Save Your Scrotum! I mean, Save Your Balls!

Save Your Scrotum! I mean, Save Your Balls!

Save Your Scrotum – You might have seen a dozen Hollywood box office movie which give you an extra scene when they have fought the gangster they will always show you the kick right into the balls. And it seems really painful (just looking at the picture above). For a man, its really painful when they get trauma there (in the testicles area). Some of you might think that the stunt men or the actor just made it so the scene will looks funny, but its actually really painful. Am I right sir ?

So actually the pain from your testicles not always comes from a trauma or accident (sports accident, fight,etc) but it can also causes by several factors including infection. You might be not really care with your balls before you understand it that your balls having a major roles for your fertility! So from now you must take care and save your scrotum! I mean, save your balls!

Also Read Vaginal Discharge Is it SEXUAL TRANSMITTED INFECTION ?


Originally men has two balls and it located under the Mr.Banana. those two balls are protected by a skin layers in the external area that we usually called scrotum. The scrotum is a male reproductive structure located under the penis. This sac divided into two compartments by the scrotal septum. Each sac included external spermatic fascia, testes (your balls), epididymis, and spermatic cord. The average wall thickness of the scrotum is about 8 mm and it has two layers. First, the parietal layer has the function of covering the inner aspect of the scrotal wall and the second was the visceral layer which coats the testis and epididymis. The scrotum responsible for protecting the testes. It helps with the thermoregulation of the testicles. It keeps the temperature of the testis several degrees below the average body temperature, which is an essential factor for sperm production.

Figure 1. The Male Genital Organs, The scrotum. On the left side the cavity of the tunica vaginalis has been opened; on the right side only the layers superficial to the Cremaster have been removed. Contributed by Gray’s Anatomy Plates (Source: Anatomy, Abdomen and Pelvis, Scrotum. NCBI Bookshelf. 2021

The balls or testes are male reproductive gland that is responsible for producing sperm and making androgens.They are oval shaped reproductive structures that are bean-shaped and measures 3cm by 5cm in length and 2cm to 3cm in width.2 The double-layered tunica vaginalis envelop the testes except at the posterior and superior borders where the epididymis and spermatic cord are attached. The visceral or inner layer of the tunica vaginalis is close to the epididymis, testes and vas deferens. On the posterior lateral surface of the testes, there is a small space between the testes and body of the epididymis which is known as the sinus of the epididymis. Deep to the tunica vaginalis is located the tunica albuginea, which is a durable fibrous covering of the testes.

The epididymis is a small curved shaped elongated structure which is highly convoluted and tightly compressed. When open in a straight line, it is estimated that its length is about 20 feet. The epididymis is found on the posterior border of the testis and consists of three parts which include the head (caput), body (corpora), and tail (Cauda). The head of the epididymis lies at the upper pole of the testes and receive seminal fluid from the ducts of the testis. It then permits passage of sperm into the distal portion of the epididymis. Because of its length, the epididymal ducts have ample space for storage and maturation of sperm.2

Figure 2. Testicle, Vas (Ductus) Deferens, Head of Epididymis (shown lifted from testis), Body of Epididymis, Tail of Epididymis, Testicular Artery, Pampiniform Plexus, Efferent Ductules, Septa, Lobules, Tunica Albuginea. Contributed Illustration by Beckie Palmer. (source: Anatomy, Abdomen and Pelvis, Testicles. NCBI Bookshelf.

Vascularization of the testis has two main roles: transport and mobilizations of endocrine factors and metabolites, as well as regulation of testicular temperature. In men, testicular temperature is about 3°-4°C below core body temperature and about 1,5°-2,5° C above the temperature of scrotal skin.3

Story behind Testicular Pain

When your balls get kicked, you might get experiencing painful sensation not only in your balls area. You will experience pain in your tummy, your back, your thigh also you may experience vomit and headache! This kind of pain called referred pain. You must save your scrotum, i mean your balls okay ?

