What are microliths and where do they come from?
Cells inside the seminiferous tubules are constantly renewed. If the desquamated cells are not completely excreted, calcium is deposited around them, and microliths with a diameter of less than three millimeters are formed. Ultrasound sees them as multiple bright dots in the thickness of the testicle. Microlithiasis is called pronounced when there are five or more such points in one section, and limited when there are fewer of them. The reason for the accumulation of microliths has not been fully established; they are associated with the development and function of testicular tissue, and not with nutrition or lifestyle.
- Microliths - calcifications in the seminiferous tubules
- Size usually less than 3mm
- Often a two-way process
- Not associated with urolithiasis
- Not caused by hypothermia or nutrition
Is microlithiasis associated with testicular tumor?
This issue worries patients the most. Modern recommendations answer as follows: in a man without additional risk factors, isolated microlithiasis is not considered a precancerous condition and does not require regular ultrasound examinations. It’s another matter if there is a history of cryptorchidism, atrophy or significant reduction of the testicle, infertility, a previous testicular tumor, or such a tumor in close relatives. In these cases, a combination of factors raises suspicion, and the doctor recommends observation.
- Isolated microlithiasis is not precancer
- History of cryptorchidism is a risk factor
- Testicular atrophy is a risk factor
- A testicular tumor in a brother or father is a risk factor
- Infertility and severe spermogram abnormalities
- Previous tumor of another testicle
Microlithiasis and fertility
Microliths are more often found in men being examined for infertility than in healthy men. However, this does not mean that calcifications interfere with conception: rather, both reflect a general feature of testicular tissue. Therefore, when planning a child, they evaluate not the ultrasound image, but the spermogram. If her indicators are normal, microlithiasis does not require any intervention. If there are deviations, their cause is dealt with in the usual way: hormones, varicocele, previous infections, lifestyle.
- Microlithiasis itself is not treated to improve sperm
- Key examination - spermogram
- In case of deviations, hormones and varicocele are assessed
- A normal spermogram eliminates the question
What examinations are needed
The main method is ultrasound of the scrotum with Doppler ultrasound: the doctor describes the number and distribution of microliths, the size of the testicles, the presence of nodes and blood flow. An examination by a urologist and palpation are required. When planning children, a spermogram is taken. Blood tumor markers are not prescribed to everyone, but only when a tumor or suspicious changes are detected. Hormonal examination is necessary for smaller testicles and signs of testosterone deficiency. A complete examination usually takes place in one visit.
- Examination and palpation of the testicles by a urologist
- Ultrasound of the scrotum with Dopplerography
- Spermogram when planning a child
- Blood tumor markers - according to indications
- Blood hormones with small testicles
What to do next
There is no need to treat microlithiasis: there are no drugs or procedures that dissolve microlithiasis, and there is no point in doing so. The main thing that really works is a monthly self-examination of the testicles after a warm shower: the man evaluates the size, density and appearance of nodules. With any new lump, you need to see a urologist without waiting for the scheduled date. For men with risk factors, the doctor draws up an individual schedule of examinations and ultrasounds. For everyone else, it’s enough to be attentive to yourself.
- There is no specific treatment
- Monthly testicular self-examination
- Visit a urologist for any new lump
- Ultrasound according to schedule - only for risk factors
- Quitting smoking and maintaining a healthy weight are beneficial in general
- Do not prescribe dietary supplements and “absorbable” agents
