iron men
OCTOBER, 2018 | The HEALTH
More than just
a back ache
Testicular
self-examination
FOR men, starting at puberty, monthly self-examination of
the testicles is also an effective way to detecting testicular
cancer (TC) at an early and curable stage.
REHAB MY PATIENT
Ankylosing spondylitis
affects young patients who
are in their later teenage
years or early adulthood
F
IRST signs of Ankylosing Spondylitis
(AS) usually occurs when patients
are in their late teens or early 20’s,
and most of them tend to brush the
pain off as a sports injury or sleeping
in a wrong position.
Arthritis Foundation Malaysia president
Associate Professor Dr Sargunan Sockalingam
explained that the back pain experienced by AS
patients can be misleading and it should not be
taken lightly.
“An important thing to note when identifying
the symptoms is that AS pain occurs when one is
in a restful state, for example when one is sleep-
ing or sitting for long hours.”
“Patients suffering from AS may experience
varied severity of symptoms, ranging from mild
stiffness to a fused spine, where the bones grow
together. Some patients may also show signs of
fever, fatigue, loss of appetite and eye inflamma-
tion (redness and pain) and in rare cases, lung
and heart problems.”
Ankylosing spondylitis largely affects young
patients who are in their later teenage years or
early adulthood. Furthermore, it affects more
The picture shows (left) normal spine on the left
while (right) a narrowed and inflamed disc.
males than females, with an approximate ratio
of 2:1.
“There is no cure for AS to date, but biologic
treatments are effective and helps patients lead
a near normal life. Not only does biologic treat-
ments help with the signs and symptoms of AS,
but it is also proven to prevent structural progres-
sion, thus averting structural spine damage and
maintain the spines’ functionality.”
He added that as the disease progresses, the
pain can become more frequent, causing patients
to take off from school or work, constrain their
movement, making them hunch and crippling
them to their beds.
When should I do self-examination?
Self-examination is best performed after a warm bath or
shower. Warmth relaxes the scrotum, making it easier to
feel anything abnormal.
How should I do it?
Stand in front of a mirror;
check for any external swell-
ing on the skin and examine
each testicle with both hands.
Place the index and middle
fingers under the testicle
with the thumbs placed on
top.
Roll the testicle gently between the thumbs and fingers.
You should not feel any pain when doing this. Don’t be
alarmed if your testicles are not exactly the same size; and
find the epididymis, the soft, tube-like structure behind the
testicle that collects and carries sperm. If you are familiar
with this structure, you won’t mistake it for a suspicious
lump. Cancerous lumps are usually found on the sides or
front of the testicle. Lumps in the epididymis are virtually
never cancerous.
What other conditions may be important?
• Any enlargement of a testicle
• Significant loss of size in one of the testicles
• Feeling of heaviness in the scrotum
• Dull ache in the lower abdomen or in the groin
• Sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or in the scrotum
Courtesy of the British Association of Urological Surgeons
19