Sensory innervation of the testis and epididymis is conducted by autonomic(The part of the nervous system that controls muscles of internal organs (such as the heart, blood vessels, lungs, stomach, and intestines) and glands (such as salivary glands and sweat glands))4 and sensory (sensory nerve, also called an afferent nerve, is a nerve that carries sensory information toward the central nervous system (CNS) and all those nerves which can sense or recognize the stimuli (Internal or External) are known as sensory nerves. Fibers that travel through the spermatic cord. The somatic fibers of the cremaster muscle and the parietal and visceral layers of the pouch that surrounds testicles travel via the genital branches of the genitofemoral nerve (originating in L1-L2) and ilioinguinal nerve, arising from the first lumbar spinal nerve (L1). Testicular nociceptive fibers travel via the sympathetic plexus (T10 to T12), whereas the deferential and epididymal nociceptive fibers travel via the pelvic plexus (T10 to L1) throughout the vas deferens.5

Causes of testicular pain are various, such as trauma, testicular torsion, post-vasectomy pain, epididymitis, varicocele and chronic orchialgia.

  • Trauma

Trauma must be considered in all ages as the cause of acute pain. Severity varies from simple organ contusions to testicular rupture (a force of 50kg is required to tear or break the tunica albuginea)4The uncommon, but more severe dislocation of the testis is a result of trauma and produces damage or avulsion(an injury in which a body structure is torn off by either trauma or surgery) of the fascia  surrounding the testis and/or of the scrotal ligament

  • Testicular torsion

Testicular torsion is a medical emergency, requiring prompt treatment or risking the loss of the testicles. The incidence is 1 in 4.000 males under the age of 25 years. The classical presentation of testicular torsion is acute onset, intense, unilateral scrotal pain also may complain of nausea and vomiting. Testicular torsion requires immediate surgical intervention with scrotal exploration, detorsion and orchidopexy .6

  • Epididymitis

Epididymitis  is another common cause of acute scrotal pain that must be differentiated from the more severe testicular torsion.5 Sexually active men younger than 35 years are usually infected with Chlamydia trachomatis and Neisseria gonorrhea, whereas older patients, patients who have undergone recent genitourinary surgery, and patients with anatomical abnormalities often have infection with urinary tract infections. Fungal agents such as Candida species, very rarely, can also cause epididymitis.

  • Post-vasectomy pain

Vasectomy is a surgical procedure for male sterilization or permanent contraception. During the procedure, the male fibromuscular tube that has function to excretory sperm are cut and tied or sealed so as to prevent sperm from entering into the urethra and thereby prevent fertilization of a female through sexual intercourse.Most common adverse event affecting the patient’s quality of life after a vasectomy is pain. The presenting symptoms included testicular pain (9cases), pain during intercourse (8cases), pain with ejaculation (4cases) and epididymal pain (2cases).6

  • Varicocele

A varicocele is an abnormal dilation of the spermatic veins commonly due to an anatomical abnormality with an incidence of 10% to 20% in the general male population and 2% to 15% in adolescent males6 and more common in younger ages 15-25.7 Varicocele pain typically presents as a dull, aching, and throbbing sensation in the scrotum without sharp radiating components.6

  • Chronic Orchialgia

Orchialgia or testicular pain. It is defined as intermittent or constant testicular pain for a period of 3 or more months that interferes with daily activities.8 The etiology of chronic orchialgia remains largely unknown with up to 50% of patients presenting with an unknown cause, but has been found to be associated with nerve damage to the spermatic cord after vasectomy, trauma, inguinal herniorrhaphy () , and epididymitis.6


Males has always to more concern about their testicles, because taking good care and save your scrotum or balls will save your future! The testicles pain etiology so many, but there are hundred cases that shows the cause of testicles pain are from trauma. Each treatment depends on the variation degree of the damage cell in your testicles, it could be only pain killer drugs, scrotal support, cold compress and the last thing is surgery.

Some tips here for you who loves sport (especially male in age of school and university) please try to wear athletic cup or jockstrap . While sports-related genital injuries are not very common, they still can give you testicular pain, but if you are not well treated it can become significant injuries.9

A Geisinger study showed that 18 percent of athletes experienced a testicular injury, and 36.4% observed injuries in team members, yet only 12.9% of athletes reported wearing athletic cups.
“A hard hit to the groin can cause severe pain and even nausea or vomiting for boys and men,” said Joel Sumfest, M.D., a Geisinger urologist who co-authored the study.

