch opens circularly and can be almost completely closed. Mammae number 12 to 18 and are arranged in a circle with one in the center. One species, the water opossum, has a pouch that seals...

Ammo Terminal Transactivation Domain

Expansion of the CAG microsatellite to 40 or more repeats causes a rare, X-linked, adult-onset, neurodegenerative disorder called spinal and bulbar muscular atrophy (SBMA), or Kennedy's disease.26,27 In addition to progressive muscle weakness and atrophy due to loss of brain stem and spinal cord motor neurons, men with this disorder frequently present with symptoms of partial androgen insensitivity (i.e., gy-necomastia and testicular atrophy), indicative of aberrant AR function.28,29 Receptor proteins encoded by SBMA AR alleles have normal andro-

Clinical Manifestations

The macules can be present at birth or arise early in life. The cutaneous lesions can fade with time, but the mucosal hyperpigmentation remains. The hyperpigmented macules in PJS can be distinguished from freckles by their mucosal involvement and the fact that they are commonly present at birth. The mucocutaneous lesions in PJS precede the gastrointestinal manifestations. The median time to presentation with polyps is 11 years of age, but the age of onset varies greatly. There are reported cases of patients presenting with polyposis at birth, but this is very rare. Extraintestinal polyposis may develop and can involve the nares, pelvis, bladder, and lungs. Although the rate of neoplastic potential of the intestinal lesions is low, 48 of patients with PJS have been reported to develop intestinal and extraintestinal malignancies that include neoplasms of the colon, esophagus, rectum, stomach, small intestine, breast, pancreas, ovaries, cervix, testicles, and...

Complications And Prognosis

The polyps in PJS are benign hamartomas and have a low rate of malignant transformation, but because the polyps progress with age, they can lead to recurrent abdominal pain, bleeding, anemia, intussusception, and obstruction. Patients with PJS are susceptible to a multitude of internal malignancies, including tumors of the gastrointestinal tract, pancreas, testicles, ovaries, cervix, and uterus aggressive screening protocols as mentioned above are recommended to decrease morbidity and mortality.

The importance of testicular hormones in men

Some effects of the removal of testicular hormones have been implicitly known for thousands of years. Starting at an unknown period of remote antiquity, castrated men, eunuchs, were used as servants in harems and as chamberlains to kings (Humana, 1973). The fact that eunuchs were preferred for employment as guards of and servants to women may suggest that already in these ancient times it was known that castrated men had reduced or no sexual interest. There are many anecdotes about preserved sexual behaviors in some eunuchs, but these anecdotes do not contradict the proposal that most of them showed no or much reduced sexual activity. Although none of the stories concerning sexual exploits of eunuchs is based on actual observation, it is not inconceivable that some men castrated after puberty retained some sexual activity for considerable periods of time. Furthermore, some eunuchs were not castrated in the contemporary sense of the word, extirpation of the testicles, but by...


Askanazy, in 1907, was the first to propose that totipotential undifferentiated cells could undergo a metamorphosis to produce teratomas.13 Several clin-icopathologic studies in the following half century supported this fundamental concept,11416 as did a series of preclinical studies (see below). In particular, support for the germ cell origin of testicular cancer has been provided by the demonstration of a preinvasive intratubular carcinoma in situ, or atypical germ cell. 1718 These atypical cells, which differ from normal germ cells in their increased size, irregular chromatin patterns, increased deoxyribonucleic acid (DNA) content, and mitotic index,19 have been found in infertile males,19,20 in the contralateral testes of patients with germ cell tumors,21 in cryp-torchid and ectopic testicles,22 and in normal tissue adjacent to germ cell tumors.23


Most of the etiologic and epidemiologic associations appear to point to an origin in atypical germ cells. The association of testicular maldescent and the formation of testicular tumors has been known for more than 200 years,84,85 and atypical germ cells have been identified in cryptorchid testicles.22 Similarly, testicular cancer is found more commonly in patients with testicular dysgenesis, infertility, and Kleinfelter's syndrome (with expression of an XXY chromosome). Additional epidemiologic associations include reduced body muscle mass and a lower prevalence of male pattern baldness, which may imply lower circulating testosterone levels, as either a cause or an effect of testicular cancer.86 Although testicular trauma and mumps orchitis have largely been discounted as antecedents of GCTs,87,88 earlier studies suggested that both could have mechanisms of oncogenesis predicated on testicular atrophy and the consequent evolution of atypical germ cells. Similar mechanisms have been...


A number of studies have explored the effects of hormones whose levels rise in puberty. In some of the studies, levels of testosterone, LH, and follicle-stimulating hormone (FSH) were measured. In others, factors that can be interpreted as proxies for androgens and gonadotropins were measured instead. In a study conducted among men with diagnosed unilateral testicular cancer, investigators examined the contralateral testicle for the presence of carcinoma in situ (CIS). Men with both testicular cancer and CIS at the time of diagnosis tended to have lower levels of testosterone and higher levels of both LH and FSH76 than men with only testicular cancer. However, the implications of this result are not clear. One possibility is that this hormone profile confers greater susceptibility to disease, indicated by carcinogenic processes that are under way in both testicles of men with CIS. Alternatively, this hormone profile may result from disease processes that are occurring in both...


