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Palpate each testicle separately and preferably after a warm bath and while relaxing.
Isolate each testicle between the thumb and the other fingers of one hand and palpate gently, without pressing.
A small tubular structure next to the testicle is the epididymis, which is a normal part of the testicle. A relatively tough cord above the testicle is the spermatic duct, an anatomical continuation of the epididymis.
If you notice any of the following, contact a Urologist immediately:
The questionnaire (IPSS) is important to determine the symptomatology that the patient reports and gives a direction to the doctor for the diagnosis.
Score: 1-7 mild symptomatology, 8-19 moderate symptomatology, 20-35 severe symptomatology.
The most important answer is the last one and it shows how much his urination has affected his quality of life. This is a factor that should be taken seriously by the physician even if the tests do not show that they are so affected.
In the past month: | Not at all | Less than 1 in 5 times | Less than half the time | About half the time | More than half the time | Almost always |
How often have you had the sensation of not emptying your bladder? | 0 | 1 | 2 | 3 | 4 | 5 |
How often have you had to urinate less than every two hours? | 0 | 1 | 2 | 3 | 4 | 5 |
How often have you found you stopped and started again several times when you urinated? | 0 | 1 | 2 | 3 | 4 | 5 |
How often have you found it difficult to postpone urination? | 0 | 1 | 2 | 3 | 4 | 5 |
How often have you had a weak urinary stream? | 0 | 1 | 2 | 3 | 4 | 5 |
How often have you had to strain to start urination? | 0 | 1 | 2 | 3 | 4 | 5 |
| None | 1 time | 2 times | 3 times | 4 times | 5 times |
How many times did you typically get up at night to urinate? | 0 | 1 | 2 | 3 | 4 | 5 |
Scores: | ||||||
Quality of life due to urinary symptoms | Delighted | Pleased | Mostly satisfied | Mixed | Mostly dissatisfied | Unhappy | Terrible |
If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that? | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
This questionnaire is important for the recognition of the symptomatology of the overactive bladder by the patient himself, and for the direction the doctor will have for the treatment.
Not at all | Slightly | A little | Quite | A lot | Too much | |
How bothered are you by frequent urination during the day? | ||||||
How much have you been bothered by an unpleasant urge to urinate? | ||||||
How bothered have you been by a sudden urge to urinate with little or no warning? | ||||||
How bothered have you been by unexpectedly losing a small amount of urine? | ||||||
How much have you been bothered by nighttime urination? | ||||||
How much have you been bothered by waking up in the night because you had to urinate? | ||||||
How much have you been bothered by an uncontrollable urge to urinate? | ||||||
How bothered have you been by urine loss associated with a strong urge to urinate? | ||||||
Are you a man? | NO | YES | ||||
The IIEF (International Index of Erectile Function) questionnaire is used to assess the severity of erectile dysfunction symptoms.
All of his questions refer to your experiences in the last month.
A score above 24 means that you have normal function.
If your score is lower, then it would be a good idea to discuss your problem with a specialist such as a Urologist or a psychiatrist/psychologist specializing in Sexology.
| I have not had sexual activity | Almost never/ never | A few times (less than half of the time) | Sometimes (about half) |
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| How often did you have an erection during any sexual activity (masturbation, intercourse)? | 0 | 1 | 2 | 3 | 4 | 5 | ||
| During sexual arousal, how often did you achieve erections so hard that they allowed penetration? | 0 | 1 | 2 | 3 | 4 | 5 | ||
| When you tried to have sex, how often were you able to penetrate (enter)? | 0 | 1 | 2 | 3 | 4 | 5 | ||
| During intercourse, how often were you able to maintain an erection after penetration? | 0 | 1 | 2 | 3 | 4 | 5 | ||
| During intercourse, was it difficult to maintain an erection until intercourse was complete? | 0 | 1 | 2 | 3 | 4 | 5 | ||
| How much confidence do you have in yourself that you can achieve and maintain an erection? | 0 | 1 | 2 | 3 | 4 | 5 |
Rapid or premature ejaculation is a common male sexual problem and can be occasional or permanent. The self-assessment of men is done with a special questionnaire, the PEDT (Premature Ejaculation Diagnostic Tool).
1) How difficult is it for you to delay ejaculation?
2) Are you ejaculating earlier than you would like?
3) Do you ejaculate with too little irritation?
4) Do you feel irritated because you are ejaculating earlier than you want?
5) How concerned are you that the timing of your ejaculation leaves your partner unsatisfied?
Hypogonadism is the condition where there are reduced levels of testosterone in the blood. The ADAM questionnaire (Androgen Deficiency in the Aging Male) is used internationally to identify symptoms related to testosterone deficiency.
A YES answer to questions 1 or 7, or any 3 of the other questions may indicate a partial deficiency of testosterone secretion.
