why do people get their testicles removed as you can tell this is an extremely important question one that i'm sure you've thought about many times but it poses other questions like what happens after removal is it a big deal does it change a person's physiology well in today's video we're going to answer those questions by going over five reasons why someone might have to remove their testicles some of those reasons might actually surprise you and we'll also talk about the procedure or how they are removed and yes discuss the aftermath about what someone could expect about their lifestyle their physiology once one or more what many males consider their prized possessions are removed some important stuff in here so hopefully we don't drop the ball let's do this so let's get right into this anatomy that's relevant to removing a testicle so you probably guessed that we're going to have to take a look at the groin region so we're going to take a look at this right side of the groin you can see specifically here is the right scrotal sac or right scrotum and inside yes everybody take a deep breath is the right testicle or testis that you can see right underneath my probe here and i do just want to mention testis and testicle same thing we can use those interchangeably so i will throughout the video very similar to like the plural versions testes it's the same thing as testicles but this right test as you can see if i flip it over you can see we kept the connective tissue on this side but removed it on this side so you could actually differentiate between the actual testis and the c-shaped structure called the epididymis this epididymis essentially stores sperm cells that were produced by the testis and this other structure we need to mention too the spermatic cord is really important to some reasons why we might remove a testis so i'm going to mention inside there are blood vessels like veins and arteries even nerve endings and a really cool tube we've actually dissected out called the bass defense and the vas deferens transports sperm cells outside of the testis but again part of that spermatic cord now when we're talking about the removal of a testicle or a testis there's an actual procedure and a name for it called orchiectomy now the first half of that word the orc or orky or orchid word root actually means testis or testicle ectomy refers to surgical removal of so you can see how that word translates but there are two types of orchiectomies that i'm going to mention one is called a simple orchiectomy and that's where they just make an incision in the scrotal sac and remove the testis and the epididymis alone a radical orchiectomy they removed those two structures that i mentioned as well as the spermatic cord and that incision would be up higher you could even see in this canal this canal that i'm sticking the probe in where the spermatic cord is emerging from this canal is called the inguinal canal and so that incision would be up closer because they'd have to get into this canal to remove the actual spermatic cord now you might wonder why would you do a simple versus a radical well again that depends on the condition you're treating or the reason for the testicle being removed and so let's jump into some of these reasons to remove the actual testis or testicle now the first item on our list that i want to mention is the testicular torsion now if a testicular torsion sounds bad to you that's because it is i mean this is not a fun thing to have happen what's going on here is the testicle and the spermatic cord are twisting within the scrotal sac that doesn't look like it feels very good and believe me when i was in the emergency department during clinical rotations during medical training saw a few patients with this and they were not happy they were in a lot of pain now people will always ask well what causes this to happen well it can be caused just spontaneously we don't know why it happens just randomly out of nowhere it can also happen with straining or physical activity and also happen due to trauma now we also know that there's people who are more increased at risk for this is when the testicle or testis isn't fixed as firmly to the actual scrotal sac during the developmental process it should be pulled fully down into the scrotal sac and attach firmly but in some people it doesn't fully get as strong of attachment and can increase their risk of a testicular torsion so what is the treatment here the initial treatment we're not looking for is this let's remove the testicle we're trying to preserve the testicle so the reason why it can happen in some cases is because of the blood vessels that are in here being twisted and compressed if blood can't go in and out of the testicle as effectively the testicular tissue could die off which if we get necrotic testicular tissue then we would remove it in that case but initially the first line treatment is let's get this twist out preserve the testicle fix it to the scrotal sac firmly so it doesn't happen again and hopefully that's all we have to do but you could see as that timeline increases the longer somebody waits to get treatment and the longer the testes don't have the blood supply the greater risk for having to remove it due to a testicular torsion so if you think you ever have a testicular torsion one it's not very subtle because it hurts pretty bad don't wait just go get it checked out make sure so you can preserve that testicle of yours and the next item on the list we want to mention is crypt organism crypt in medical terminology means hidden we already know orchid refers to testis or testicle so apparently we have a hidden testicle on our hands now most of us know cryptorquidism as something that's commonly referred to as an undescended testicle now normally the testes should descend while you're developing inside mom and just prior to birth they should make it through this inguinal canal that i mentioned earlier and push into the scrotal sac now if that doesn't occur even people who are born with an undescended testicle often clinicians will wait about three to four months to see if it'll still come down spontaneously on its own but after that four-month period we're looking into interventions now some of you may be thinking whoa whoa whoa you're telling me cryptorchism or an undescended testicle means i'm going to get a testicle removed and some of you know people who've had that had an undescended testicle maybe you even had an undescended testicle and you still got it because you're right the first line treatment is to actually bring it down and fixate it into the scrotal sac and make it so it can't retract up and just stays put where it's supposed to be now that's easy for us to say in say a first world country or somewhere where we have easy access to medical care what if someone's in a developing country doesn't have access to health care maybe this person made it into their teenage years or even adulthood without an undescended testicle