What you prob­a­bly have is in­guino­scro­tal her­nia, lo­cally known as GOADIES.

Better Health - - HEALTH -

Dear Doc,

I have a swelling in my left testicle that goes down when I lie down and in­creases in size when I lift heavy loads. My wife says that the swelling is goadies, which comes from quar­relling too much.

I am 46 years old and I work in con­struc­tion, driv­ing a fork­lift. I thought goadies came from suf­fer­ing, tell me more doc.

– An­gus

Dear An­gus,

There are many causes of swelling in the testicle, usu­ally di­vided into those that cause pain and those that don’t.

Scro­tal swelling with pain:

• Epi­didymi­tis – In­fec­tion or in­flam­ma­tion of the epi­didymis. The epi­didymis is a twisted tube be­hind the testicle through which sperm passes

• Or­chi­tis – In­fec­tion or in­flam­ma­tion of the testicle • Tes­tic­u­lar trauma – In­jury to the testicle

• Tes­tic­u­lar tor­sion – When the testicle twists on the blood ves­sels and tubes that it hangs from • Com­pli­cated scro­tal her­nia – When the con­tents of a her­nia are stuck

• Tes­tic­u­lar tu­mor – A lump in the testicle that may be can­cer­ous or non-can­cer­ous

Scro­tal Swelling with­out Pain:

• Hy­dro­cele – Fluid in the testicle

• Sper­ma­to­cele – A cyst that de­vel­ops in the epi­didymis; it may con­tain sperm

• Varic­o­cele – Swelling of the veins around the testicle • He­ma­to­cele – Col­lec­tion of blood in the testicle due to in­jury or due to can­cer

• Scro­tal her­nia – Scro­tal her­nias usu­ally do not hurt un­til there is a prob­lem

• Tes­tic­u­lar tu­mor – A lump in the testicle that may be can­cer­ous or non-can­cer­ous

What you prob­a­bly have An­gus, is in­guino­scro­tal her­nia, lo­cally known as GOADIES.

A her­nia oc­curs when an or­gan or fatty tis­sue squeezes through a weak spot in a sur­round­ing mus­cle and lin­ing tis­sue called fas­cia.

The most com­mon her­nia is an in­guinal her­nia, which starts in a weak spot in the groin and may con­tinue into the testicle.

Other her­nias are: In­ci­sional her­nia (re­sult­ing from a weak sur­gi­cal scar), femoral her­nia (up­per thigh), um­bil­i­cal her­nia (belly but­ton or navel), and hi­atal her­nia (up­per stom­ach).

What Causes Her­nias?

Gen­er­ally all her­nias are caused by a com­bi­na­tion of pres­sure and an open­ing or weak­ness of mus­cle or fas­cia; the pres­sure pushes an or­gan or tis­sue through the open­ing or weak spot. Some­times the mus­cle weak­ness is present at birth; more of­ten, it oc­curs later in life.

Her­nias are most com­mon in the ab­domen, but they can also ap­pear in the up­per thigh, belly but­ton, and groin ar­eas. Most her­nias aren’t im­me­di­ately life-threat­en­ing, but they don’t go away on their own. Some­times they can re­quire surgery to pre­vent po­ten­tially dan­ger­ous com­pli­ca­tions.

Any­thing that causes an in­crease in pres­sure in the ab­domen can cause a her­nia, in­clud­ing:

• Lift­ing heavy ob­jects with­out sta­bil­is­ing the ab­dom­i­nal mus­cles

• Di­ar­rhea or con­sti­pa­tion

• Per­sis­tent cough­ing or sneez­ing

• Sud­den weight gain

• In our en­vi­ron­ment, when males have an en­larged prostate mak­ing them strain to pass urine, they are li­able to de­velop her­nias.

In ad­di­tion, preg­nancy, obe­sity, poor nu­tri­tion, and smok­ing, can all weaken mus­cles and make her­nias more likely.

Com­pli­ca­tions from her­nias.

If left un­treated, her­nias may re­sult in com­pli­ca­tions

• A her­nia may be in­car­cer­ated mean­ing it would not go down and re­turn to where it was pro­trud­ing from.

• A her­nia may be stran­gu­lated – it could get twisted com­pro­mis­ing its blood sup­ply. This is a sur­gi­cal emer­gency re­quir­ing im­me­di­ate surgery

• A her­nia may be ob­structed – when in­testines are, for ex­am­ple, blocked by their con­tents. This is also a sur­gi­cal emer­gency.

Un­com­pli­cated her­nias are usu­ally re­paired by elec­tive surgery (that is non-emer­gency surgery).

Whilst await­ing surgery, it is rec­om­mended that the in­di­vid­ual re­frain from lift­ing heavy ob­jects, and other con­tribut­ing fac­tors should be cor­rected, or the her­nia may re­oc­cur af­ter surgery. Af­ter the cough and con­sti­pa­tion is treated, med­i­ca­tion to re­lieve prostate ob­struc­tion should be given if nec­es­sary. An In­guinal Truss may be worn – Spe­cial un­der­wear that puts pres­sure on the af­fected area pre­vent­ing pro­tru­sion of the her­nia. – Doc

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