Male medicine

  1. In general, the left testis lies a bit lower in the scrotum then the right. The testes should appear as 2 discrete swellings, although if the room is particularly cold, they may retract a bit up towards the inguinal canal (more of problem in pediatric then adult medicine).
  2. Gently feel the testes, palpating the tissue between the thumb and next 2 fingers of your examining hand. Each should be of the same consistency and size. If there is a significant size discrepancy (or complete absence of one of the testes) ask the patient if this has always been the case. They may have had one surgically removed... or perhaps suffer from a congenitally undescended testis. The patient should be able to relate whether he was ever able to feel both testes or if anyone has ever told him that he has a testicular abnormality. If there appears to be a single testis, carefully examine the inguinal canal (see below) for evidence of a discrete swelling that could represent the location of an undescended testis. Make careful note of any discrete lumps or bumps within the body of the testis. The presence of a firm nodule would be worrisome for testicular malignancy. Occasionally, the entire testis feels enlarged. This is most commonly caused by a hydrocele, which is a collection of fluid that fills a potential space surrounding the testis. Hydroceles have a characteristic texture that is different from that of testicular tissue. You can also distinguish them from the body of the testis by trans-illumination. To do this, shut off the lights in the exam room and place a flash light on the scrotum, directly over the area in question. A hydrocele will allow the transmission of light, while testicular tissue will not. Testicular enlargement caused by hydrocele. Orchitis: Picture on left demonstrates testicular enlargement caused by infection within the body of the testis.
    The inflammation has spread from the testis to the skin of the scrotum, with resulting edema causing fewer skin folds over the right testicle compared with the left. No transillumination is seen (picture on right) as the inflamed testis does not allow the passage of light (as opposed to hydrocele shown above, which readily conducts light). This is not always the case, as sometimes orchitis will cause a "reactive hydrocele" to form, which will transilluminate.

    Though seahorses are not known to mate for life, many species form pair bonds that last through at least the breeding season. Some species show a higher level of mate fidelity than others. [28] [29] However, many species readily switch mates when the opportunity arises. H. abdominalis and H. breviceps have been shown to breed in groups, showing no continuous mate preference. Many more species' mating habits have not been studied, so it is unknown how many species are actually monogamous, or how long those bonds actually last. [30]

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