1 | Do you have a decrease in libido (sex drive)? | YES | NO |
2 | Do you have a lack of energy? | YES | NO |
3 | Do you have a decrease in strength and/or endurance? | YES | NO |
4 | Have you lost height? | YES | NO |
5 | Have you noticed a decreased "enjoyment of life"? | YES | NO |
6 | Are you sad and/or grumpy? | YES | NO |
7 | Are your erections less strong? | YES | NO |
8 | Have you noticed a recent deterioration in your ability to play sports? | YES | NO |
9 | Are you falling asleep after dinner? | YES | NO |
10 | Has there been a recent deterioration in your work performance? | YES | NO |
Pain or discomfort
1. IN THE LAST WEEK, HAVE YOU FELT ANY PAIN IN THE FOLLOWING AREAS? | ||||||||||||
Α. AREA BETWEEN RECTUM AND TESTICLES (PERINEUM) | YES (1) | NO (0) | ||||||||||
B.TESTICLES | YES (1) | NO (0) | ||||||||||
C. TIP OF THE PENIS (NOT RELATED TO URINATION) | YES (1) | NO (0) | ||||||||||
D.BELOW YOUR WAIST IN YOUR PUBIC OR BLADDER AREA | YES (1) | NO (0) | ||||||||||
2.IN THE LAST WEEK, HAVE YOU EXPERIENCED: | ||||||||||||
A.Pain of burning during urination? | YES (1) | NO (0) | ||||||||||
Β.Pain or discomfort during or after sexual climax (ejaculation)? | YES (1) | NO (0) | ||||||||||
3. How often have you had pain or discomfort in any of these areas over the last week? | 0 NEVER | 1 RARELY | 2 SOMETIMES | 3 OFTEN | 4 USUALLY | 5 ALWAYS | ||||||
4. Which number best describes your AVERAGE pain or discomfort on the days that you had it, over the last week?
0 = NO PAIN | 10 = PAIN AS BAD AS YOU CAN IMAGINE
| 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | |
URINATION
| 0 NOT AT ALL
| 1 LESS THAN 1 TIME IN 5
| 2 LESS THAN HALF THE TIME | 3 ABOUT HALF THE TIME
| 4 MORE THAN HALF THE TIME | 5 ALMOST ALWAYS
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5. How often have you had a sensation of not emptying your bladder completely after you finished urination, over the last week? |
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6. How often have you had to urinate again less than two hours after you finished urinating, over the last week? KATHOLU? |
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IMPACT OF SYMPTOMS
| 0 NONE | 1 ONLY A LITTLE | 2 SOME | 3 A LOT |
7. How much have your symptoms kept you from doing the kinds of things you would usually do, over the last week? |
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8. How much did you think about your symptoms, over the last week? |
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Quality of life
| 0 DELIGHTED | 1 PLEASED | 2 MOSTLY SATISFIED | 3 MIXED | 4 MOSTLY DISSATISFIED | 5 UNHAPPY | 6 TERRIBLE |
9. If you were to spend the rest of your life with your symptoms just the way they have been during the last week, how would you feel about that? |
Scoring the NIH-Chronic Prostatitis Symptom Index Domains:
PAIN: TOTAL FROM 1A, 1B, 1C, 1D, 2A, 2B, 3 AND 4 = /21
UROLOGICAL SYMPTOMS: TOTAL FROM 5 KAI 6 = /10
IMPACT ON QUALITY OF LIFE: TOTAL FROM 7, 8 AND 9 = /12
If your score is high, you need to see a urologist.
To help your doctor have a direction for diagnosing interstitial cystitis you can answer the following questions below. If your total score is high, your doctor will tell you about the tests that need to follow.
DURING THE PREVIOUS MONTH
Q1. How often have you felt the strongneed to urinate with little or no warning; | 0 Not at all
| 1 Less than 1 in 5 times
| 2 Less than half the time
| 3 About half the time
| 4 More than half the time
| 5 Almost always
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Q2. Have you had to urinate less than 2 hours after you have finished urinating? | 0 Not at all
| 1 Less than 1 in 5 times
| 2 Less than half the time
| 3 About half the time
| 4 More than half the time
| 5 Almost always
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Q3. How often did you, most typically, get up at night to urinate? | 0
| 1
| 2
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| 4
| 5 or more
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Q4. Have you experienced pain or burning in your bladder? | 0 Not at all
| 1 A few times
| 2 Quite often
| 3 Usually
| 4 Almost always
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TOTAL
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During the past month, how much has each of the following been a problem for you?
| No problem | Very small problem | Small problem | Medium problem | Big problem |
Q1. Frequent urination during the day?
| 0 | 1 | 2 | 3 | 4 |
Q2. Getting up at night to urinate?
| 0 | 1 | 2 | 3 | 4 |
Q3. Need to urinate with little warning?
| 0 | 1 | 2 | 3 | 4 |
Q4. Burning pain, discomfort or pressure in your bladder?
| 0 | 1 | 2 | 3 | 4 |
TOTAL
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