14.2 Testicle

Question 1

Mumps orchitis

-what to remember about age of pt

Answer 1

• increased risk for infertility in teenage males
• less risk in children

Question 2

Hydrocele

• mech
• Causes: (infant vs adult)

Answer 2

-fluid collection in tunica vaginalis (covers the testicle and internal surface of scrotum)

Causes:

infants: incomplete closure of processus vaginalis, leading to communication with peritoneal cavity
adults: blockage of lymphatic drainage

Question 2

Hydrocele

-how to dx

Answer 2

-scrotal swelling that can be transilluminated

Question 3

Orchitis caused by chlamydia, gonnorhea

how is this affected:
-fertility

-libido

Answer 3

• fertility: increased risk of sterility
• libido: no effect b/c Leydig cells are spared

Question 4

Cryptorchidism

• what % of newborn males
• when to perform surgery?
• complications (2)

Answer 4

• 1%, most common male congenital reproductive abnormality
• if testes do not descend, perform at 1-2 years age
  1. infertility with testicular atrophy (heat)
  2. seminoma

Question 6

Orchitis

• causes (6 total)
• divided into ages

Answer 6

testicular inflammation

Young adults

1. chlamydia–STD
2. gonorrhea–STD
3. Mumps–respiratory

Older adults (spread of UTI)

4. E Coli
5. Pseudomonas
6. autoimmune

Question 8

Mumps:

-infects what? (4)

Answer 8

1. parotid
2. pancreas
3. testes
4. meninges

Question 8

Testicular torsion

• mech
• common cause
• clinical presentation (2)

Answer 8

• twisting of spermatic cord. thin walled veins become obstructed, leading to congestion and hemorrhagic infarction
• usu due to congenital failure of testes to attach to inner lining of scrotum
• Presents in adolescents with:
  1. sudden testicular pain
  2. absent cremasteric reflex

Question 9

13 yo boy presents to ED with suddent testicular pain and you find lack of cremasteric reflex

-think what

Answer 9

Think testicular torsion

Question 10

Varicocele

• mech
• clinical presentation
• assoc with what

Answer 10

• dilation of spermatic vein due to impaired drainage
• “bag of worms”
• assoc with renal call carcinoma–RCC often invades renal vein. If L renal vein invaded, increased risk of L sided varicocele

Question 11

Autoimmune orchitis

• characterized by what
• what else has this similar presentation?

Answer 11

• granulomas involved seminiferous tubules
• TB also can have granulomas here. To distinguish–TB is necrotizing, autoimmune is non-necrotizing.