Male reproductive organ disorders: tuberculosis infection, pelvic congestion syndrome and early screening for breast cancer

161. Male reproductive organ tuberculosis Male reproductive organ tuberculosis is mostly caused by infection of the reproductive system after renal tuberculosis, which often causes great distress to men. The main types are as follows: (1) Prostate and seminal vesicle tuberculosis: Regardless of whether the infection is transmitted through the bloodstream or urinary tract, the prostate and seminal vesicles are often the first sites of infection and often occur simultaneously. Generally, there are no obvious symptoms, but sometimes there may be discomfort in the genital area, decreased semen volume, and bloody semen. Digital rectal examination may reveal enlargement of the prostate and seminal vesicles, irregular hard nodules, but no tenderness. (2) Spermatic cord tuberculosis: It mostly occurs in young adults and is manifested as a hard, tender nodule in the spermatic cord. A pathological section is required for diagnosis. Bilateral cases should be treated with drugs, and surgical removal may be performed if local symptoms are obvious and anti-tuberculosis treatment is ineffective. (3) Epididymal tuberculosis: It manifests as gradual swelling of the scrotum, generally without pain. Epididymal tuberculosis can form an abscess after adhering to the scrotal skin, and a sinus tract will appear after rupture. Examination reveals a hard nodule with minimal tenderness at the tail of the epididymis, thickened spermatic cord, and numerous small nodules in the vas deferens, resembling a string of beads. (4) Testicular tuberculosis: mostly caused by the spread of epididymal tuberculosis, or by tuberculosis bacteria reaching the testis via the bloodstream. Patients may find that one testis gradually swells to the size of an egg or fist, and experience lower abdominal pain and a feeling of heaviness in the scrotum on the affected side. Examination reveals a smooth, relatively hard, oval mass in the scrotum, with a feeling of heaviness, and a negative transillumination test. (5) Penile tuberculosis: seen in cases of tuberculous lesions from sucking the glans penis or sexual contact with the cervix. Initially, it presents as a small hard nodule, which later ulcerates to form a well-defined ulcer with caseous necrotic material. The ulcer may expand and invade the glans penis or penile shaft. Treatment mainly involves excision of the local tuberculous lesion and the use of anti-tuberculosis drugs.

Male Pelvic Congestion Syndrome and Its Treatment Pelvic congestion syndrome often occurs in young men. It is more common in the dating stage, and it occurs suddenly after prolonged intimacy, or even sexual fantasies without reaching orgasm. It can lead to increased secretion of accessory glands such as the prostate and seminal vesicles, resulting in discomfort in the genitals and perineum. Increased smooth muscle tension in these glands and the vas deferens and epididymis is also the cause of the above symptoms. Young men who experience this symptom for the first time often feel tense, anxious and depressed. They are anxious and always think that intimacy and other activities have caused them serious harm, and suspect that they will become infertile or contract sexually transmitted diseases. Treatment methods for male pelvic congestion syndrome: (1) Psychological treatment: The patient should be given a detailed explanation, explaining that no abnormalities were found in the physical examination and laboratory tests, and that there is only some physiological congestion in the genitals and glands. This is not a pathological change, and there is no risk of sexually transmitted diseases, infertility or cancer. Dispel their concerns. Moderate masturbation is beneficial for symptom relief in unmarried men. (2) Adjunctive treatment: Strengthen physical exercise, take sitz baths, and calm and relax as much as possible. (3) Reduce adverse stimuli: Try to drink less alcohol, coffee and tea, and avoid spicy food to avoid stimulating the sympathetic nerves and aggravating congestion. (4) Drug treatment: Under the guidance of a doctor, analgesics such as aspirin or anti-prostaglandin drugs can be taken for a short period of time.

Men may suffer from "women's diseases": (1) Male breast cancer: mostly discovered between the ages of 50 and 60. Characterized by a painless lump under the areola, with possible nipple discharge, retraction, or ulceration. Once the nipple is severely deformed, the cancer cells have mostly metastasized. (2) Inflammatory lumps in the male breast: caused by local irritation, injury, or bacterial infection, manifested as redness, swelling, heat, and pain, which can be cured in a short period of time with antibiotic treatment. (3) Male pathological pregnancy: positive pregnancy tests in middle-aged and elderly men are actually caused by testicular tumors producing human chorionic gonadotropin. (4) Male gynecomastia: symptoms include a tender, disc-shaped enlarged mass under the areola, accompanied by breast hypertrophy, often bilateral. Causes include cirrhosis, hyperthyroidism, testicular tumors, and certain antihypertensive drugs or estrogen therapy.

Early detection and treatment of breast cancer in men: Men account for 0.35% to 1.5% of all breast cancer cases, with 90% occurring in men aged 45 to 60. Early symptoms include a small, painless, hard, and immobile lump in the breast. The tumor may subsequently enlarge, causing the skin to dimple, resembling orange peel. If it spreads, swollen lymph nodes in the armpit may appear. Methods for early detection of male breast cancer include: 1) Palpation: Gently apply pressure around the nipple with five fingers together, palpating in both clockwise and counterclockwise directions. 2) Visual inspection: Observe the breast skin in a well-lit area using a mirror to check for normal color and any dimpling. Treatment for male breast cancer primarily involves surgical removal, supplemented by radiotherapy and chemotherapy depending on the severity of the condition. Early detection, diagnosis, and treatment are crucial for a complete cure.