The monument to "war" and the hardened "grievances"
**Monuments to the War**
The epididymis is an inconspicuous accessory reproductive organ in the human body, and it doesn't usually attract much attention. However, once the epididymis becomes diseased, it is easy for a lump to grow that won't go away, causing worry and annoyance.
The epididymis and testis are closely connected neighbors. Its "territory" is a long, narrow area, medically divided into three regions: the head, body, and tail. The epididymis is tightly attached to the testis, with its head connected to the testis and its tail connected to the vas deferens. From head to tail, numerous tiny tubes run through this "territory," connecting the testis and vas deferens. Its main function is to receive the semi-finished sperm "from the testis," further refining their function. The epididymis is essentially a large-scale sperm "assembly workshop."
Furthermore, the epididymis serves as the "gateway" between the testes and the vas deferens. Invading pathogens first arrive at the epididymis via the vas deferens and attempt to penetrate it and invade the testes. To combat these "invaders," the body devises a "battle plan," making the epididymis the main battlefield, sacrificing its own tissues to protect the testes. The body mobilizes a large number of white blood cells from the bloodstream into the epididymis, setting up a "battlefield" within it. This battle can last for weeks or months, depending on the body's resistance and the struggle against the pathogens. A prolonged battle leaves the epididymis riddled with wounds. When the body's resistance is low, bacteria can penetrate deeper into the testes, worsening the condition.
If, at different times, medical intervention is employed, using effective antibiotics to work alongside the body's "guardians," white blood cells, the damage to the epididymis caused by the war can be mitigated. After the war, to repair the damage, the body sends a large number of fibroblasts to the epididymis. These fibroblasts produce fibrous tissue, filling in the war-damaged wounds. The original tubular structures within the epididymis are also severely altered by the damage and the filling with fibrous tissue. Therefore, the post-war epididymis almost completely loses its reproductive function, replaced by a fibrous lump. As the inflammation subsides, the fibrous lump shrinks slightly but becomes increasingly hard. Unless surgically removed, it will remain as a permanent fixture for the rest of the body.
When people accidentally touch it, their first thought is often whether it's a tumor. Finding a lump in that sensitive area is certainly not a good sign. Hearing from the doctor that it's a "relic" of epididymitis, they worry about whether it might become malignant. However, since the tissue forming the lump is fibrous tissue, not mutated cancer cells-they are two different types of substances-there's no need to worry. But this lump can affect fertility. Due to the damage caused by the local inflammation, the sperm ducts are mostly shortened or blocked, resulting in complete or partial loss of fertility.
Loss of fertility is a great misfortune for an unmarried young man, and damage to the epididymis is often irreversible. Therefore, preventing epididymitis is of paramount importance. Maintaining proper hygiene of the reproductive organs is the first priority. Phimosis (tight foreskin) is the most common cause of inflammation of the reproductive organs and should be corrected promptly. If the epididymis has already fulfilled its reproductive function before becoming ill, the damage is insignificant. Even after epididymitis is controlled, the resulting fibrous lesion will likely remain for life. If you truly dislike it, it may be necessary to have it surgically removed.
Author: Zhong Wei, Chief Physician of Urology, Beijing Coal General Hospital
**The hardened "grievance"**
Penile induration? Never heard of it, right? It's an uncommon name, and people are quite unfamiliar with it. Wouldn't a man worry if he felt a hard lump on his penis? We often hear that tumors can grow on the penis, so what else could that lump be but a tumor? Thus, penile induration is often unjustly labeled as a "tumor," leaving it feeling wronged and unable to speak out.
In fact, penile induration does not harm the body; it only occasionally and quietly grows on the penis of some middle-aged and elderly men. Therefore, people know very little about it, and even non-specialist doctors may know very little about it. No wonder people label it as a "tumor."
In its early days, doctors were unfamiliar with it. It wasn't until 1943, when a researcher named Peyronie introduced it into the medical literature, that doctors gradually became aware of it. In honor of this person, doctors also called it Peyronie's disease. In reality, this disease is not uncommon. Often, some middle-aged and elderly men find slight pain in their penis during erection, and it may even bend downwards. Upon closer inspection, they discover a hard lump inside the penis, causing them to panic and suspect a tumor, prompting them to rush to the doctor.
Penile induration is a "special" condition because it is neither a tumor nor an inflammatory mass caused by bacteria. What exactly forms it? This has long been a mystery. To unravel this mystery, doctors removed the induration for pathological examination and discovered its unique pathological changes: no tumor cells, no bacterial infection, but simply a group of proliferating fibrous cells. Finally, pathologists concluded that penile induration is a proliferative change in connective tissue occurring on the tunica albuginea of the penis. However, what causes this connective tissue proliferation? Its etiology remains a mystery.
Penile induration commonly occurs in middle-aged and elderly men, and is usually discovered incidentally. Because it develops silently, the patient has no idea how long it has been present. The induration does not grow on the surface of the penis and is invisible to the naked eye. It grows on the tunica albuginea between the corpora cavernosa and the corpus spongiosum, mostly located in the middle of the penile shaft. Its shape can be cord-like or oval, and it measures approximately 5-10 mm in size. There is usually one, but occasionally two. The induration is tough and relatively fixed, but it is not adhered to the skin of the penis, nor does it compress the urethra. Touching it may cause slight pain or a feeling of soreness. The induration grows extremely slowly, neither invading surrounding tissues nor affecting urination. Therefore, it has little impact on health, but discomfort during penile erection can cause anxiety for the patient.
Penile induration is often mistaken for a penile tumor, causing patients great anxiety. Because the condition is relatively rare, doctors frequently misdiagnose it, mistaking penile induration for a tumor and undertaking excessive procedures, ranging from partial biopsy of the induration to complete surgical removal. Only pathologists can truly diagnose penile induration.
Penile induration is harmless and can coexist with the body for a long time, although it may cause some discomfort in the affected area. If you really dislike it, don't rush to have it surgically removed. Simply injecting some hormone-based medication into the induration area can inhibit the proliferation of local fibroblasts and control its development. Combined with physical therapy and thermal therapy, the discomfort caused can be significantly reduced. Many patients find that the induration gradually shrinks or even disappears after several courses of treatment.
Penile induration is neither a friend nor a number one enemy of mankind-tumors. It only occasionally intrudes into the human body and does not harm human health. It is hoped that people can understand and forgive it, so as not to label it as a tumor, or even cause unnecessary surgical pain because of it, and let a small penile induration "suffer" for life.
Author: Zhong Wei, Chief Physician of Urology, Beijing Coal General Hospital