“And if the hit is hard enough, it can also lead to testicular fracture or testicular rupture.”10


  1. Rosa A.Garcia, Hussain Sajjad. Anatomy, Abdomen and Pelvis, Scrotum. 2021. StatPearls Publishing LLC. Bookshelf ID: NBK549893PMID: 31751083. Access: March 20 2021)
  2. Manpreet S. Tiwana, Stephen W. Leslie. Anatomy, Abdomen and Pelvis, Testicles. 2020. StatPearls Publishing. Bookshelf ID: NBK470201PMID: 29261881. Access: March 20 2021
  3. G.F. Weinbauer. E. Nieschlag et al. (eds.), Andrology, DOI: 10.1007/978-3-540-78355-8_2. Springer-Verlag Berlin Heidelberg. 2010. Page 37
  4. Autonomic nervous system. National cancer institute. Access:,salivary%20glands%20and%20sweat%20glands).  March 20 21021
  5. Juan Fernando Uribe-Arcila, Andres Delgado-Montoya, Federico Gaviria-Gil. Etiology of testicular pain 2019: Classification into ten logical subgroups. Revista Mexicana de URología ISSN: 2007-4085, Vol. 80, núm. 4, julio-agosto 2020:pp. 1-19. Access: March 20 2021
  6. Chirag G Gordhan, Hossein Sedeghi-Nejad. Scrotal pain: Evaluation and management. The Korean Urological Association. 2015. Korean J Urol 2015;56:3-11. pISSN 2005-6737  •  eISSN 2005-6745)
  7. Condition Treated. What is a Varicocele. UCLA Health. Access: March 23 2021
  8. Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol 1990;143:936-9.
  9. Urology Associates. Protect Your Male Athletes from Genital Injuries&Testicular Pain. 2018. Access:, March 23 2021
  10. Why your athletic son needs to wear a cup. Geisinger. 2016. Access:, March 23 2021

Save Your Scrotum

Save Your Scrotum!

Save Your Scrotum!

Antibiotics From Hero To Zero?

Antibiotics From Hero To Zero?

Improper Use Of Antibiotics Can Cause Double Trouble

Antibiotics From Hero to Zero – Since everyone knows about the efficacy of antibiotics to treat such an illness, everyone without any hesitation will easily to buy all kind of antibiotics without any prescription. Consumption of antibiotics for treating illness, infection or etc are not always right to do. Basically, antibiotics is made for treated infection caused by bacteria. But we have to know that bacteria which cause problem to our illness are not always the same bacteria. For example: you can not treat skin infection with antibiotics for lung infection, yea maybe it will help but we need more specific antibiotics and the right choice of antibiotics will clearly heal the infection.

Everyone knows antibiotics. Not only they who lives in a city, but also everyone in rural place, village they all knows that antibiotics sometimes become their “life saver” when it faces with infection. Nevertheless, society are not well known how to properly using antibiotics. When you feel sick and miserable, and you really wanted to get better faster, you’ll probably thinking antibiotics is the answer. You can’t take antibiotics for all kind of cough, flu or else before the diagnosis and proper diagnostic examination has been done to you by medical doctor. When antibiotics are not needed for your symptoms, actually it will not help you either! Unfortunately antibiotics will cause harm your body.


The History of Antibiotics

The term antibiotics also known as antibacterial, which is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of such infections. Sometimes, the term antibiotic literally “opposing life”, from the Greek roots ἀντι anti, “against” and βίος bios, “life”—is broadly used to refer to any substance used against microbes, but in the usual medical usage, antibiotics (such as penicillin) are those produced naturally (by one microorganism fighting another), whereas nonantibiotic antibacterials (such as sulfonamides and antiseptics) are fully synthetic.1

Antibiotics have been used since ancient times. Many civilizations used topical application of moudly bread, with many references to its beneficial effects arising from ancient Egypt, Nubia, Serbia, Greece, and Rome. The first person to directly document the use of molds to treat infections was John Parkinson.1 In the 1920s, British scientist Alexander Fleming  was working in his laboratory at St. Mary’s Hospital in London when almost by accident, he discovered a naturally growing substance that could attack certain bacteria. In one of his experiments in 1928, Fleming observed colonies of the common Staphylococcus aureus bacteria that had been worn down or killed by mold growing on the same plate or petri dish. He determined that the mold made a substance that could dissolve the bacteria. He called this substance penicillin, named after the Penicillium mold that made it. Fleming and others conducted a series of experiments over the next 2 decades using penicillin removed from mold cultures that showed its ability to destroy infectious bacteria.2

