138; Bone pain / test. lump Flashcards
What is a hydrocele?
What are the causes?
Collection of fluid within the tunica vaginalis
- Idiopathic
- Infection
- Trauma
- Tumour
- Patent processus vaginalis in neonates
What are the signs and symptoms of a hydrocele?
- Extra-testicular swelling
- Painless
- Cystic; feels like fluid filled sack
- Transilluminates
Investigations for a hydrocele?
Only investigate if pathology suspected:
- USS
- Exploratory surgery
- Aspiration of fluid; but may aid the spread of malignant cells
Treatment of a hydrocele?
Conservative; unless pathological or uncomfortable
Therapeutic aspiration
Surgical excision of tunica vaginalis
Surgical closure of processus vaginalis in neonates
What is an epididymal cyst?
Fluid filled bebign cyst, not associated with the testicle
Usuallyin the head of epididymis
What is a spermatocele?
A sperm-filled benign cyst anywhere in rete testis or epididymis
Signs and symptoms of epididymal cyst / spermatocele?
- Extra-testicular cystic swelling
- May fluctuate
- Transluminates
Neither has an effect on fertility
Management of an epididymal cyst / spermatocele?
- NOT aspirate, not useful for diagnosis or treatment
- Conservative treatment if asymptomatic
- Surgical excision
- Sclerotherapy
- tetracycline injected to shrink cyst
What is a varicocele?
Abnormal dilation of the veins of pampiniform plexus, may cause infertility
What are the causes of a varicocele, and which side is most often affected?
Raised venous pressure within the panpiniform plexus:
- Incompetent venous valves causing back-flow
- Venous blockage within the abdomen
Left side most commonly affected;
90* angle of the testicular vein entering the renal vein
What are the signs and symptoms of a varicocele?
- Visible/palpable ‘bag of worms’
- Pinless
- May be infertile
Infertility thought due to altered temperature regulation (increased), and may impair testiculat growth and testosterone production.
Diagnosis and treatment of varicocele?
Examine whilst standing; increase abdominal pressure
USS & doppler venography
- Conservative mgmt if asymptomatic
- Surgery
- Sclerotherapy
- Embolisation
What are the causes of epididymitis & epididymo-orchitis?
STI in young- gonorrhoea, chlamydia
E. coli
Pseudomonas
Mumps
Trauma
Autimmune
Signs and symptoms of epididymitis(orchitis)?
Unilateral swelling +/- erythema
Gradual onset pain
Systemic symptoms, fever
Reactive hydrocele
Diagnosis & treatment for epidymitis(orchitis)?
Must differentiate from torsion
Urine sample (STI)
Urethrla swabs
USS
Treat with ABX
Anti-inflammatories
Analgesics
