making a difference

Q&A: Ask the Experts 

How do men get tested for infertility?

Male infertility is when a man has a health issue that lowers the chances of getting his female partner pregnant. It’s most often caused by issues linked to sperm production or sperm delivery. The path to finding out why you are having trouble with fertility starts with a physical exam and questions about your medical history. It may also include blood work and ultrasound and semen tests.

Your health care provider will ask about childhood illnesses, current health problems or medications that might harm sperm production or delivery. They will also ask about your use of alcohol, tobacco, marijuana and other recreational drugs.

There are workplace hazards, such as being exposed to ionizing radiation, heavy metals or pesticides that can affect fertility. This means your doctor may ask about your work history and lifestyle. He or she will also ask if you have sexual problems, such as trouble with erections.

The physical exam will search for problems in your penis, epididymis, vas deferens and testicles. Your doctor will also look for varicoceles. A varicocele is when veins become enlarged inside your scrotum, and can be found easily with a physical exam. Visit to learn more about these tests and fertility issues in men.

Dr. Tobias Köhler is Associate Professor & Residency Program Director at Southern Illinois University (SIU), Division of Urology. He is also Chief, Division of Male Infertility, SIU Fertility and IVF Clinic.

How do you do a testicular self-exam?

Testicular Cancer is the most common cancer in young men (ages 15-34). When it’s found early, it’s one of the most treatable and curable forms of cancer. The Testicular Self-Exam is a way to check for things that are not normal. Doing it can help your chances of catching testicular cancer early. 

Boys can start these exams in their teens. It only takes a few minutes and should be done once a month. The best time to start the self-exam is during, or right after, a hot bath or shower, when the scrotal skin is most relaxed and the testicles can be felt more easily. 

Do the exam while standing. You should gently feel the scrotal sac to find a testicle. Look for swelling in the scrotum. Check each testicle one at a time. Check it by rolling the testicle between the thumb and fingers of both hands to feel the whole surface. 

You should be gentle, but also firm. This will help you find any small (pea-size) hard lumps. Tell your health care provider if you feel any lumps, swelling, pain or soreness. You should also let your provider know if there are any other changes that you notice. 

It’s normal for one testicle to be slightly larger than the other. It’s also normal to feel a cord-like structure (called the epididymis) on the top and back of each testicle. 

Learn more about Testicular Cancer by visiting

Dr. Vitaly Margulis is Associate Professor of Urology at University of Texas (UT) Southwestern Medical Center in Dallas. He is a member of the Urology Care Foundation’s Public Education Council. 

What is Peyronie’s Disease?

Peyronie’s Disease is when scar tissue forms under the skin of the penis. This scar tissue can cause the penis to bend or become indented during erections. It’s estimated there are more than 200,000 cases in the U.S. each year.

If you have a slightly curved erection, it might not be Peyronie’s Disease. With Peyronie’s Disease the bend is major. Having Peyronie’s Disease can be painful, especially while trying to have sex.

Peyronie’s Disease is likely caused by a minor injury to the penis. This type of damage could be caused by rough or strong contact during sex (such as bending the penis during penetration or pressure from a partner’s pubic bone). It can also be caused by sports or other accidents. 

Not all men who suffer mild trauma to the penis get Peyronie’s Disease. For this reason, most researchers believe there must be a genetic (or some other) reason that causes Peyronie’s Disease. Men with certain connective tissue disorders and men who have a close family member with Peyronie’s Disease have a greater risk of getting it. 

Make sure to speak up if you think you have symptoms of Peyronie’s Disease. Talk to your health care provider and start your journey to recovery as soon as possible.

For more information, visit

Dr. Ajay K. Nangia is Professor of Urology and Clinical Director of Andrology at the University of Kansas Medical Center. He is a member of the Urology Care Foundation’s Public Education Council.  |  SPRING 2017  |  UROLOGYHEALTH extra