Before long, other researchers in Europe and the United States started recreating Fleming’s experiments. They were able to make enough penicillin to begin testing it in animals and then humans. Starting in 1941, they found that even low levels of penicillin cured very serious infections and saved many lives. For his discoveries, Alexander Fleming won the Nobel Prize in Physiology and Medicine. It was used widely for treating soldiers during World War II, curing battlefield wound infections and pneumonia. By the mid- to late 1940s, it became widely accessible for the general public. Newspaper headlines hailed it as a miracle drug (even though no medicine has ever really fit that description).2

Antibiotics From HERO to ZERO

Antibacterials are specifically designed to treat bacterial infections. When it used in proper right time, they can cure many infections or even life threatening illness. This recent worldwide concern is antibiotic resistance. Can you imagine if we are get infected by bacteria but in the end we cannot survive without being noticed we couldn’t get help because the bacteria had already resistance for some of antibiotics that usually we used.

Do you know what is Resistance of Antimicrobial mean?

Antibiotic resistance occurs when bacteria change in response to the use of these medicines.

Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria. Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality.3

Can you imagine how many infectious diseases in this world? And by the time, we cannot put our hope in antibiotic anymore because of this. WHO said Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanism are emerging and spreading globally, threatening our ability to treat common infectious disease. A growing list infections such as pneumonia, tuberculosis, blood poisoning, gonorrhea, and foodborne disease are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.3

Data from CDC about Antibiotic Resistance threats in the US 2019 reported more than 2.8 million antibiotic-resistance infections occur in the US each year and more than 35.000 people die as a result. In addition, 223.900 cases of Clostridioides difficile(a bacteria which transfer into human gut and passed in the faces and spread to food, surfaces and objects when people who are infected don’t wash their hands thoroughly. If you touch a surface contaminated with C.defficile sproes, you may then unknowingly swallow the bacteria) occurred in 2017 and at least 12.800 people died.5Drug-resistant infections are already estimated to kill at least 700.000 people a year, and could kill 10 million people a year by 2050 if left unchecked.4 WHO reported the rate of resistance to ciprofloxacin, an antimicrobial frequently used to treat urinary tract infections, varied from 8,4% to 92,9% in 33 reporting countries.6

WHO is concerned that the trend will further be fueled by the inappropriate use of antibiotics during the COVID-19 pandemic. Evidence shows that only small proportion of COVID-19 patients need antibiotics to treat subsequent bacterial infections and the Organization has issued guidance not to provide antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless there is a clinical indication to do so.6

WHO Recommendation to Prevention and Control Antibiotic Resistance


To prevent and control the spread of antibiotic resistance, individuals can:

  • Only use antibiotics when prescribed by a certified health professional.
  • Never demand antibiotics if your health worker says you don’t need them.
  • Always follow your health worker’s advice when using antibiotics.
  • Never share or use leftover antibiotics.
  • Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.
  • Prepare food hygienically, following the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials) and choose foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals.

Health professionals

To prevent and control the spread of antibiotic resistance, health professionals can:

  • Prevent infections by ensuring your hands, instruments, and environment are clean.
  • Only prescribe and dispense antibiotics when they are needed, according to current guidelines.
  • Report antibiotic-resistant infections to surveillance teams.
  • Talk to your patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse.
  • Talk to your patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing).


  1. Wikipedia. Access 13 Maret 2021
  2. The History of Antibiotics. Access 13 Maret 2021
  3. WHO. Antibiotic Resistance. Access 13 Maret 2021.
  4. Prof. David Heymann, Emma Ross. Preserve the Effectiveness of Antibiotics with a Global Treaty.
  5. Biggest Threats and Data. Access: 13 Maret 2021.,-CDC’s%20Antibiotic%20Resistance&text=According%20to%20the%20report%2C%20more,at%20least%2012%2C800%20people%20died. )
  6. WHO. Record number of countries contribute data revealing disturbing rates of antimicrobial resistance. Access: 13 Maret 2021.

Antibiotics From Hero to Zero

Antibiotics From Hero to Zero

Antibiotics From Hero to Zero