Testicular atrophy

　　The testicle is an important organ for producing sperm. If atrophy occurs, it will affect the spermatogenic ability of the testicle, leading to male infertility. As one of the important reproductive organs in males, even minor changes can attract great attention from male friends. Congenital atrophy is due to genetic defects from parents or some adverse factors during embryonic development, such as cryptorchidism, congenital malformation, etc. Acquired atrophy is generally caused by cold stimulation of the scrotum, which can cause contraction, which is normal and does not belong to testicular atrophy. Medical testicular atrophy refers to the situation where the testicles were originally normal but gradually shrank due to some reason.

　　In addition to its clinical manifestations, testicular atrophy can also lead to other diseases. The main complications of this disease include the following types:

    1. Decreased sexual function, such as impotence, premature ejaculation, and infertility.

　　2. Poor development of male secondary sexual characteristics.

　　Patients with testicular atrophy can be seen in clinical practice with one or both testicles atrophied, which are small and soft, occasionally with slightly harder texture or mild distension and pain. In addition, patients may have varying degrees of incomplete development of secondary sexual characteristics, such as breast development in males, delayed puberty, or even feminization in males. Currently, the internationally recognized testicular volume measuring device is commonly used to measure testicular volume. The size range of the testicles in Chinese people is 15-25, and those smaller than 12 are often diagnosed as 'testicular atrophy'. In addition to measuring the size of the testicles, attention must also be paid to the texture of the testicles, as softening of the testicular texture indicates a more severe degree of damage. Moreover, semen examination is also very helpful for diagnosis, but the most accurate method for diagnosing testicular atrophy is still testicular biopsy.

　　Loose four-sided underwear

　　Loose four-sided underwear is better for preventing testicular abnormalities. Loose and hanging, maintaining the natural shape of the testicles is the best, so four-sided pants are better than tight triangle pants, which is a good method to prevent testicular abnormalities.

　　Strengthen physical exercise

　　People who work in sedentary jobs should strengthen physical exercise. Sitting for more than 10 hours a day is more likely to get testicular cancer, which is a special point to pay attention to for testicular abnormalities.

　　Self-examine the testicles

　　Self-examine the testicles; they should feel like a firm boiled egg, smooth and solid, but not hard. Any lumps or hard areas should be noted and not ignored, so that any abnormalities in the testicles can be quickly identified.

　　Reduce fatty foods

　　To prevent testicular abnormalities, it is important to reduce fatty foods. High-fat diets can interfere with the production of testicular hormones and are associated with the occurrence of testicular abnormalities. Therefore, it cannot be said that men who eat a lot of meat and drink heavily are more masculine; they may look good but not be useful. On the contrary, those who have a light diet, a regular lifestyle, often exercise, and seem to live a disciplined life are more sexually capable. Therefore, preventing testicular abnormalities is very important.

　　1. Routine physical examination: During the physical examination, attention should be paid to whether there is atrophy of the testicles or changes in the texture of the testicles. Hypogonadism secondary to pituitary disease may have normal or slightly smaller testicles, which is related to the duration of the pituitary disease. Increased serum PRL also indicates a problem with the pituitary gland, often accompanied by hypogonadism. Not all patients with impotence have low serum testosterone levels. Patients suspected of having a pituitary adenoma should undergo cranial X-ray or CT scan to make a definite diagnosis.

　　2. Laboratory examinations: In addition to blood and urine analysis, routine examination of seminal fluid and sperm, liver and kidney function, blood electrolytes, blood glucose, blood lipids, and thyroid function, serum testosterone (TE), thyroid-stimulating hormone (LSH), luteinizing hormone (LH), prolactin (PRL), and other measurements should also be conducted.

　　3. Special examinations: According to男科experts, when necessary, these should be performed in hospitals or specialized clinics with the necessary conditions, including quantitative penile vibration, penile dorsal nerve somatosensory evoked potential test, nocturnal penile erection test, and other neurological examinations, as well as penile rigidity, penile systolic pressure, penile blood flow measurement, and penile internal artery angiography, etc., to further make a more definite diagnosis of the location, nature, and degree of the lesion in impotence.

　　4. Serum testosterone measurement: Patients with impotence should at least undergo a serum testosterone test. If the level is within the normal range, no further examination of other hormones is needed. In cases of hypogonadism, the testosterone level decreases. If the first measurement of serum testosterone level is low, it is best to repeat the test and simultaneously measure LSH, LH, PRL, etc. If the testosterone level is still low on the second test, the patient may have hypogonadism. If the levels of LSH and LH in the serum are normal or increased, hypogonadism is considered to be primary testicular abnormality.

　　Patients with testicular atrophy should pay attention to their diet:

　　1. Pay attention to diet and lifestyle adjustments. Avoid long-term intake of rough and irritating foods; avoid hot drinks and salty foods; maintain a regular diet with proper portion control, and prevent overeating and undereating.

　　2. Avoid stimulation. Do not use or use as little as possible drugs that are strongly irritating to the stomach, such as corticosteroids, non-steroidal anti-inflammatory drugs, and potassium, iron, iodine, and other drugs; and quit smoking and drinking. Avoid eating cottonseed oil, and eat less spicy fried and greasy foods.

　　3. Eat more vegetables and fruits to relieve symptoms.

　　4. Increase the intake of various minerals, especially trace elements: the human testis, prostate, and seminal fluid itself contain high concentrations of zinc. Long-term insufficient intake of zinc will cause sperm to be scarce and testicles to atrophy. Shellfish are the main source of high zinc food, such as oysters which contain the most zinc, and can be eaten more.

　　5. Appropriately increase the intake of foods rich in sex hormones: such as sheep kidney, pork kidney, dog testicles, bull penis, chicken liver, which can promote the division and maturation of spermatogonia and is very beneficial to spermatogenesis.

　　The Western medical treatment for testicular atrophy includes medication and surgery:

　　(I) Western Medicine Treatment

　　1. Hormonal Treatment

　　(1) Human chorionic gonadotropin (HCG) 1000u~2000u, once a week, intramuscular injection, for continuous 8 times.

　　(2) Human menopausal gonadotropin (HMG) 150u, intramuscular injection, three times a week.

　　(3) Pregnant mare serum gonadotropin (PMSG) 2000u~3000u, twice or thrice a week, intramuscular injection, 3 months as one course.

　　(4) Methyltestosterone 5mg, three times a day, oral administration, for continuous 2 weeks.

　　2. Vitamin treatment Vitamin A 25,000 IU, three times a day, oral administration; Vitamin B complex, 2 tablets, three times a day, oral administration; Vitamin C 100mg~200mg, three times a day, oral administration; Vitamin E 50mg, twice a day, oral administration.

　　3. Arginine 1g, once daily, oral administration, 2 months~3 months as one course.

　　4. Glutamic acid, 2g~4g, once daily, oral administration.

　　(II) Surgical Treatment

　　If内科treatment is ineffective and there is a tendency for atrophic testicles to undergo malignant transformation, they should be surgically removed.