not being detected and in that case they may look into removing that testicle now there are variables that they'll have to consider but in those cases the testicle may have atrophied there's also data that shows that undescended testicles increase the risk for testicular cancer so these are considerations that may cause someone to have an orchiectomy due to cryptocrypt organism and speaking of crypt orchidism if you want to be a little bit more hidden like an undescended testicle you might appreciate the sponsor of today's video private internet access private internet access is the world's most transparent vpn provider with over 30 million downloads and if you don't know what a vpn stands for it stands for virtual private network because when you're online browsing about doing your thing websites are constantly trying to get information about your location your device and your browsing habits and private internet access 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is in the description below now the next item on this list is probably the condition that most people think about in regards to removing of a testicle and that is testicular cancer now we could do a whole video just on testicular cancer and we will and even cancer in general but let's just talk briefly about cancer starting in this testicle here this would be the formation of abnormal cells that would essentially be growing out of control and they could even grow to the point where you'd fill a palpable mass even through the scrotal skin and yes we're concerned about the mass here and what it could do at the local level but even more concerned about any of those cancerous cells leaving the testicle and going to other regions of the body and you can see i'm tracing the spermatic cord for a reason because remember vasculature which could be a pathway for cancerous cells to leave and this is the situation where we'd see a radical orchiectomy where we wouldn't just remove the testicle and surrounding structures here but also that spermatic cord which would be important for staging of the cancer and even assessing risk for those cells to spreading to other regions of the body now one last thing i want to mention about testicular cancer and even cancer in general one of the most important things you can do is early detection whether that's through routine physical exams with your primary care provider or learning about the signs or symptoms or risk factors for certain cancers in in this case testicular cancer and we'll put some information below that you guys can take a look at to kind of assess those risks and things to look out for and next we have trauma now luckily the testicles do have some level of resiliency and so those average kicks to the joules don't typically result in any long-term serious consequences but with enough blunt force trauma you can cause damage to the testicle and even cause rupturing in some cases even think about a penetrating trauma or a penetrating wound where it went through the scrotal tissue and into the testicle that obviously could cause damage and even rupturing now again a clinician's knee-jerk response isn't to just yank that thing out of there there's going to be a full assessment of the extent of the damage and even ruptured testicles can be repaired surgically to a certain degree and there's actually data that shows that early intervention and early repair of a damaged testicle reduces the risk of a future need to remove that testicle if again it's handled early now there are going to be cases where the damage is so extensive right from the get-go that it might just have to come out unfortunately and finally on to the last item of our list but i did forget to ask our video quiz question because we're asking quiz questions in each of our videos now so let me ask that real quick and then we'll continue but our quiz question is what muscle or muscles would you need to engage in order to click the like button i'm kidding mostly i say mostly because i would be all excited if you could answer that question but our real question that has to do with some of the anatomy we talked about today is why are males more likely to develop an inguinal hernia or a groin hernia more so than females if you know the answers to any of those questions post them in the comments below and we'll actually pin a comment at the top that shows the correct answers to those so you can see if you got them right but back on to this last item the last item on our list is gender reassignment surgery now up to this point we've been really talking about a case where you'd remove just one testicle but in gender reassignment surgery we would remove both testicles and so obviously this is more of a choice situation than kind of conditions that we talked about in the earlier cases but these all these situations should maybe pose the question in you well what happens afterwards how well does somebody live with say one testicle versus even removing two testicles now with one testicle most people will do just fine and even in certain cases during the surgery the surgeon will ask the patient if they want a prosthetic testicle to be put in place of the one that they removed if the patient is concerned about or for cosmetic reasons or how the testicles will look afterwards and if that one leftover testicle not the prosthetic one the one that's still there is functioning properly they can still have kids because they can produce sperm cells even produce enough testosterone levels in some cases now granted they may want to check testosterone levels to check and see but each situation is a little different but generally they do just fine and lead normal lives now in the case of gender reassignment surgery you take both testicles away obviously no sperm cells are going to be produced and then testosterone levels are going to essentially just wipe off the map there or drain or drop dramatically but that's kind of the point in that situation and you could talk about other situations say somebody had the testicles removed removed in a situation that wasn't for gender reassignment then we just go through well if those testosterone levels are so low that's going to affect muscle mass fat distribution libido energy levels we have a whole video on testosterone which would answer those questions so if you want to check those out you can get a lot of d excuse me details from that but hopefully that gives you guys a lot of different ideas on why you might remove the testicles and it wasn't an all-inclusive list we could always find other reasons for testicular removal but again like i said hopefully that gives you the answers that you're looking for if you have more questions post them in the comments below like i said engage those skeletal muscles if you feel the need to like and subscribe and check out our vpn link to private internet access if you're interested in being a little more hidden and getting a discount there and we'll see in the next video [Music] you