Male Reproductive System

Phimosis is a condition in which the foreskin of the penis cannot be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. The foreskin is completely non-retractile, and this can be painful during sex, can lead to infections and poor hygiene, and in some severe cases retention of urine. In teenagers and adults, it may result in pain during an erection, but is otherwise not painful. Those affected are at greater risk of inflammation of the glans, known as balanitis, and other complications

Initially a steroid cream may be used to attempt to loosen the tight skin. If this method, combined with stretching exercises, is not effective then other treatments such as circumcision may be recommended

A paraphimosis occurs when a tight foreskin has been pulled over the head of the penis and become stuck. This is an emergency, and if this occurs you should head to A&E. It is usually possible to reduce the problem with local anaesthetic if done soon enough.

The definitive treatment for both of these conditions is a circumcision. This is a simple day case procedure that can be performed under local or general anaesthesia

There are 2 very common scrotal swellings that can occur at any age, hydrocoeles and epididymal cysts.

A hydrocoele is a collection of fluid that accumulates in a sac around the testicle. These are very common. When they grow they can give rise to discomfort and if large warrant an operation. This is a simple day case procedure performed under general anaesthesia.

An epididymal cyst is a fluid filled cyst that occurs in the epididymis (tubes that carry semen from the testicle). Again if large or painful they can be easily removed with a small operation.

Vasectomy is a small operation, normally carried out under local anaesthetic, to cut the vas deferens (the tubes that carry sperm from the testes to the penis). It is a permanent form of contraception with a very low failure rate of around 1 in 2000. This is because the tubes can rejoin.

It is performed through 1 or 2 small holes on the scrotum and takes about 30 minutes. The risk of bleeding is very rare. It can take several months for the tubes to clear of sperm, and alternative contraception is needed, until a semen analysis is performed at 2 and 3 months which shows no live sperm.

Cancer of the testicle is one of the less common cancers and tends to mostly affect men between 15 and 49 years of age.

The most common symptom is a painless lump or swelling in one of the testicles. It can be the size of a pea or it may be much larger. Risk factors for testicular cancer include a family history of testicular cancer, and an undescended testicle even if operated on at a young age. If in doubt it is always important to be seen by a doctor If a cancer is confirmed then the testicle and cord are removed through a small incision in the groin as a day case under general anaesthetic. There is an option of inserting a prosthesis at the time, and if fertility is an issue, of banking sperm beforehand. An oncologist would see you after surgery with the results, and you might require further treatment with chemotherapy.

Penile cancer is a rare type of cancer that occurs on the skin of the penis or within the penis. In the UK, around 550 men are diagnosed with cancer of the penis each year. It most commonly affects men over 60 years of age.

It may start with a red patch on the head or shaft of the penis, and later progress to a lump or ulcer. Red patches on the penis are however very common and not usually cancer related

If there is a concern then you will be advised to have a biopsy