The ovaries are hidden within the abdominal cavity. This may be a reason why they have not attracted so much attention as the clearly visible testicles. Furthermore, it has not been possible surgically to eliminate the ovaries and assure survival of the victim until recently. Therefore, there are no stories of great deeds performed by spayed women in antiquity, like the ones we have about eunuchs. In the same way, we have no old anecdotes about the sexual consequences of removal of the ovaries in women. This lack of historical interest in the sexual glands of women as well as of females of other mammalian species forces us to focus our attention on rather recent contributions. The word recent is here employed in relation to a time scale of the same length as the one employed during my discussion of eunuchs.


Regardless of age, depression is the most common factor in suicide (Carson & Butcher, 1992). However, it is not the only factor. Despite the fact that depression is significantly more prevalent among females than males, the suicide rate is substantially lower for females than males-whiteor black. Contributing to the higher rate for males is the fact that males who attempt suicide employ more lethal methods, such as firearms. Another factor contributing to the sex difference in suicide rate is that the more assertive, achievement-oriented, middle-aged man has greater difficulty than the more passive, nurturant, middle-aged woman adapting to role changes in later life. Women also tend to have more extensive social supports, which can act as a buffer against despair. Many older men, especially the less affluent, are unable to attain satisfaction in their new roles while retaining the macho myth that they can only maintain their dignity or manliness by keeping quiet about their problems...

Testicular Volume

Remarks Comparative palpation with the orchidometer of Prader is a quick and fairly accurate way to estimate testicular size (Fig. 10.9). The volume in milliliters is clearly printed on each of the elliptical models. At young ages, intermediate volume size models can be obtained (0.5, 1.5, and 2.5 mL size), and very large volume size models have also been developed for macro-orchidism.


Unlike in adults, the incidence of extragonadal tumors exceeds that of gonadal tumors in children less than 15 years of age. However, in the population aged 15 to 19 years, the testicles and ovaries are the most common sites of tumor origin. Several large pediatric series show that approximately 59 of these tumors originate in extragonadal sites and that 41 originate in the gonads.3

Water opossum

The female constructs a den on the bank of a river or stream where she builds a nest with vegetation. The young are born very undeveloped after a short gestation. The female keeps the young in a well-developed pouch that closes hermetically when she swims. The male also has a marsupium to protect the testicles.

Surgical Anatomy

Bifurcated Testicles

The lymphatic drainage of the testis is to the retroperitoneum. The region of lymphatics draining the testicles includes that area bordered by the crus of the diaphragm superiorly, the bifurcation of the iliac arteries inferiorly, and the ureters laterally. The lymphatic drainage of the testicles is usually very predictable, and metastatic disease reliably involves the area described above. However, exceptions do occur when metastatic disease is found in the retroperitoneum of patients with low-stage disease, it is located in an aberrant drainage area approximately 5 of the time.

Milne Edwardss sifaka

Milne-Edwards's sifakas live in monogamous pairs, harems, multi-male, multi-female groups and in polyandrous groups. Breeding is seasonal, and males' testicles begin to expand three months before the mating in December to January. During estrus the female's vulva becomes swollen and pink. Milne-Edwards' sifakas mate 3-4 times within a 10-hour period with the male mounting the female from the back. Females may mate with one or more males in the group. The gestation period is six months, and infants are born in May or June. One infant is born per mother on average every second year. Newborn infants weigh about 4.4 oz (125 g) and are 0.2 of the weight of the mother. The infant clings ventrally to the mother for the first four weeks and then rides on her back for five months. Males help transport older infants about 10 of the time, and defend the group against attacks by large raptors. Females are dominant in feeding and social situations. Infant mortality is high (over 50 ).

Western tarsier

Ormed Island

Different field studies suggest pair bonds or polygynous social organization. Births occur throughout the year, with a conspicuous increase in frequency by the end of the rainy season between February and June. The giant baby, weighing about one quarter of its mother's weight, is able to climb on the first day of its life. Some skeletally adult males have small testes, suggesting the existence of a social category of reproductively inactive spare males.


Sometimes the obvious can stare you in the face. Until 1955, it was agreed that human beings had twenty-four pairs of chromosomes. It was just one of those facts that everybody knew was right. They knew it was right because in 1921 a Texan named Theophilus Painter had sliced thin sections off the testicles of two black men and one white man castrated for insanity and 'self-abuse', fixed the slices in chemicals and examined them under the microscope. Painter tried to count the tangled mass of unpaired chromosomes he could see in the spermatocytes of the unfortunate men, and arrived at the figure of twenty-four. 'I feel confident that this is correct,' he said. Others later repeated his experiment in other ways. All agreed the number was twenty-four.

Chest Radiation

Little as 6 Gy will induce ovarian failure in women between 40 and 50 years.41 Male testicles are even more sensitive to radiation. Spermatogenesis will be affected with doses as low as 0.2 Gy, and may be permanent above 1.2 Gy.42 Gonadal shielding can be somewhat effective but cannot be relied upon to preserve fertility.

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